bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of relapsed and non‐relapsed abstinent pathological gamblers following behavioural treatment
Authors: BLASZCZYNSKI A. , McCONAGHY N. , FRANKOVA A.
Published: January 2006

Eighteen pathological gamblers reporting abstinence at a 2–9‐year follow‐up period were classified into two samples; those reporting complete abstinence, or those abstinent with intermittent relapse episodes. Results indicated that both samples improved significantly on post‐treatment psychological and demographic measures, and did not differ from each other. It was concluded that a subgroup of gamblers may experience intermittent brief relapses that are not invariably associated with a continued return to addictive gambling habits. Complete abstinence as a criterion for successful treatment outcome may be too stringent in that it fails to acknowledge the possibility of continued abstinence following brief episodes of relapse.
Perspectives and future on testing for abuse liability in humans
Authors: CAMI JORDI
Published: January 2006

Testing of drugs for abuse liability can benefit public health. By encouraging proper therapeutic use, appropriate regulation, and development of safer and more effective drugs, such testing can benefit both consumers and pharmaceutical manufacturers. Many factors influence actual abuse; animal and human drug abuse liability testing procedures are useful, though imperfect, predictors of abuse. Three suggestions are made concerning human drug abuse liability testing: (1) that more research is needed on differences between individuals and between different subpopulations tested with these procedures (2) that actual epidemiological experience concerning abuse should be the ‘gold standard’ for assessing the validity and utility of drug abuse liability testing methods; and (3) that methods for drug abuse liability testing in humans should be introduced and used systematically to guide appropriate development, regulation, and marketing of drugs.
The alcoholism treatment service at the Maudsley Hospital, London
Authors: EDWARDS GRIFFITH
Published: January 2006

This article describes the linked clinical, research and teaching functions of the Maudsley's Alcoholism Treatment service. Emphasis is placed on the heterogeneity of the patients who are seen. Therapy must therefore always be patient‐specific and the Procrustean insistence that patients should fit the programme rather than the programme fit the patients should be resisted. Within the diversity of approaches which are employed some important common elements can though be identified: detailed case assessment as the necessary basis for everything else, goal setting, a flexible intensity of response, networking with other treatment resources, and attention to methods of patient recruitment. The relationship between outpatient and inpatient services is discussed: about 80% of all new referrals are treated entirely on an outpatient basis. The clinical setting provides a teaching base for the Diploma in Addiction Behaviour. There is a close link between this clinical service and the Addiction Research Unit; issues of clinical and research collaboration and the interpretation and clinical application of research findings are considered. Whatever the theories in which a team believes or the techniques which it practices, the nurturing of hope is the vital essence of the practical business of treatment.
Alcoholism, antisocial behavior and family history*
Authors: LEWIS COLLINS E. , BUCHOLZ KATHLEEN K.
Published: January 2006

Previous investigations in selected and clinical samples have demonstrated a close association between alcoholism and both antisocial behavior and a family history of problem drinking. This study uses the National Institute of Mental Health (NIMH) Epidemiological Catchment Area (EGA) data to assess this relationship in the general population in St. Louis, Missouri (U.S.A.). The results showed that serious antisocial behavior (both conduct disorder and antisocial personality disorder), gender, and a family history of problem drinking were all significantly associated with alcoholism (DSM‐III alcohol abuse or dependence). Having either conduct disorder, antisocial personality, or a first‐degree relative (parent, sibling, or child) with problem drinking increased the probability of alcoholism; being male also increased its probability. Antisocial behavior and gender interacted in that antisocial behavior was a more potent risk factor for women than for men. However, despite their close association with alcoholism, having either antisocial personality or a positive family history of problem drinking identified only 49% of male alcoholics and 14% of female alcoholics. Thus, these two important predictors of alcoholism would be somewhat inefficient screeners for primary prevention. More investigation is needed to understand the development of alcoholism in those without these major risk factors and the lack of alcoholism in those with them.
Nicotinic receptor blockade therapy and smoking cessation
Authors: CLARKE PAUL B. S.
Published: January 2006

Smoking is a behaviour with a significant conditioned component. Attempts to quit will likely fail unless the effects of primary and secondary reinforcers are extinguished. Current smoking cessation methods scarcely address this issue, which may explain why they meet with little success in the long term. In contrast, the administration of centrally‐active nicotinic receptor antagonists should provide a means of extinguishing both primary and secondary reinforcers associated with smoking. Thus, nicotine blockade therapy presents a promising new approach to smoking cessation.
The role of nicotine and nicotinic mechanisms in neuropsychiatric disease
Authors: NEWHOUSE PAUL A. , HUGHES JOHN R.
Published: January 2006

Cigarette smoking, and by implication nicotine, may be involved as a negative or positive risk factor in some neuropsychiatric disorders and possibly as a treatment in others. Nicotine exposure may be a negative risk factor for the development of Parkinson's disease, but a positive risk factor for the development of tardive dyskinesia. For Alzheimer's disease and Tourette's syndrome, the role of nicotine exposure is equivocal, however, the role of nicotine as a possible therapeutic agent, alone or in combination, remains an intriguing question. For functional psychiatric disorders, the data are suggestive of a link between tobacco use and at least exacerbation of some disorders. While nicotine exposure is unlikely to be critical in the genesis of these disorders, it may complicate the pharmacological therapeutics and long‐term prognosis. Further research is needed to examine the actual importance of tobacco use in behavioural disturbances. The relative importance of central nicotinic mechanisms in normal and disordered human cognition and movement is now beginning to be fully explored.
Towards better diagnoses and more individual treatment of tobacco dependence
Authors: FAGERSTRÖM KARL OLOV
Published: January 2006

The nicotine dependence concept is well founded and it is clear that it is necessary to assess this before treatment starts. Behavioural dependence, although difficult to disentangle from the pharmacological dependence, is also important. With the development of tools for assessing behavioural dependence, the behavioural treatment methods could be applied to patients more appropriately. The place of new drugs such as clonidine and anti‐depressants is also discussed. It is suggested that some of the nicotine withdrawal syndrome may have similarities with hypoglycemia and increased eating after stopping smoking may be a form of self‐medication. Lastly, the new forms of giving nicotine replacement are put in perspective.
Smoking and economic incentives in Europe
Authors: BOSANQUET NICK , TRIGG ANDREW
Published: January 2006

This paper reviews the agenda for economic research near the beginning of a formative period for policy marked by much greater involvement by the EC (European Community). There are few signs as yet of any diffusion process at work in Europe to bring about reductions in smoking. Effective use of incentives will be needed to bring about reductions in smoking by 2000 and to stop yet further massive increases in mortality from smoking related disease. Research is needed on price and income elasticities in Europe as the EC introduces new policies for raising cigarette taxes and prices. Currently most estimates are based on US and UK data. There is also an important research agenda on the decision‐making process in Europe covering the policy response of national governments and professions as well as the future role of the EC Commission. Finally, research is needed on the micro‐economic determinants of the demand for tobacco products across Europe by households. Household data from family expenditure surveys are now available across Europe so that it is now possible to construct micro demand systems for each European country.
Benzodiazepine problems
Authors: LADER MALCOLM , MORTON SALLY
Published: January 2006

Benzodiazepines present problems related to both unwanted and withdrawal effects. Dosage adjustments usually obviate unwanted effects except for paradoxical reactions such as hostility. Patients with apparent benzodiazepine dependence need careful assessment with respect to personality, social situation and psychiatric disorder. The patient must be motivated and carefully prepared for withdrawal and taught anxiety management techniques. Withdrawal must always be gradual over at least 6 weeks but very prolonged schedules are counter‐productive. Substituting a long‐acting for a medium‐acting benzodiazepine may be helpful in the more intractable cases. An antidepressant may be needed if a depressive disorder supervenes, but other adjunctive therapies are usually unhelpful.
Sexual lifestyles in injecting drug users in Italy: potential for HIV infection transmission
Authors: SASSE HARTMUT , SALMASO STEFANIA , CONTI SUSANNA , REZZA GIOVANNI ,   THE FIRST MULTICENTRE STUDY GROUP
Published: January 2006

To better target efforts aimed at modifying sexual behaviour among injecting drug users (IDUs), we conducted a detailed analysis of sexual partners and practices reported by 1214 Italian heterosexual drug users during the period June 1985–June 1987. Females were more likely to have only drug‐using partners (42.8% vs 17.1%), while males were more likely to have only non drug‐using partners (50.5% vs 21.4%). Female drug users were more likely to report either one partner or >10 partners, while males were more likely to report 2–10 partners. Nearly 90% of women with only drug‐using partners had only one partner. Overall, 29% of women with only non drug‐using partners reported that they always used condoms. This proportion increased to 65% among women with >10 non drug‐using partners. In Italy, male IDUs may play a greater role than female IDUs in sexual transmission of HIV infection to the heterosexual non drug‐using partners.
The Fagerström Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire
Authors: HEATHERTON TODD F. , KOZLOWSKI LYNN T. , FRECKER RICHARD C. , FAGERSTROM KARL‐OLOV
Published: January 2006

We examine and refine the Fagerström Tolerance Questionnaire (FTQ; Fagerström, 1978). The relation between each FTQ item and biochemical measures of heaviness of smoking was examined in 254 smokers. We found that the nicotine rating item and the inhalation item were unrelated to any of our biochemical measures and these two items were primary contributors to psychometric deficiencies in the FTQ. We also found that a revised scoring of time to the first cigarette of the day (TTF) and number of cigarettes smoked per day (CPD) improved the scale. We present a revision of the FTQ: the Fagerström Test for Nicotine Dependence (FTND).
Functioning, life context, and help‐seeking among late‐onset problem drinkers: comparisons with nonproblem and early‐onset problem drinkers
Authors: BRENNAN PENNY L. , MOOS RUDOLF H.
Published: January 2006

We compared the functioning and life contexts of late‐middle‐aged adults classified as late‐onset problem drinkers (n=229), early‐onset problem drinkers (n=475), and nonproblem drinkers (n=609). Compared with nonproblem drinkers, late‐onset problem drinkers consumed more alcohol and functioned more poorly; they also reported more negative life events and chronic stressors, fewer social resources, and more use of avoidance coping. However, late‐onset problem drinkers consumed less alcohol, had fewer drinking problems, functioned better, and had more benign life contexts than did early‐onset problem drinkers. We found no evidence of an association between age‐related loss events and the onset of late‐life drinking problems. Very few problem drinkers sought help specifically for their alcohol abuse, but about 25% did seek treatment from mental health practitioners. Problem drinkers who were functioning more poorly and who reported more life stressors and fewer social resources were more likely to seek help.
Calculating standard drink units: international comparisons
Authors: MILLER WILLIAM R. , HEATHER NICK , HALL WAYNE
Published: January 2006

Simple calculation rules are providing for converting alcohol consumption data among four standard units currently used by researchers and educators in the USA, Canada, the UK, and Australia. A plea is made for the adoption of a common method for reporting alcohol consumption in research, using metric fluid volume units.
Tobacco addiction and control in Spain From L. Sanchez Agudo (Health Institute, Madrid, Spain).
Authors: Agudo L. Sanchez
Published: January 2006

In Spain there is a high prevalence of smokers: 39.2% in the general population, 61.9% of the working population, and 35% of doctors. At the same time, health education on smoking is inadequate, and tobacco is cheap. As a result, it is difficult to implement legislation which bans or restricts smoking in some areas. It is clear that more education on smoking and health is needed at every level of the Spanish population.
The motivation for change from problem alcohol and heroin use
Authors: KLINGEMANN HARALD K.‐H.
Published: January 2006

This paper provides an overview of the first study in Switzerland on spontaneous remission from substance abuse, conducted in 1988. After a rigorous screening process, 60 practically treatment‐free remitters could be identified. While 14 of the 30 alcohol cases reduced their consumption almost to abstinence, all but two heroin remitters stopped their consumption altogether. No selection bias could be detected when comparing the groups studied with clinic populations, survey data and police records. The qualitative analysis of the collected extensive life histories led to a typology of the autoremission process. The motivation to change, the implementation of the decision, the maintenance and the negotiation of a new identity or meaning in life represent the three major stages. This paper focuses on the first stage and the role of negative vs positive experiences in setting off subsequent changes in alcohol or heroin consumption. The variation in the motivational background is illustrated by a close look at the rich life history accounts as well as by quantitative data on life events and cognitive prerequisites of change. Methodological drawbacks of this first exploratory study, such as recall problems and a narrow definition of addiction excluding psychological problems, are discussed and the necessity of future prospective studies is underlined.
Quantity‐frequency measures of alcohol consumption: beverage‐specific vs global questions
Authors: RUSSELL MARCIA , WELTE JOHN W. , BARNES GRACE M.
Published: January 2006

Estimates of alcohol consumption (ounces of absolute alcohol per day, AA) based on beverage‐specific and global quantity‐frequency (QF) questions were compared in a survey representative of the adult drinking population in New York State. Beverage‐specific AA estimates were higher than global (0.72, 95% confidence intervals=0.68, 0.76) compared to 0.49 (95% confidence intervals=0.47, 0.51), although estimates were highly correlated (r=0.75). Discrepancies between beverage specific and global AA estimates increased as the number of beverages and the amount drunk increased. Sociodemographic characteristics were not significantly related to differences between beverage‐specific and global AA estimates after adjusting for the amount drunk; however, drinking patterns did influence the differences. It was concluded that beverage‐specific QF questions are probably more valid measures of alcohol consumption than global QF questions, but that the global questions provide useful information. Parallel analyses of variant global QF questions employed in the first US Health and Nutrition Examination Survey obtained similar results.
Psychological symptoms, psychiatric disorder and alcohol dependence amongst men and women attending a community‐based voluntary agency and an Alcohol Treatment Unit
Authors: ALLAN CAROLE A.
Published: January 2006

One‐fifth of clients attending a community‐based voluntary agency presented for treatment with an alcohol problem complicated by affective disorder, phobic anxiety or personality disorder. A matched sample of patients recruited from an Alcohol Treatment Unit, and assessed using the same stringent clinical criteria, had similar levels of formal psychiatric disorder, except for a small group of women. One quarter of women in this group were phobic with some overlap of affective disorder. Rates of psychological symptoms as opposed to psychiatric disorder were high in both samples and appeared to be associated with severity of dependence on alcohol. No sex differences were apparent in the rates of psychological symptoms. The practical as well as theoretical implications of these findings were discussed.
Hearing the noise in the system. Exploration of textual analysis as a method for studying change in drinking behaviour
Authors: EDWARDS GRIFFITH , OPPENHEIMER EDNA , TAYLOR COLIN
Published: January 2006

This paper explores how treatment research is to catch within its design those many unplanned influences which lie outside therapeutic control, but which may influence processes of change. These factors are excluded from the conventional controlled trial. The background literature is briefly reviewed. A study is then described which employed a computer assisted method of textual analysis and an entirely open‐ended coding system. The material which was analysed derived from interviews with 49 subjects whose accounts were tape recorded 10 years after treatment contact. Episodes of successful or unsuccessful ‘change attempt’ (CA) were identified. The two types of CA were compared in relation to coded issues pertaining to the periods before, during and after the episode. A number of significant findings are reported. In the pre‐attempt phase ‘Success’ CAs were significantly associated with traumatic events in the person's life, and with a variety of positive and negative events. During the ‘attempt phase, ‘Success’ was associated with choice of an abstinence goal. For ‘post‐attempt’, ‘Success was associated with Substitution’, ‘Altruism’, ‘Fulfilment’, and finding the process ‘Difficult’. The very preliminary nature of these findings is stressed and the need for further rigorous methodological development.
Patterns of alcohol consumption in white collar‐workers–a cross‐sectional and longitudinal study
Authors: HARVEY SHARON , BUTLER TONY , THOMAS RUTH LLOYD , JENKINS RACHEL
Published: January 2006

A 6‐year follow‐up of a cohort of male and female while collar workers in whom there was baseline information on alcohol consumption and access co data on sickness absence, promotion and labour turnover, revealed that even moderate alcohol and consumption in this population was associated with social costs for the employer and the employee, particularly in terms of sickness absence. The longitudinal examination of consumption in this study suggests that early intervention in a drinking career may reduce alcohol consumption and consequently avoid years of morbidity and sickness absence, as well as having a favourable influence on promotion prospects and labour turnover.
A feminist critique of problem gambling research
Authors: MARK MARIE E. , LESIEUR HENRY R.
Published: January 2006

Using a liberal feminist orientation, the literature on a diverse range of topics concerning the profile of the pathological gambler, from personality traits to psychiatric orientation, as well as consequences of the behavior on individuals was reviewed for its gender‐related content. The vast majority of this research has been on male subjects; gender of respondents has not been discussed; gender‐related findings have not been reported; mostly male‐dominated gambling sites have been investigated. To say that most compulsive gamblers are men and therefore, theorists need to explain them first and only later apply these same explanations to the ‘rare’ [female] cases is to acquiesce to a patriarchal notion of the world. Action is suggested which would put a halt to this trend and suggestions are made for future research.
The Temptation and Restraint Inventory for measuring drinking restraint
Authors: COLLINS R. LORRAINE , LAPP WILLIAM M.
Published: January 2006

In the present study, the measurement of drinking restraint was broadened by developing new items that better characterized its cognitive nature as well as by testing a factor structure which represents restraint as including both the regulation and the failure to regulate alcohol intake. A previously observed (Collins, George & Lapp, 1989) three‐component structure of the Restrained Drinking Scale (RDS; Ruderman & McKirnan, 1984) was confirmed. In addition, two factors were extracted from the new set of cognitive items, which when combined with the RDS clusters formed a new measure of drinking restraint, the Temptation and Restraint Inventory (TRI). The factor structure of the TRI matched the conceptualization of drinking restraint as involving successful and unsuccessful regulation of alcohol intake, and differentially predicted self‐reported weekly consumption and alcohol‐related problems.
Substance misuse and social work qualifying training in the British Isles: a survey of CQSW courses
Authors: HARRISON LARRY
Published: January 2006

In 1989, all Certificate of Qualification in Social Work (CQSW) courses in the British Isles were included in a survey of the training offered social work students on responding to psychoactive substance misuse. There was a 74% response rate. Eleven per cent of the courses that responded provided no formal substance misuse training. Those that offered training provided a median of 8 hours, with over 70% of students receiving less than 11 hours, indicating that many students were being given the briefest of overviews. Outside of four or five ‘centres of excellence’, social workers and probation officers training in 1988–89 received less than adequate preparation to work with people with alcohol– and drug–related problems, despite evidence that they account for a large and growing proportion of their caseloads.
Patterns of drug use in Castille and Leon (Spain)
Authors: ALVAREZ F. JAVIER , QUEIPO DANIEL , DEL RIO M. CARMEN , GARCIA M. CLARA
Published: January 2006

A total of 2500 individuals, aged 14–70years and living in Castille and Leon (Spain), were surveyed in the spring of 1989 with regard to their drug consumption and patterns of use. ‘Lifetime’ drug users' rates were 30.0% for cannabis, 5.4% for cocaine, 5.2% for amphetamines, 2.4% for psychedelic drugs, 1.5% for opiates, 1.1% for tranquillizers, and 0.4% for inhalants. ‘Regular’ drug users were more common among cannabis,–2.8% of the surveyed,–and less frequent among cocaine, opiates and amphetamine users–0.3% of everyone of the substances mentioned above. ‘Lifetime’ drug users were more common among males than among females, among singles than among married, in those younger (18–29 years of age) and with work problems. The starting age of drug consumption ranged between the average of 15.6 years of age for those who consumed inhalants and 19.5 for those who consumed cocaine. The results allow a better understanding of the pattern of drug use in Castille and Leon (Spain), as well as the ‘high’ prevalence of drug use in our region.
The impact of intravenous drug use on mortality of young adults in Rome, Italy
Authors: PERUCCI CARLO A. , FORASTIERE FRANCESCO , RAPITI ELISABETTA , DAVOLI MARINA , ABENI DAMIANO D.
Published: January 2006

To estimate the impact of intravenous drug use (IVDU) on mentality in the general population of young adults in Rome, Italy, the Population Attributable Risk (PAR) was calculated for the overall and cause‐specific mortality in the 15–34 years age group. Relative risks were derived from a previous historical cohort study on mortality among 4200 intravenous drug users (IVDUs) in Rome, in which increased mortality from cardiovascular, respiratory, and gastrointestinal diseases as well as from violence, overdose and AIDS had been observed. The prevalence of the risk factor (i.e. the proportion of IVDUs) in the general population was estimated using the ‘multiplier formula’ and ‘capture‐recapture’ methods. The proportion of all deaths attributable to IVDU in the 15–34 age group in the Roman population was 16% and 9% in males and females, respectively. The cause‐specific attributable proportions were 66% for endocarditis and 37% for cirrhosis in males, and 36% for endocarditis and pneumonia in females. These findings further document the relevant health consequences of IVDU on the general population of a large metropolitan area.
Prevalence and characteristics of at‐risk drinkers among elderly acute medical in‐patients
Authors: BRISTOW M. F. , CLARE A. W.
Published: January 2006

Three‐hundred‐and‐twenty‐seven male and 323 female medical and geriatric admissions over the age of 65 were interviewed about their drinking habits. Thirty (9%) of the men were found to drink in excess of the Royal College of Psychiatrists' recommended safety limits. The majority of these were lifelong heavy drinkers. Another 33 (10%) had previously drunk heavily over the age of 65, but had cut down, the majority spontaneously. Alcohol usage among women was less, although there was strong circumstantial evidence of heavy usage in a few. Twenty‐five of the 30 men identified above as ‘at risk’ were interviewed in greater depth. These were compared with 25 age‐matched light drinkers or non‐drinkers. Forty‐eight per cent of the men admitted to one or more alcohol related problem and if the admission diagnosis were included the number rose to 60%. The ‘at risk’ drinkers were significantly more likely to smoke, not to be married and to have some impairment of mobility.
Implications of gender for alcohol treatment research: a quantitative and qualitative review
Authors: JARVIS TRACEY J.
Published: January 2006

Previous reviews of alcohol treatment research have indicated that in the majority of studies there are no sex differences in treatment outcome. The current meta‐analysis was used to measure the magnitude and direction of trends of sex difference in treatment outcome. The results indicated that women had better treatment outcomes than men in the first 12 months after treatment while men showed greater improvement than women in follow‐ups after 12 months. However, the estimated differences were small and derived from a heterogeneous sample of studies. Evidence from the studies in the meta‐analysis is used to highlight the importance of gender‐related factors which may impact on the processes and outcomes of treatment. In particular, sex differences in physiological responses to alcohol, in social norms for alcohol, and in socio‐cultural experiences are considered important areas for future investigation in alcohol treatment research.
A comparison of women seeking drug and alcohol treatment in a specialist women's and two traditional mixed‐sex treatment services
Authors: COPELAND JAN , HALL WAYNE
Published: January 2006

The paucity of research on the treatment needs of women with substance abuse problems has been a serious impediment to the development of empirically validated treatment programmes. Women continue to be seriously under‐represented as research subjects and clients of treatment services. This study compares the characteristics of 80 women attending a specialist women's treatment service with those of eighty women attending two traditional mixed‐sex treatment agencies. Women attending a gender‐sensitive service were significantly more likely to have dependent children, to be lesbian, to have a maternal history for drug or alcohol problems and to have suffered sexual abuse in childhood. These results suggest that gender‐sensitive treatment services may be recruiting women who might not otherwise have sought treatment for their substance dependence problems.
Predicting initiation to and cessation of buprenorphine and temazepam use amongst adolescents
Authors: HAMMERSLEY RICHARD , LAVELLE TARA , FORSYTH ALASDAIR
Published: January 2006

Two interviews separated by 12 months (mean) were conducted with a purposive sample of Glaswegian adolescent drug misusers. Across that interval, beginning to use buprenorphine and temazepam were predictable by prior extent of other substance use, especially cannabis and tobacco, and by the Drug Misuse Scale, using selected MMPI items. About 50% of those who had been using either drug prior to first interview did not use at all between first and second interview. For temazepam, this cessation was not predictable, but ceasing to use buprenorphine was more likely the less time subjects had used this drug and if they had never injected. It is concluded that personality and frequent substance use predispose to drug misuse, but that additional factors must lead to dependence.
Problem drinking and high‐risk driving: an analysis of official and self‐reported drinking‐driving in New York State
Authors: YU JIANG , WILLIFORD WILLIAM R.
Published: January 2006

The authors collected data from 878 respondents at high risk of problem drinking and drunk driving and tested a hypothesis that stipulates problem drinking and high‐risk driving as two necessary conditions of drunk driving. Controlling for a number of alcohol and non‐alcohol‐related variables, the analysis shows problem drinking to have consistent and significant effects on repeat DWI offenses and on the frequency of self‐reported drinking‐driving events. High‐risk driving increases the frequency of self‐reported drinking‐driving. Males are more likely than females to be arrested for DWI, but there is no gender differences in self‐reported drinking‐driving. The authors further note a possible ‘suppress effect’ in that a negative relationship between DWI arrests and high‐risk driving is concealed by problem drinking. That is, problem drinkers with multiple DWI arrest records may drive more carefully than before so as to avoid further contact with the police and licensing authorities. Public policy implications of the findings are discussed.
Cross system agreement for substance use disorders: DSM‐III‐R, DSM‐IV and ICD‐10
Authors: ROUNSAVILLE BRUCE J. , BRYANT KENDALL , BABOR THOMAS , KRANZLER HENRY , KADDEN RONALD
Published: January 2006

This report presents results of a field trial of Substance Use Disorders as defined by DSM‐III‐R, DSM‐IV (proposed) and ICD‐10. Diagnoses based on the three systems were derived from interviews using the Composite International Diagnostic Interview (CIDI) in a heterogeneous sample of 521 adults drawn from clinical and community settings. Two issues are addressed: (1) cross system agreement; and (2) syndrome coherence of proposed criterion sets for Substance Dependence in each of the three systems. Findings were as follows: (1) Cross system agreement for Dependence was generally high, especially between DSM‐III‐R and DSM‐IV. (2) Cross system agreement was lower for DSM‐III‐R and DSM‐IV Abuse and very low for DSM‐IV Abuse and ICD‐10 Harmful Use. (3) Agreement varied across drug categories with lowest DSM‐III‐R/DSM‐IV agreement for alcohol abuse and DSM‐IV/ICD‐10 agreement for marijuana use disorders. (4) Overall prevalence differed for the three systems with DSM‐IV yielding highest rates followed by DSM‐III‐R and ICD‐10 in that order. (5) Factor analysis of Dependence criteria showed high loadings of all items on a single factor across the three diagnostic systems and for all categories of drugs. Implications for validity of the dependence syndrome construct and for revisions in DSM‐IV are discussed.
Alcohol consumption and sickness absence: from the Whitehall II study
Authors: MARMOT M. G. , NORTH FIONA , FEENEY AMANDA , HEAD JENNY
Published: January 2006

Previous studies suggest that problem drinkers have markedly increased sickness absence. However, it is not dear how more moderate alcohol consumption and abstinence relate to sickness absence. As part of the Whitehall II study the relationship between different drinking patterns and, sickness absence is examined. A total of 10314 male and female civil servants completed a baseline questionnaire about their drinking habits—the amount of alcohol consumed over the past 7 days and the frequency of drinking over the past 12 months. All sickness absence has been recorded prospectively. Drinking patterns and sickness absence are examined for short spells (7 days) and long spells (> 7 days) adjusting for other causes of sickness absence: age, grade of employment, smoking, work characteristics and baseline health. Alcohol consumption was strongly related to employment grade, the lower the grade the higher proportion of men and women reporting no alcohol consumption. For men the relation of alcohol intake to short spelts of sickness absence (> 7 days) appeared to be U‐shaped, for long spells (> 7 days) increased rates of absence were found only in frequent drinkers. There was no clear relationship for women, however higher rates of sickness absence were found in non‐drinkers.
Evidence of normal emotional responsiveness in alcoholic Korsakoff's syndrome in the presence of profound memory impairment
Authors: DOUGLAS JACQUELINE J. , WILKINSON D. ADRIAN
Published: January 2006

Memory and likeability ratings for emotion‐laden and neutral stimuli were investigated in Korsakoff amnesics, former heavy drinkers and light drinkers. Tasks were recall of self‐generated paired‐associates, primed recognition and likeability ratings for faces previously paired with emotional or neutral descriptors, and ratings of the emotionality of items in a 64‐word list. The Profile of Mood States and Geriatric Depression Scale were also administered. Despite severely impaired recall in Korsakoff's amnesics, the effects of emotional versus neutral material were not distinguishable among the three groups. These findings indicate a need to re‐examine the notion that flattening of emotional responsiveness is a central characteristic of Korsakoff's Syndrome.
Opiate users and the first years after treatment: outcome analysis of the proportion of follow up time spent in abstinence
Authors: SHEEHAN MARGARET , OPPENHEIMER EDNA , TAYLOR COLIN
Published: January 2006

This second report on a follow‐up study of drug users focusses on changes that occurred on a number of variables between intake and follow‐up and during the follow‐up period. The length of abstinence from opiates was considered as a proportion of the total follow‐up period. Overall there was a reduction in opiate use, in injecting and sharing equipment at follow‐up. There had been, however, a high level of these risky activities during the follow‐up period. Sustained abstinence from opiates was associated with increased employment, enhanced social stability and mental health. Intake drug use was strongly related to follow‐up drug status. In particular, those who were injectors of multiple drugs at intake were far less likely to be long term opiate abstainers at fallow‐up than those who were not injectors at intake or injectors of opiates only.
Modelling the interactions between alcohol, crime and the criminal justice system
Authors: ENSOR TIM , GODFREY CHRISTINE
Published: January 2006

Similarities in the trends of the number of offences and the level of alcohol consumption are often used as evidence as a link between alcohol and many forms of criminal activity. However, such crude correlations may be misleading as they neither take account of other factors that might be important, not assist the understanding of the causal links between alcohol and crime. In this paper, the role that economic models may play in furthering the understanding of the potential links between alcohol and crime are explored. A complete model is presented which allows for complex interactions between alcohol, crime and the criminal justice system. Results from testing this model with time series data (1960–88) for England and Wales for different types of crime are discussed in detail. Data defined by standard regions and for the years 1980 to 1988 were also compiled and a summary of the results discussed. The argument that alcohol consumption may be one of the determinants of a wide range of crimes receives some support and is also found that alcohol consumption may affect the probability of detection for some types of crime.
Physical, subjective, and social availability: their relationship to alcohol consumption in rural and urban areas
Authors: ABBEY ANTONIA , SCOTT RICHARD O. , SMITH MARY JO
Published: January 2006

The alcohol availability literature indicates that under some conditions, physical availability is positively associated with per capita alcohol consumption. Smart (1980) suggested that at the individual level, subjective and social aspects of availability may mediate and outweigh the influence of physical availability. The study described here examined the simultaneous effects of physical, subjective, and social availability on alcohol consumption. Standardized telephone interviews were conducted with 781 adult drinkers. As hypothesized, physical availability was not a significant multivariate predictor of alcohol consumption for residents of high, medium, and low alcohol outlet density counties in Michigan (USA). Subjective and social availability indicators were significant predictors of alcohol consumption. Similar patterns of results were found in multiple regression analyses for blacks and whites and women and men, although blacks and women consumed less alcohol than did whites and men. The theoretical and practical implications of these results are discussed.
Paternal lineage of alcoholism, cohort effects, and alcoholism criteria
Authors: DE JONG JUDITH A. , ROY ALEC
Published: January 2006

Adoption studies have led to the suggestion that there may be two distinct subgroups of alcoholics with differing genetic contributions. Among 249 male alcoholics we used discriminant analysis to relate the features of type 1 and type 2 alcoholism it the presence or absence of a family history of alcoholism in male paternal relatives. We found that guilt and hinging, features usually attributed to type 1 (milieu‐limited) alcoholism, were in fact more prevalent m the family history positive group. An additional cohort analysis found cohort‐related variations in type 1/type 2 characteristics. The possible implications of these findings are discussed.
Doctors and substance misuse: types of doctors, types of problems
Authors: BROOKE DEBORAH , EDWARDS GRIFFITH , ANDREWS TOBY
Published: January 2006

The casenotes of 144 doctors who had received treatment for substance misuse were analysed. There were no differences between general practitioners (h = 61) and hospital doctors (n = 58) in terms of their substance misuse histories or the problems they incurred. Differences emerged between the consultant (n = 24) and the non‐consultant (n = 34) grades of hospital doctor. The consultants were older at onset of problematic use (42.6 ±8.6 vs. 29.9 ± 9.8 years); they suffered fewer career problems and misused fewer substances. The most frequent pathways into substance use were personality difficulties (76 subjects, 52.8%) and anxiety or depression (46 subjects, 31.9%). A history of depression (n = 36) was associated with perceived stress at work (p = 0.014), and at home (p = 0.06). Past neurotic disturbances (n = 20) were associated with personality difficulties (p = 0.035), anxiety or depression (p = 0.004), and with an earlier onset of problematic substance use (30.2 ± 8.3 vs. 36.5 ± 9.8 years, p = 0.014). Principal components of possible antecedents yielded one major component on which all elements loaded; this was labelled the ‘disturbance score’. This score showed a reduction with increasing age of onset of problematic substance use.
Needle sharing in context: patterns of sharing among men and women injectors and HIV risks
Authors: BARNARD MARINA A.
Published: January 2006

This paper looks at the social contexts within which needle sharing took place among a sample of Glasgow injectors. The intention is to show that needle sharing is rarely random but instead highly patterned and influenced by circumstance and social relationships. Gender can also be seen to have an important influence on sharing patterns. Consideration of the reported instances of needle sharing provides some indication that women injectors may be at increased risk of HIV transmission relative to their male counterparts.
Drinking contexts and drinking problems among black and white women
Authors: HERD DENISE , GRUBE JOEL
Published: January 2006

This study explored whether black and white women differ in how often they drink in particular types of social settings and if drinking in different contexts independently predicts alcohol‐related problems. The analysis was based on the interview responses of 635 black and 663 white women drinkers who represent sub‐samples from a nationwide survey of 5221 respondents conducted in 1984. The findings revealed that white women are more likely to attend restaurants, bars and parties away from home than black women and that a larger proportion of their alcohol consumption occurs in these settings than among black women. Factor analysis was used to develop scales on the the frequency of drinking in different social contexts. The results confirmed a three‐dimensional factor structure that distinguished between drinking at home; drinking in social settings such as bars, restaurants and parties; and drinking in outdoor public areas like street comers and parks. A simultaneous equations path analysis was used to model the relationships among drinking contexts, the frequency of heavier drinking, drinking problems, race and other social characteristics. The major findings of the resulting models were that drinking contexts independently predict drinking problems and that race is not directly associated with drinking contexts or alcohol‐related problems. However racial differences do exert significant indirect effects on social settings and drinking problems through differences in socio‐economic status and normative attitudes. The conclusion emphasizes the complexity of the interrelationships of ethnic and social characteristics that underlie visible racial differences in the social patterns and situational contexts of alcohol use.
The role of alcohol‐related expectancies in the prediction of drinking behaviour in a simulated social interaction
Authors: KNIGHT ROBERT G. , GODFREY HAMISH P. D.
Published: January 2006

This study investigated the relationship between socially‐relevant alcohol‐related beliefs and drinking behaviour in a laboratory‐based study. Ninety male subjects were told they would be videotaped while completing the Simulated Social Interaction Test; they were then assigned to one of three conditions. In the first, alcohol consumption prior to the interaction was optional, in the second, a standard dose was administered, and in the third, no alcohol was offered. The outcome measures included drinking behaviour and rated level of social skill. In the optional condition, beliefs that alcohol would reduce anxiety in social situations and enhance social competence predicted amount consumed. The decision to continue drinking after the compulsory dose was predicted by anxiety level. In the no alcohol condition, rated social skill was negatively correlated with the beliefs that alcohol reduces tension and reduces fear of negative evaluation. Results are discussed with reference to social learning approaches to understanding drinking behaviour.
Prevalence of alcohol problems among selected AIDS risk groups: United States, 1988
Authors: STINSON FREDERICK S. , DEBAKEY SAMAR FARHA
Published: January 2006

The Data Note Series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism, USA.

Estimates of the prevalence of various alcohol problems (DSM‐III‐R alcohol abuse/dependence, heavier drinking, and consuming 5 or more/9 or more drinks per occasion) were examined for a general population group of 29 155 persons age 18 years and older at self‐reported risk for contracting AIDS by several definitions. All AIDS risk groups showed elevated risk for alcohol problems. Results are presented separately for males and females and for various demographic groups (age, marital status, family income, education, and race).
AIDS risk behaviors and knowledge among heterosexual alcoholics and non‐injecting drug users
Authors: FITTERLING JAMES M. , MATENS PAUL B. , SCOTTI JOSEPH R. , ALLEN J. SCOTT
Published: January 2006

The disinhibitory effects of abusable substances on sexual behavior and the increasing HIV prevalence among heterosexuals suggest that alcoholics and non‐injection drug users may be at risk for HIV infection. We examined alcohol and non‐injection drug use as AIDS risk factors, AIDS risk knowledge, and the effect of AIDS education upon voluntary HIV testing among 91 heterosexual male inpatients in a VA alcohol rehabilitation program. Questionnaire data revealed relationships between age, the use of alcohol, marijuana and intranasal cocaine just prior to sex and an increase in the number of female sexual partners. Use of alcohol just prior to sex was also associated with an increased number of unprotected sexual behaviors. AIDS risk knowledge in our sample was comparable to norms from previous studies. Inpatients received education concerning alcohol and sexuality either with or without an AIDS component. AIDS education and offer of HIV testing were associated with increased requests for HIV testing.
The Significant‐other Behavior Questionnaire (SBQ): an instrument for measuring the behavior of significant others towards a person's drinking and abstinence
Authors: LOVE CRAIG T. , LONGABAUGH RICHARD , CLIFFORD PATRICK R. , BEATTIE MARTHA , PEASLEE CHRISTINE F.
Published: January 2006

The psychometric properties of the Significant‐other Behavior Questionnaire (SBQ), an instrument measuring the specific social support in terms of the patient's drinking. Assessments of the significant other's behavior in the presence of the patient drinking is provided by both the patient and significant other. Data from the two SBQ forms were analyzed with a principal axis factor analytic procedure with varimax rotation. The scales were similar for the two forms with four behavioral reactions, withdraw from the patient, support drinking, support sobriety, and punish drinking. Correlations between the two forms on the same four scales were higher than correlations within groups on three of four scales and differed from measures of general social support. Applications of the SBQ are discussed.