Biomedical subjects

C Leukefeld

Publications and source records attributed to C Leukefeld.

17 recordsLinked to original sources

PubMed2001

Personality disorders as extreme variants of common personality dimensions: can the Five-Factor Model adequately represent psychopathy?

The present study examined Widiger and Lynam's (1998) hypothesis that psychopathy can be represented using the Five-Factor Model (FFM) of personality. Participants in the study consisted of 481 21-22-year-old men and women who are part of an ongoing longitudinal study. Psychopathy was assessed by the degree of similarity between an individual's NEO-PI-R and an expert-generated FFM psychopathy prototype. The expert-based prototype supported the account of Widiger and Lynam (1998), as did the correlations between the NEO-PI-R Psychopathy Resemblance Index (PRI) and the individual personality dimensions. The PRI was also related in predicted ways to measures of antisocial behavior, drug use, and psychopathology. The results support the contention that psychopathy can be understood as an extreme variant of common dimensions of personality, and underscore the utility of a dimensional model of personality disorders.

Adult↗

PubMed2000

Sexual and drug use behaviors among female crack users: a multi-site sample.

The purpose of this paper was to compare female crack users who report exchanging sex for drugs and/or money with female crack users who did not report exchanging sex for drugs and/or money. A multi-site sample of (n = 4667) female crack users who participated in the National Institute of Drug Abuse (NIDA) AIDS Cooperative Agreement Project from 20 sites were interviewed. Statistical analysis compared two groups on selected variables of interest: women crack users who reported exchanging sex for drugs and/or money (n = 2658) and women crack users who did not report exchanging sex (n = 2009). Results indicated that both groups of women had frequent unprotected sex. However, women who exchanged sex had more sexual partners, had sex more often, used drugs before and during sex more often, and had a higher rate of STDs than women who did not exchange sex. In addition, African-American women, homeless women, and women who reported past substance abuse treatment were about twice as likely to exchange sex. Regional differences were also examined.

Adolescent↗

PubMed2000

Differences in young adult psychopathology among drug abstainers, experimenters, and frequent users.

Shedler and Block offered the provocative proposal that individuals who experiment with drugs are psychologically healthier than either those who abstain completely or those who are frequent users. Not all studies have come to such conclusions, however. In an effort to specify under what conditions Shedler and Block's conclusions might hold, the present study examined three groups of drug users (abstainers, experimenters, frequent users) classified according to three different criteria: (a) marijuana use at age 20; (b) alcohol use during 10th grade; and (c) alcohol use at age 20. The three groups were compared at age 20 in terms of personality, deviant behavior, and psychopathology. The results revealed that abstainers were never more psychologically impaired, and were occasionally healthier, than experimenters. Frequent users of marijuana were consistently more imparied than both the abstainers and experimenters, in terms of both internalizing and externalizing disorders. Classification according to marijuana use appeared to be more related to psychopathology than did classification according to alcohol use.

Adolescent↗

PubMed2000

Homelessness and gender in out-of-treatment drug users.

This study examines 5225 out-of-treatment crack users and drug injectors drawn from five different geographic areas to examine selected factors associated with homelessness. Of these crack users, 27% considered themselves undomiciled, and 60% had previously entered some type of drug treatment. Logistic regression found that substance abusers who were married, female, and persons of color were less likely to be without a home when other variables were controlled. Trading sex for money and perceived chance of getting acquired immunodeficiency syndrome (AIDS) were associated positively with homelessness, while participating in methadone detoxification and methadone maintenance programs seemed to offer some protection from homelessness.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Card Perseveration Task performance and post-task feeling states: relationship to drug use in adolescents.

This study examined whether performance on the Card Perseveration Task (Card Task) and self-report of feeling state after the task are related to self-report of drug use. The evaluation was of 64 adolescents from an adolescent psychiatric outpatient clinic (40 males, aged 15.5 years, SD = 1.6; 24 females aged 16.9 years, SD = 1.5). Drug use histories were obtained using a substance dependence symptom checklist based on DSM-III-R. The Card Task was administered, and after completion, a Post-Task Self-Report (PTSR) was administered. A factor analysis with varimax rotation grouped the 28 items of the PTSR into Distress, Happy, Satisfied, and Wanting to Win subscales. Correlations of drug use with performance on the Card Task and the PTSR subscales were obtained. Cards Played on the Card Task were correlated with alcohol (cc = .31, p < or = .01); marijuana (cc = .35, p < or = .01) and polydrug (cc = .26, p < or = .05) dependence symptoms. Money Won on the Card Task was correlated negatively with nicotine (cc = -.26, p < or = .05) and marijuana (cc = -.27, p < or = .05) dependence symptoms. The PTSR Distress subscale correlated with nicotine (cc = .49, p < or = .001), alcohol (cc = .37, p < or = .01), marijuana (cc = .39, p < or = .01), and polydrug (cc = .49, p < or = .001) dependence symptoms. These findings provide evidence that both the Card Task and feeling states associated with task performance are related to self-reports of drug use.

Adolescent↗

PubMed2000

Stalking as a variant of intimate violence: implications from a young adult sample.

There is a limited but growing literature which suggests that stalking is a variant of intimate violence. The purpose of this study was to examine physical, psychological, and stalking victimization and perpetration among males and females. Alcohol use was also examined. The sample was 46 male and 84 female undergraduate students who reported stalking victimization and perpetration after a difficult breakup, and psychological and physical victimization and perpetration during that specific relationship. Overall, 27% of the sample study was classified into the stalking victimization group, which is consistent with other stalking prevalence rates among college samples. For females, stalking victimization was significantly associated with physical and psychological abuse victimization. For males, stalking victimization was significantly associated with psychological abuse victimization. However, there was also a strong significant reciprocal relationship of stalking and psychological abuse victimization and perpetration, especially for males. Also, alcohol use was significantly associated with victimization and perpetration of stalking and psychological abuse for males. The data from this study contribute to the hypothesis that stalking is a variant of or extension of intimate violence, especially for females. Implications and recommendations for future research are discussed.

Adolescent↗

PubMed1999

Case management and behavioral contracting. Components of rural substance abuse treatment.

This article presents a model of case management with rural clients entering drug and alcohol treatment. As part of a larger treatment protocol called Structured Behavioral Outpatient Rural Therapy, behavioral contracting is combined with strengths perspective case management to help rural clients motivate themselves to engage and complete drug and alcohol treatment. This combined approach is designed to continually communicate and teach an "A-B-C" cognitive-behavioral approach to problem-solving and change. While not a panacea for addressing the myriad problems facing clients with drug use problems, such an approach promises to improve "treatment as usual" formats, which often ignore the formidable obstacles to human change experienced by rural clients and clinicians.

Adult↗

PubMed1999

Project DARE: no effects at 10-year follow-up.

The present study examined the impact of Project DARE (Drug Abuse Resistance Education), a widespread drug-prevention program, 10 years after administration. A total of 1,002 individuals who in 6th grade had either received DARE or a standard drug-education curriculum, were reevaluated at age 20. Few differences were found between the 2 groups in terms of actual drug use, drug attitudes, or self-esteem, and in no case did the DARE group have a more successful outcome than the comparison group. Possible reasons why DARE remains so popular, despite the lack of documented efficacy, are offered.

Adolescent↗

PubMed1999

Risky sex behavior and substance use among young adults.

Many young adults, despite widespread prevention and education efforts that target this age group, engage in behaviors that place them at risk of HIV infection. These behaviors include frequent experimentation with alcohol and other drugs before sex, sexual activity with different partners, and inconsistent safe-sex practices. The combination of these risky behaviors causes increased concern about the spread of HIV among this age group. The study discussed in this article examined the relationship between substance use during adolescence and HIV risk behavior among young adults ages 19 to 21 with and without a college education. Results indicated that increased use of alcohol and marijuana at younger ages is related to riskier sexual activity and increased use of alcohol and marijuana as young adults. Recommendations for interventions are made.

Adolescent↗

PubMed1998

Sexual and drug use behaviors among women crack users: implications for prevention.

The literature suggests that important and contributing factors in the rise of HIV and AIDS among women are crack use and the exchange of sex for drugs or money. However, not all women who use crack report they are exchanging sex for drugs or money. Thus, women are at differential risk for HIV and AIDS. The purpose of this study is to compare and describe women crack users (n = 292) who reported exchanging sex for drugs and money with women crack users who did not report exchanging sex. Results indicated that both women crack users who exchanged sex (n = 162) and women crack users who did not exchange sex (n = 130) were likely to be African American, to be about the same age, to have had incomes below +500 during the previous month, to have had similar education and martial backgrounds, to have had unprotected sexual intercourse as often, to have had similar drug use patterns, and to have initiated drug use at similar ages. However, women who exchanged sex had more sexual partners, had unprotected oral sex more often, used drugs before and during sex more often, and had a higher rate of sexually transmitted diseases than women who did not exchange sex. In addition, women who exchanged sex were also twice as likely to be homeless, four times more likely to have been in treatment, and twice as likely to have been arrested and charged/booked two or more times in their lifetime than women who did not exchange sex.

Adult↗

PubMed1997

Recovery: with and without self-help.

Although self-help/mutual-help groups, like Alcoholics Anonymous, are important factors in the recovery of many chemically dependent individuals, the large dropout rates from such groups and the awareness that many who drop out do not return to dependent behavior raises interesting questions about other paths to sustained abstinence and recovery. Current emphasis on treatment outcome studies provides a means for researching factors in both those who recover with and without the assistance of self-help/mutual-help groups. The authors suggest some questions which might be investigated.

Adult↗

PubMed1992

Treating the drug-abusing offender.

The association between drug abuse treatment and criminal justice control is examined in this article. A framework is presented for mental health administrators and policy-makers to examine and appreciate the use of authority derived from the criminal justice system for drug abusers involved in community treatment. In addition, an overview of relevant literature is provided to encapsulate the literature related to the drug-abusing criminal offender which is most useful for mental health administrators and policy-makers.

Community Mental Health Centers↗

PubMed1992

Recommendations for improving drug treatment.

Recognizing that drug use is both chronic and relapsing once an individual is addicted, and that treatment is effective in reducing drug use/misuse, improving drug misuse treatment is examined and research as well as practice recommendations are presented. Drug misuse treatment is now recognized in the United States to meet the expanding drug use problem and for reducing the spread of HIV. With that background, the current status of drug misuse treatment is reviewed, clinical issues are emphasized, and policy issues are noted. Recommendations include the need for uniform funding, linkage with community agencies, technology transfer, training, and expanding research and evaluation efforts.

HIV Infections↗

PubMedDate not supplied

Effectiveness of HIV risk reduction initiatives among out-of-treatment non-injection drug users.

While attention has been paid recently to the effectiveness of HIV/AIDS interventions among injection drug users, less focus has been given to out-of-treatment noninjecting drug users. This study examines the the NIDA Cooperative Agreement standard intervention versus an enhanced intervention for HIV/AIDS risk among noninjecting drug users. Data come from five sites of the NIDA-funded Cooperative Agreement on HIV risk behaviors. The sample is comprised of those who never injected drugs or reported not injecting in the 12 months prior to the interview; and who completed a three-month follow-up assessment. Three risk behaviors in the prior 30 days were analyzed: frequency of crack/cocaine use, number of sex partners, and frequency of condom use. The levels of both baseline and follow-up risk were analyzed. Individuals remaining at low risk or decreasing risk behaviors were classified as "improved." Those increasing risk behavior or remaining at moderate or high levels were classified as "worsened." Of the 1,434 noninjecting crack/cocaine users, 82% improved crack/cocaine use at the follow-up. The enhanced intervention group showed more improvement in crack/cocaine use than the standard intervention group. Overall, 76% reported reducing sexual partners, maintaining a one-partner relationship, or abstaining from sex at both time periods. Women in the enhanced intervention group improved more than women in the standard intervention (81% versus 75%). In terms of condom use, more respondents worsened than improved (55% versus 45%). This study confirms that HIV/AIDS interventions can reduce crack/cocaine use; however, high-risk sexual behaviors are more difficult to change. Reasons for this lack of improvement and suggestions for future interventions are discussed.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

HIV risk behavior among bisexual and heterosexual drug users.

This study examined the sexual and drug use behaviors for bisexual and heterosexual drug users (n=11,435 males and n=5,636 females) who participated in the NIDA AIDS Cooperative Agreement study. Results of the study suggest that, for males, bisexuality was highly associated with being homeless, having ever been paid for sex, having five or more sex partners in the month preceding the interview, having an IV drug-using sexual partner in the month preceding the interview, using crack, and sharing injection equipment in the month preceding the interview. For females, bisexuality was associated with ever having been arrested, past substance abuse treatment, ever having been paid for sex, ever having paid for sex, having five or more sexual partners in the month preceding the interview, ever using cocaine, and sharing injection equipment in the month preceding the interview. Overall, results from this study indicate that both male and female bisexuals, when compared to heterosexuals, were at higher risk for HIV and were more likely to be HIV positive. One implication of these results is that a universal prevention message may not be as effective as targeting prevention messages specifically for bisexual males and females.

Adult↗

PubMedDate not supplied

Substance use health services research.

This report provides an introduction to substance use health services research based upon the conceptual model of Andersen and Aday and demonstrates how the subsequent papers provide important insights into issues raised in this conceptual model. These issues include access and barriers to health care, needs for care, health care utilization, outcomes of care, and costs of care. We show how these issues are also expanded beyond more traditional definitions. We conclude by indicating some broad areas for further research.

Health Services↗

PubMedDate not supplied

Health service utilization and victimization among incarcerated female substance users.

Women represent the fastest growing population of prison inmates, which has increased dramatically in the past decade. Generally, women use more health services than men but with limited access to health care, incarcerated women tend to experience multiple problems, including problems with drugs, alcohol, and victimization. The purpose of this exploratory qualitative study was to identify specific factors related to health, mental health, drug use, and violence among incarcerated female substance users. Perspectives from 34 females who participated in focus groups in prison are discussed. Key findings indicate that drug use, victimization, and living in a rural area were barriers to accessing health services. In addition, implications for interventions targeting women are presented.

Adult↗