Biomedical subjects

Gallus Bischof

Publications and source records attributed to Gallus Bischof.

8 recordsLinked to original sources

PubMed2007

[Improvement of medical care by supporting the intention to change health risk behavior].

A large proportion of disease and death cases could be prevented, if efficacious programs, particularly concerning tobacco smoking, obesity, and alcohol risk drinking, could be applied. Feasible approaches are based, among others, on the Transtheoretical Model of intentional health behavior change. This model allows to develop practical approaches to reduce risk factors of common diseases at the general population level. Evidence about the promotion of the intention to change health risk behaviors revealed successes, e. g., according to smoking cessation. The effects are growing by time. Intervention that is focused at the promotion of change of health risk behaviors can add to the improvement of health care.

Behavior Therapy↗

PubMed2006

Intention to utilize formal help in a sample with alcohol problems: a prospective study.

BACKGROUND: Studies investigating factors of treatment entry have predominantly focussed on persons that have already taken an initial step in the process of help-seeking. With particular emphasis on intention to utilize help, this study aims to detect predictors for alcohol-related help-seeking among a non-help-utilizing sample. METHODS: Using 312 individuals with diverse alcohol problems (dependence, abuse, at-risk drinking), intention to utilize help was assessed in addition to evidence based predictors for utilization of help (e.g. severity of alcohol problem, prior help-seeking). RESULTS: In addition to prior utilization of help (OR=9.76, CI: 4.60-20.74) and adverse consequences from drinking (OR=1.13, CI: 1.02-1.25), intention to utilize help (OR=4.84, CI: 2.04-11.51) was a central predictor for help-seeking. Among individuals who had not obtained prior help, individuals intending to seek help were 8.7 times more likely to utilize help than those not intending to seek help (CI: 1.05-72.2). CONCLUSIONS: In the past, intention to utilize help has been neglected from models investigating treatment entry. This study's findings show that intention is a central factor for utilization of alcohol-specific formal help. Consequently, brief interventions focusing on enhancing motivation are expected to improve early help-seeking among general hospital patients with diverse alcohol problems.

Alcohol Drinking↗

PubMed2006

Stability of remission from alcohol dependence without formal help.

AIMS: To determine the stability of remission from alcohol dependence without formal help. METHODS: In a cohort of untreated remitters, a follow-up after 24 months was conducted. Participants were recruited through media solicitation and via a general population study. At baseline, all participants (n = 144) fulfilled criteria of remission from alcohol dependence for the previous 12 months without prior use of formal help (sustained full remission according to DSM-IV, neither inpatient nor outpatient treatment, no more than two self help group meetings). Personal interviews were conducted using standardized instruments. RESULTS: In the follow-up period, four individuals died; 92.9% of the remaining participants were re-interviewed (n = 130). Of those interviewed 92.3% showed stable remission without formal help, 1.5% were currently alcohol dependent according to DSM-IV, 1.5% were classified alcohol dependent on grounds of collateral information, 1.5% fulfilled one or two criteria of dependence, and 4.6% utilized formal help. CONCLUSIONS: Untreated remission is not a transient phenomenon. Therefore, studying remitters from alcohol dependence without formal help can yield valid information on pathways to recovery.

Alcoholism↗

PubMed2006

Performance of the pictorial representation of illness and self measure in individuals with alcohol dependence, alcohol abuse or at-risk drinking.

BACKGROUND: The impact of chronic illnesses is not only influenced by one's physical functioning but also by its subjective importance to the individual's life. However, it is often difficult to asses such an impact in an appropriate way. PRISM (pictorial representation of illness and self measure) measures the perception of illness and first data on its validity have been published. The aim of the present study was to prove the applicability of PRISM regarding alcohol-dependent patients. Therefore, a comparison was made between alcohol-dependent patients, alcohol abusers and at-risk drinkers. METHOD: The sample consisted of 763 general practice patients, who scored above the cutoff in alcohol-related screening questionnaires. Of this sample, 330 were diagnosed as alcohol dependent, alcohol abusers (both according to DSM-IV) or at-risk drinkers. To prove the applicability, PRISM was put in context with the severity of alcohol dependence and the core constructs of the transtheoretical model of behavior change. RESULTS: PRISM was related to the severity of the drinking problem: the severer the drinking problem, the shorter the distance between self and illness. High correlations with aspects of alcohol consumption - such as adverse consequences from drinking, temptation to drink, and self-efficacy to abstain - were found. Concerning stages of change according to the transtheoretical model of behavior change, data show a significant difference in the self-illness separation between patients in the stage of contemplation compared to those in the precontemplation or action stage. CONCLUSIONS: The PRISM task is applicable to patients with alcohol use disorders. Within this group and in contrast to other chronic diseases, PRISM reveals a significant relationship not only to the severity of drinking, but also to the readiness to change one's drinking behavior.

Adolescent↗

PubMed2006

The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample.

OBJECTIVE: Our goal was to analyze the retest reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a primary-care setting and recommend a cut-off value for the different alcohol-related diagnoses. METHOD: Participants recruited from general practices (GPs) in two northern German cities received the AUDIT, which was embedded in a health-risk questionnaire. In total, 10,803 screenings were conducted. The retest reliability was tested on a subsample of 99 patients, with an intertest interval of 30 days. Sensitivity and specificity at a number of different cut-off values were estimated for the sample of alcohol consumers (n=8237). For this study, 1109 screen-positive patients received a diagnostic interview. Individuals who scored less than five points in the AUDIT and also tested negative in a second alcohol-related screen were defined as "negative" (n=6003). This definition was supported by diagnostic interviews of 99 screen-negative patients from which no false negatives could be detected. As the gold standard for detection of an alcohol-use disorder (AUD), we used the Munich-Composite International Diagnostic Interview (MCIDI), which is based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. RESULTS: On the item level, the reliability, measured by the intraclass correlation coefficient (ICC), ranged between .39 (Item 9) and .98 (Item 10). For the total score, the ICC was .95. For cut-off values of eight points and five points, 87.5% and 88.9%, respectively, of the AUDIT-positives, and 98.9% and 95.1%, respectively, of the AUDIT-negatives were identically identified at retest, with kappa = .86 and kappa = .81. At the cut-off value of five points, we determined good combinations of sensitivity and specificity for the following diagnoses: alcohol dependence (sensitivity and specificity of .97 and .88, respectively), AUD (.97 and .92), and AUD and/or at-risk consumption (.97 and .91). CONCLUSIONS: Embedded in a health-risk questionnaire in primary-care settings, the AUDIT is a reliable and valid screening instrument to identify at-risk drinkers and patients with an AUD. Our findings strongly suggest a lowering of the recommended cut-off value of eight points.

Adolescent↗

PubMed2005

Intention to change drinking behaviour in general practice patients with problematic drinking and comorbid depression or anxiety.

AIMS: This paper examines the interaction of intention to change drinking behaviour with comorbid depression and anxiety in pro-actively recruited individuals with a range of drinking problems. METHODS: Cross-sectional data of 408 general practice (GP) patients aged 18-64 years, who meet the diagnostic criteria of alcohol dependence or abuse according to DSM-IV, criteria of at-risk drinking or binge drinking, were drawn from a brief intervention study. Of the sample, 89 participants were diagnosed with comorbid anxiety and/or depressive disorders. The Transtheoretical Model (TTM) of behaviour change constructs: stages and processes of change, self-efficacy, and decisional balance were assessed in relation to presence and absence of the respective psychiatric disorders. RESULTS: Analysis including all categories of problematic drinking revealed comorbid anxiety and/or depression to be significantly related to later stages of change. Within subgroups, this was only true for alcohol abuse, not for dependence, at-risk or binge drinking. In addition, comorbidity was related to higher use of processes of change and more pros and cons of drinking, when compared to non-comorbid participants. Comorbid individuals showed higher temptation to drink and lower self-efficacy to abstain from drinking. Separate analyses of readiness to change drinking between the categories anxiety/no comorbidity and depression/no comorbidity both obtained significance, while for anxiety disorders, this was more profound. A multinomial logistic regression analysis revealed that adverse consequences better predicted readiness to change when compared to comorbidity. DISCUSSION: Individuals with problematic drinking and comorbid anxiety or depression may be well accessible for pro-active intervention to reduce drinking. Strategies should focus on the enhancement of coping skills to control temptation and self-efficacy.

Adolescent↗

PubMed2002

The role of family and partnership in recovery from alcohol dependence: comparison of individuals remitting with and without formal help.

The aim of this study was to analyse the role of family and partnership in remission from alcohol dependence in treated (n = 50) and untreated (n = 115) individuals. Standardised questionnaires to assess social support, social pressure, coping behaviour, and self-efficacy to stay remitted were used. In both media-solicited samples, social support increased from the pre- to the post-resolution period and was stated as an important resolution maintenance factor. Remitters with formal help experienced more partnership conflicts prior to remission and tended to experience more social pressure from their partner. Social support and social pressure from the family and partner were related to an increase in cognitive coping, as hypothesised, however, only in remitters without formal help, whereas an inverse relationship was found in formal help seekers. Implications for alcohol-related interventions are discussed.

Adaptation, Psychological↗

PubMed2002

Remission from alcohol dependence without help: how restrictive should our definition of treatment be?

OBJECTIVE: Studies on untreated remissions from addictive behaviors have utilized very different definitions of treatment, ranging from regular self-help group participation to almost no help at all. The purpose of this article is to examine the impact of different treatment definitions on triggering and maintenance mechanisms of recovery. METHOD: Sample 1 consists of 103 remitted alcohol dependent subjects (30% female) who never received any kind of treatment or counseling for alcohol problems. Sample 2 consists of 75 remitted alcohol dependent subjects (20% female) who received minor help, defined as contact with alcohol treatment not exceeding nine self-help group sessions or three counseling sessions by a specialty provider. Sample 3 consists of 50 remitted alcohol dependent subjects (24% female) who regularly participated in self-help group meetings. All participants were media recruited. Groups were compared on grounds of a comprehensive, standardized interview, including the assessment of sociodemographic and substance related variables as well as triggering and maintenance factors of remission. RESULTS: On most triggering and maintenance factors of the remission, remitters from alcohol dependence who received minor help are comparable with remitters who received no help, and both groups differ significantly from regular self-help group participants. CONCLUSIONS: Inconsistencies in studies on recovery from alcohol dependence without treatment cannot be accounted for by varying definitions of treatment, as the inclusion of subjects who received some minor help does not lead to a bias in most variables associated with remission.

Adult↗