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Biomedical subjects

Peter Seraganian

Publications and source records attributed to Peter Seraganian.

4 recordsLinked to original sources

Salivary cortisol: a predictor of convictions for driving under the influence of alcohol?

AIMS: To examine the relationship between salivary cortisol and frequency of past driving under the influence of alcohol (DUI) convictions. METHODS: A total of 104 males with previous DUI convictions (from one to eight) and mean age of 44.7 years were assessed on measures characterizing repeat DUI offenders, including sociodemographic information, alcohol use behaviours, biological indices of the organic consequences of chronic abuse, negative consequences of excessive drinking, past DUI conviction history, impulse control, and antisocial behaviour tendencies. Saliva samples were taken approximately every 30 min over a 6 h period during an exhaustive multidimensional assessment protocol, and were then assayed to obtain cortisol responses. RESULTS: Blunted cortisol response, typically observed in alcoholics and in high-risk non-alcoholics, was associated with increased number of past DUI convictions. This association was particularly pronounced in multiple DUI offenders, and was stronger than, and independent of, other measures of alcohol use severity and chronicity commonly used for DUI assessment. CONCLUSIONS: Cortisol response may be useful in understanding the mediators underlying repeat DUI offending and the frequent failure of intervention efforts in curbing DUI behaviour.

Accidents, Traffic↗

Randomization in a substance abuse treatment study: participants who consent vs those who do not.

OBJECTIVE: A mixed research design study compared patients who consented to treatment randomization with patients who opted for usual care. METHODS: Patients in substance abuse rehabilitation who consented to randomization (that is, consenting group [CG]) were compared with those unwilling to undergo randomization (that is, nonconsenting group [NG]) but who, nevertheless, underwent the experimental assessment sessions, which spanned from intake to 6-month follow-up. RESULTS: Patients in the CG exhibited a longer history of drug abuse, less occupational stability at intake, and following intensive treatment, tended not to do as well in terms of recovery, compared with those in the NG. CONCLUSION: Inclusion of data from partial participants in research protocols may offer a viable strategy to better appraise data generalizability.

Adult↗

Process and outcome changes with relapse prevention versus 12-Step aftercare programs for substance abusers.

AIMS: Presumptive support was sought for mechanisms of action whereby two conceptually distinct aftercare programs, relapse prevention (RP) and 12-Step facilitation (TSF), impact upon substance abusers. PATIENTS AND DESIGN: Adults who had just completed intensive treatment were assigned randomly to either RP (n=61) or TSF (n=70) aftercare programs. SETTING: Three residential treatment facilities. INTERVENTIONS: Trained counselors delivered to small groups a manualized aftercare program which focused either upon the utilization of cognitive-behavioral processes to orchestrate change through an individualized treatment plan (i.e. RP) or which sought to facilitate utilization of AA's 12 Steps (i.e. TSF). MEASUREMENTS: Process measures developed specifically to quantify either: (a) the changes in self-efficacy process in RP or (b) the utilization of AA's principles in TSF, as well as psychosocial and substance abuse indices were administered to all patients pre- and post-aftercare and at 6-month follow-up. FINDINGS: A significant relationship between changes in measures of self- efficacy for RP participants as well as a trend for a relationship between process-specific change for TSF participants partially satisfied the first condition for presumptive support. The fact that the intervention-specific mediators covaried with several outcome indices, and that removal of such mediators attenuated prediction of outcome met, respectively, the second and third conditions for presumptive support. CONCLUSION: Carefully orchestrated RP and TSF aftercare programs yield process changes that are related positively to improved outcome.

Adult↗

Matching substance abuse aftercare treatments to client characteristics.

This study investigated matching client attributes to different aftercare treatments. A naturalistic sample of adults entering substance abuse treatment was randomized into either Structured Relapse Prevention (RP, n=61) or a 12-Step Facilitation (TSF, n=72) aftercare program. Four patient attributes were matched to treatment: age, gender, substance abuse profile, and psychological status. Substance use outcomes were assessed 3 and 6 months posttreatment. At 6 months, four significant matches were uncovered. Females and individuals with a multiple substance abuse profile reported better alcohol outcomes with TSF aftercare than their cohorts exposed to RP aftercare. Individuals with high psychological distress at treatment entry were able to maintain longer periods of posttreatment abstinence with TSF aftercare compared to their cohorts exposed to RP. Inversely, RP was found to maintain abstinence significantly longer for individuals reporting low distress compared to those with high distress. Finally, better outcomes were achieved when random assignment to aftercare was consistent with participant preference. Overall, an Alcoholics Anonymous approach to aftercare appears to provide the most favorable substance use outcomes for most groups of substance abusers. RP may be most suitable for clients whose psychological distress is low, especially where maintenance of abstinence is targeted. Where choice in aftercare program is possible, matching client preference with type of aftercare program can improve outcome.

Adult↗