Biomedical subjects

William Fals-Stewart

Publications and source records attributed to William Fals-Stewart.

At least 37 records · Page 2Linked to original sources

PubMed2004

Psychiatric disorders of children living with drug-abusing, alcohol-abusing, and non-substance-abusing fathers.

OBJECTIVE: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. METHOD: Children's lifetime psychiatric diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. In addition, both parents completed the Pediatric Symptom Checklist. Substance-abusing fathers were recruited from an outpatient treatment program. RESULTS: Children who lived with DA fathers were more likely to have a lifetime psychiatric diagnosis (i.e., 53% versus 25% in AA homes and 10% in non-substance-abusing homes). Compared to children in the other groups, children in DA homes were more than twice as likely to exhibit clinical levels of behavioral symptoms. CONCLUSIONS: Children living with DA fathers were more likely to experience a lifetime psychiatric disorder and more negative behaviors compared to children living with an AA father or non-substance-abusing parents.

Adult↗

PubMed2004

The temporal relationship between college women's alcohol consumption and victimization experiences.

BACKGROUND: The primary objective of the study was to assess changes in the conditional probability of sexual and nonsexual victimization on days of any alcohol consumption compared with days of heavy and no alcohol consumption in a sample of college women. METHODS: We used the Timeline Followback calendar method to assess daily alcohol consumption and concurrent daily incidents of sexual and nonsexual aggression over a 6-week period. RESULTS: The odds of experiencing sexual aggression were 9 times higher on heavy days and 3 times higher on nonheavy days of alcohol consumption compared with days of no alcohol consumption. The odds of experiencing nonsexual aggression were more than 7 times higher on heavy days and nearly 3 times higher on nonheavy days of alcohol consumption compared with days of no alcohol consumption. CONCLUSIONS: These findings provide evidence of a temporal association between college women's alcohol consumption and increased risk for victimization. In addition, use of the TLFB appears to be a reasonable and cost effective means for collecting daily data on alcohol consumption and victimization experiences among college women.

Adult↗

PubMed2003

An examination of indirect risk of exposure to HIV among wives of substance-abusing men.

The purpose of the present investigation was to explore risk and preventive behaviors for potential HIV exposure among 362 married drug-abusing men entering outpatient treatment and their wives. During the year before entering treatment, 144 husbands (40%) reported they had engaged in sexual or drug use behaviors that placed them at high risk for HIV exposure. Nearly all of the wives of these husbands (n=138, 96%) reported they had sexual intercourse with their spouses during this same time period. Among these sexually active couples, 108 of the wives (78%) reported that condoms were not regularly used when they had intercourse with their spouses, thus placing them at high risk for indirect exposure to HIV. Seventy-seven (71%) of these 108 wives reported they were not aware their husbands had engaged in high risk behaviors and thus were unknowingly placed at high risk for indirect exposure to HIV. Among those couples with husbands who had engaged in a high risk behavior, longer marriages, a diagnosis of antisocial personality disorder for husbands, and wives' lack of knowledge of husbands' high risk behaviors were uniquely associated with an increased likelihood of wives being placed at high risk for indirect exposure to HIV.

Adult↗

PubMed2003

Intimate partner violence and substance use: a longitudinal day-to-day examination.

The likelihood of male-to-female physical aggression on days of male partners' substance use, during a 15-month period, was examined. Participants were from married or cohabiting partner violent men entering a drug abuse treatment program (N=149). Compared to days of no drug or alcohol use, the likelihood of male-to-female physical aggression was significantly higher on days of substance use, after controlling for male partners' antisocial personality (ASP) disorder and couples' global relationship distress. Of the psychoactive substances examined, the use of alcohol and cocaine was associated with significant increases in the daily likelihood of male-to-female physical aggression; cannabis and opiates were not significantly associated with an increased likelihood of male partner violence.

Adult↗

PubMed2003

Concurrent validity of a brief self-report Drug Use Frequency measure.

This study examined two sources of concurrent validity information for a brief Drug Use Frequency (DUF) measure--the well-validated Timeline Followback (TLFB) measure and knowledgeable collateral informants (i.e., spouses)--for 106 male alcoholic patients and their female partners (treatment sample couples) and for 130 male and female participants without current alcohol/drug problems (community sample couples). Results showed generally good concurrent validity of self-reported frequency of illicit drug use on the DUF. Treatment sample results showed high correlations (a) between patient self-reported frequency of drug use on the DUF and on the TLFB for all drug types and (b) between self- and collateral reports on the DUF for male patients and their female partners for the most commonly abused drugs (cannabis, cocaine, and heroin). Community sample results showed (a) high correlations between self- and collateral reports on the DUF for male and female participants for frequency of cannabis and cocaine use and (b) average percent agreement of 99% for all drug types on whether or not male and female participants had used each drug.

Adult↗

PubMed2003

Predictors of the psychosocial adjustment of children living in households of parents in which fathers abuse drugs: the effects of postnatal parental exposure.

The purpose of this study was to examine the relationship between the psychosocial adjustment of children living in households of parents (N=112) in which fathers were entering treatment for substance abuse and the following sets of variables: (a) parents' sociodemographic characteristics, (b) parents' dyadic adjustment, (c) fathers' substance use severity, and (d) parents' psychological adjustment. Mothers did not meet current criteria for a psychoactive substance use disorder on alcohol or other drugs; moreover, based on reports by parents, none of the children was not exposed prenatally to illicit drugs. Results of hierarchical-by-blocks regression analyses revealed that each of the variable sets made a significant unique contribution to the prediction of children's psychosocial adjustment. Furthermore, the following variables within the sets were also found to be significant: (a) parents' age, (b) weekly family income, (c) frequency of male-to-female physical aggression between the parents, (d) frequency of fathers' substance use during the previous year, (e) diagnosis of antisocial personality disorder of fathers, and (f) mothers' level of psychological distress.

Adaptation, Psychological↗

PubMed2003

Domestic violence treatment referrals for men seeking alcohol treatment.

The annual prevalence of intimate partner violence (IPV) in samples of men seeking alcohol treatment has been estimated at 50% or higher. One proposed approach to these co-occurring problems is the provision of IPV screening and treatment referrals within alcohol treatment programs. The current study found that alcohol treatment providers infrequently referred men with a pretreatment year history of IPV to domestic violence treatment programs, and that men receiving such referrals rarely followed the recommendation and sought additional treatment. These findings suggest future research is necessary to identify factors that may act as barriers to IPV assessment or referral in alcohol treatment settings, factors that may limit client follow-through on such referrals, and new strategies for addressing IPV in substance abusing populations.

Adult↗

PubMed2003

The occurrence of partner physical aggression on days of alcohol consumption: a longitudinal diary study.

The likelihood of partner physical aggression on days of male partners' alcohol consumption, during a 5-month period, was examined for men entering a domestic violence treatment program (n = 137) and domestically violent men entering an alcoholism treatment program (n = 135). For men entering the domestic violence treatment program (alcoholism treatment program odds in parentheses), the odds of any male-to-female physical aggression were more than 8 times (11 times) higher on days when men drank than on days of no alcohol consumption. The odds of severe male-to-female physical aggression were more than 11 times (11 times) higher on days of men's drinking than on days of no drinking. These findings support the proximal effect model of alcohol use and partner violence.

Aggression↗

PubMed2003

Partner violence before and after individually based alcoholism treatment for male alcoholic patients.

This study examined partner violence in the year before and the year after individually based, outpatient alcoholism treatment for 301 married or cohabiting male alcoholic patients and used a demographically matched nonalcoholic comparison sample. In the year before treatment, 56% of the alcoholic patients had been violent toward their female partner, 4 times the rate of 14% in the comparison sample. In the year after treatment, violence decreased significantly to 25% of the alcoholic sample but remained higher than in the comparison group. Among remitted alcoholics after treatment, violence prevalence of 15% was nearly identical to the comparison sample and half the rate among relapsed patients (32%). Thus, partner violence decreased after alcoholism treatment, and clinically significant violence reductions occurred for patients whose alcoholism was remitted after treatment.

Adult↗

PubMed2003

The neuropsychological test performance of drug-abusing patients: an examination of latent cognitive abilities and associated risk factors.

The purpose of this study was to examine the latent structure of neuropsychological abilities of drug-abusing patients. Four factors were identified in an exploratory factor analysis (N = 329) and a subsequent confirmatory factor analysis (N = 258): Executive Functioning, Verbal Ability, Memory, and Speed, Education, years of regular alcohol use, number of substance use dependence disorders, percentage of days of heavy drinking in the previous year, depression, familial alcoholism, premorbid level of cognitive functioning, liver functioning, and previous head injuries were identified as risk factors to these latent abilities.

Adult↗

PubMed2003

Behavioral family counseling and naltrexone for male opioid-dependent patients.

Men (N = 124) entering treatment for opioid dependence who were living with a family member were randomly assigned to one of two 24-week treatments: (a) behavioral family counseling (BFC) plus individual treatment (patients had both individual and family sessions and took naltrexone daily in presence of family member) or (b) individual-based treatment only (IBT; patients were given naltrexone and were asked in counseling sessions about their compliance, but there was no family involvement). BFC patients, compared with their IBT counterparts, ingested more doses of naltrexone, attended more scheduled treatment sessions, had more days abstinent from opioids and other drugs during treatment and during the year after treatment, and had fewer drug-related, legal, and family problems at 1-year follow-up.

Adult↗

PubMed2003

Intimate partner violence and drinking: new research on methodological issues, stability and change, and treatment.

This article represents the proceedings of a symposium at the 2002 RSA meeting in San Francisco, California. The presentations were (1) Assessing couples' agreement about alcohol involvement in intimate partner violence, by John Schafer; (2) The occurrence of partner physical aggression on days of alcohol consumption: a longitudinal diary study, by Williams Fals-Stewart; (3) The 5-year stability of intimate partner violence and drinking among White, Black, and Hispanic couples, by Raul Caetano; (4) Partner violence before and after individually-based alcoholism treatment for male alcoholic patients, by Timothy O'Farrell. The discussant was Brenda Miller.

Aggression↗

PubMed2003

Alcohol abuse.

We reviewed 38 controlled studies of marital and family therapy (MFT) in alcoholism treatment. We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, (a) Al-Anon facilitation and referral help family members cope better; (b) Community Reinforcement and Family Training promotes treatment entry; and (c) the popular Johnson intervention apparently does not effectively promote treatment entry. Once the alcoholic enters treatment. MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. BCT also reduces social costs, domestic violence, and emotional problems of the couple's children. Future studies need to specifically evaluate: MFT with women and with minority patients, mechanisms and processes of change, and transportability of evidence-based MFT approaches to clinical practice settings.

Adaptation, Psychological↗

PubMed2003

Factors associated with partner violence among female alcoholic patients and their male partners.

OBJECTIVE: This study described the extent of partner violence victimization and perpetration among married or cohabiting female alcoholic patients and the factors associated with it. METHOD: Male-to-female and female-to-male physical partner violence were examined for 103 female alcoholic patients seeking couples-based outpatient alcoholism treatment. Partner violent (PV) and nonpartner violent (NPV) groups were compared on hypothesized risk factors. RESULTS: In the year before treatment, about two thirds of the women were victimized by their male partners, and a similar proportion engaged in violence toward their male partners. Severe violence also was high, with 22% victimization and 50% perpetration prevalence. Women committed more violent acts overall and were more likely to commit severely violent acts than the men in these couples. Risk factors for PV in both the victimization and perpetration models were as predicted: less education, lower income, greater relationship problems, stronger beliefs in the link between relationship problems and the female patient's drinking, greater cocaine use by the perpetrator of violence and greater emotional distress of the men. Greater alcohol and drug use and more severe alcohol problems also distinguished male perpetrators from their nonviolent counterparts in the female victimization model. Predictions that female patients in the PV group would report greater substance use and problems, childhood violence exposure and emotional distress than their female counterparts in the NPV group were not supported for either victimization or perpetration models. CONCLUSIONS: Partner violence is a serious problem for women in alcoholism treatment. More research is needed to increase understanding of risk factors and explanatory models for such violence.

Adult↗

PubMed2002

Behavioral couples and family therapy for substance abusers.

Behavioral couples therapy (BCT) sees the substance-abusing patient with the spouse to arrange a daily "sobriety contract" in which the patient states his or her intent not to drink or use drugs, and the spouse expresses support for the patient's efforts to stay abstinent. For patients taking a recovery-related medication (eg, disulfiram, naltrexone), daily medication ingestion witnessed and verbally reinforced by the spouse also is part of the contract. Behavioral couples therapy also teaches communication and increases positive activities. Findings of the past few years have added considerably to the evidence base showing that BCT produces greater abstinence and better relationship functioning than typical individual-based treatment; BCT also reduces social costs and domestic violence. Noteworthy recent advances have extended the positive effects of BCT to women drug abusers, showed the indirect benefits of BCT for the couple's children, expanded BCT to include family members other than spouses, integrated BCT with pharmacotherapy, and started to address barriers to technology transfer.

Behavior Therapy↗

PubMed2002

Behavioral couples therapy for drug-abusing patients: effects on partner violence.

Using data from a previous investigation, the purpose of the present study was to examine the effect of Behavioral Couples Therapy (BCT) on the prevalence of partner violence among married or cohabiting substance-abusing men (N = 80). Participants were randomly assigned to receive either BCT or individual-based treatment (IBT). The proportion of couples who engaged in male-to-female physical aggression was not different during the year before treatment for dyads in BCT (n = 17, 43%) and IBT (n = 19, 48%). However, a smaller proportion of couples in the BCT condition reported male-to-female physical aggression during the year after treatment (n = 7, 18%) than those in the IBT condition (n = 17, 43%). Dyadic adjustment, frequency of heavy drinking, and frequency of drug use during the year after treatment mediated the relationship between type of treatment and the prevalence of male-to-female physical aggression.

Adult↗

PubMed2002

Behavioral couples therapy for female substance-abusing patients: effects on substance use and relationship adjustment.

Married or cohabiting female drug-abusing patients (N = 75) were randomly assigned to either a behavioral couples therapy condition (BCT; n = 37), which consisted of group, individual, and behavioral couples therapy sessions, or to an equally intensive individual-based treatment condition (IBT; n = 38), which consisted of group and individual counseling. During most of the 1-year follow-up, compared with participants who received IBT, those who received BCT reported (a) fewer days of substance use, (b) longer periods of continuous abstinence, (c) lower levels of alcohol, drug, and family problems, and (d) higher relationship satisfaction. However, differences in relationship satisfaction and number of days of substance use dissipated over the course of the posttreatment follow-up period and were not significantly different by the end of 1 year.

Adult↗

PubMed2002

Couples- versus individual-based therapy for alcohol and drug abuse: effects on children's psychosocial functioning.

The study compared the effect of couples-based versus individual-based therapy for men who entered outpatient substance abuse treatment on the psychosocial functioning of children in their homes. Men were randomly assigned to (a) behavioral couples therapy (BCT), (b) individual-based treatment (IBT), or (c) couples-based psychoeducational attention control treatment (PACT). For both children of alcohol--(N = 71) and drug-abusing men (N = 64), parents' ratings of children's psychosocial functioning was higher for children whose fathers participated in BCT at posttreatment and at 6- and 12-month follow-up than for children whose fathers participated in IBT or PACT. BCT resulted in greater improvements in parents' dyadic adjustment and fathers' substance use. Thus, couples-based intervention that addresses both issues may have greater benefits for children in these homes.

Adult↗