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PubMed1986

[Apropos of projective tests conducted on substance-dependent clients].

This article presents the conclusions of a study which used projective tests--Rorschach and TAT--on a group of young drug addicts. Do the collected clinical findings as a whole suggest the existence, in these patients, of psychopathological structures or constellations which are specific to them? Following this initial question, the author presents a more detailed analysis of the protocols in a metapsychological perspective (fantasy life, internal conflictuality and defensive organization, approach of depression, hypotheses as to the function of the addictive behavior in the psychic economy of the subject, etc.). Finally some clinical and methodological reflections suggested by the compiled and interpreted data of this study are presented.

Adolescent↗
PubMed1986

[Dependence on gambling].

The indicated symptomatology of pathological gambling makes clear that a reduction of the problematic nature of addiction to substance dependence - alcohol, illegal drugs and medicaments - is not valid. Beside the consumption of substance, gambling as well can produce the desired effect, cause pleasant sensations or avoid aversion and addictive behavior can develop. Biological, psychological and sociological theories of pathological gambling are presented, each of which does not serve as a convincing frame of arguments. On the contrary considerations have to be based on an interaction between individual, gambling and social surrounding field to do justice to complex reality. As a matter of fact the actual state of research leaves many questions unanswered. A completion or alternative to the professional methods of treatment consists in the self-help groups which have been founded by dependent gamblers in many cities during the last few years.

Gambling↗
PubMedDate not supplied

Methadone maintenance: past, present, and future.

Since first developed by Dole and Nyswander, there have been significant changes in the clinical use of methadone, based on evaluation of the initial programs and a better understanding of the psychology and pharmacology of addictive behavior. Treatment has evolved from Dole's original concept that methadone "blockaded" the euphoric effect of heroin to current usage which reflects a greater appreciation of methadone's ability to prevent the development of withdrawal symptoms and to moderate intense affective states. The successes and limitations of methadone maintenance are best appreciated in comparison with alternative treatment modalities including therapeutic communities and detoxification. Program administrators face unique pressures because of the need to resolve the often contradictory goals of patients, staff, community groups, law enforcement officials, government regulators and funding agents. The evolution of effective treatment models has been greatly impaired by these pressures. Clinicians must become more effective leaders in helping to resolve these problems and to help formulate more rational drug abuse treatment policy.

Attitude↗
PubMed1977

[Psychosocial development of an opiate addict--a catamnestic study].

In the summer of 1974, 204 opiate users in West Berlin were extensively interviewed in regard to their present living conditions (housing situation, employment, social contacts, use of drugs, subjective complaints, vocational goals, political und ideological orientation), their family background (education of parents, occupation of parents, intactness of family, family atmosphere, type of child rearing methods used by the parents, other addicts in the family), and the development of the opiate addict himself (significant personal relationships in childhood and adolescence, psychosocial disturbances prior to use of drugs, addictive behavior prior to use of drugs, educational and vocational background). The results of this catamnestic study were presented and discussed.

Adolescent↗
PubMed1995

Monoamines and nitric oxide are employed by afferents engaged in midline thalamic regulation.

The neurochemical identities of afferents to the midline thalamus were investigated in chloral hydrate-anesthetized adult Sprague-Dawley rats. The retrograde tracers, FluoroGold or cholera toxin B subunit, were centered on the paraventricular thalamic nucleus (n.Pvt), a periventricular member of the diffuse thalamocortical projection system that is reciprocally linked with visceral areas of cerebral cortex and implicated in food intake and addictive behavior. Tissues were processed with antisera raised against 5-HT, the catecholamine-synthesizing enzymes, tyrosine hydroxylase or phenylethanolamine N-methyltransferase or the cholinergic anabolic enzyme, ChAT. Serotonergic afferents principally derive from dorsal and median constituents of the mesopontine raphé. Previously unrecognized sources of catecholaminergic afferents were detected. Adrenergic afferents were traced to neurons in the C1 and C3 areas of rostral medullary reticular formation and periventricular gray, respectively, and the C2 area corresponding to the dorsal general viscerosensory field of nucleus tractus solitarii. Noradrenergic afferents arise principally from neurons in the locus ceruleus and A5 area. Dopaminergic projections to the n.Pvt derive from the A14, A13 and A11 cell groups in diencephalon. Afferents presumed to generate nitric oxide (NO) as a diffusible membrane-permeant transcellular signal were detected by processing retrogradely labeled tissues histochemically for NADPH-diaphorase, a molecule associated with nitric oxide synthase. NO in the n.Pvt is generated predominantly by noncholinergic neurons in the lateral hypothalamic area and mesopontine tegmentum. In striking contrast, extensive interactions were predicted between NO and ACh in the central medial and other loci in the nondiscriminative thalamus. We conclude that the n.Pvt is a site of interaction of NO and monoaminergic afferents derived from nuclei implicated in sensory gating, regulation of electrocortical neural activity and behavior. Taken collectively, our data predict that the labile transcellular messenger NO may enable structurally differentiated subnuclei of the diffuse thalamocortical projection system to act in concert as a functionally unified unit.

Adrenergic Fibers↗
PubMedDate not supplied

Road to recovery. Post-traumatic stress disorder: the hidden victim.

1. Post-traumatic stress disorder (PTSD) is characterized by the development of a set of specific symptoms following a psychologically distressing event that is outside the range of usual human experience. 2. Recovery does not seem to feel as difficult or overwhelming if it is approached "one day at a time." 3. The psychologic damage that occurs in PTSD is due primarily to holding the experiences inside, "stuffing" them down through various psychodynamics, or keeping the experiences subdued through addictive behaviors. 4. PTSD among Vietnam veterans is not a mental illness; it is a reaction to extreme stress and a reaction to keeping memories stuffed down and not allowed to surface.

Alcoholism↗
PubMedDate not supplied

The extent of cigarette brand and company switching: results from the Adult Use-of-Tobacco Survey.

To evaluate the effects of cigarette advertising on brand switching, an accurate estimate of the extent of cigarette brand and company switching among current smokers is needed. Data from the 1986 Adult Use-of-Tobacco Survey were analyzed to estimate the percentage of adult smokers who switched cigarette brands and companies in the previous year. Approximately 9.2% of adult smokers (4.2 million) switched cigarette brands in 1986, and 6.7% (3.1 million) switched cigarette companies. The aggregate profitability of brand switching in 1986 was approximately $362 million. Based on this analysis, brand switching alone justifies only a small percentage of a cigarette company's advertising and promotion expenditures, suggesting that future research should address other potential effects of advertising, including maintenance of brand loyalty and expanding the cigarette market. Medical Subject Headings (MeSH): addictive behavior, advertising, smoking, tobacco.

Adolescent↗
PubMed1996

Latent transition analysis for longitudinal data.

Assessing outcome is a critical problem for the study of addictive behaviors. Traditional approaches often lack power and sensitivity. Latent Transition Analysis is an alternative procedure that is applicable to categorical latent variable models such as stage models. The method involves four different types of parameters, each of which may be relevant to different research questions. Two examples that employ the Stages of Change construct are used to illustrate the method. In the first example, three different models of longitudinal change are compared. In the second example, the effects of an expert system intervention for smoking is compared to a control condition. The method permits the investigation of a series of specific comparisons: (1) the effectiveness of the intervention for individuals in different stages can be assessed; (2) the effectiveness of the intervention can be evaluated for different time intervals; and (3) the effects of intervention on both progression through the stages and regression through the stages or relapse can be assessed. Other potential applications of the method are also discussed.

Alcoholism↗
PubMed1997

Comparing Hatha yoga with dynamic group psychotherapy for enhancing methadone maintenance treatment: a randomized clinical trial.

BACKGROUND: As more methadone treatment programs are funded in an attempt to curb substance abuse and HIV infection among i.v. drug users, more cost effective treatment approaches are being sought. OBJECTIVES: To investigate whether clients in outpatient methadone maintenance treatment who practice weekly Hatha yoga in a group setting experience more favorable treatment outcomes than those who receive conventional group psychodynamic therapy. METHODS: After a 5-day assessment period, 61 patients were randomly assigned to methadone maintenance enhanced by traditional group psychotherapy (ie, conventional methadone treatment) or an alternative Hatha yoga therapy (ie, alternative methadone treatment). Patients were followed for 6 months and evaluated on a variety of psychological, sociological, and biological measures. The revised Symptom Check List provided the primary psychological measures; the Addiction Severity Index provided various indices of addictive behaviors. RESULTS: The evidence revealed that there were no meaningful differences between traditional psychodynamic group therapy and Hatha yoga presented in a group setting. Both treatments contributed to a treatment regimen that significantly reduced drug use and criminal activities. Psychopathology at admission was significantly related to program participation regardless of treatment group. DISCUSSION: In addition to examining the characteristics of patients who present for treatment, this study identifies unexpected staff issues that complicate the integration of alternative and traditional treatment strategies. CONCLUSION: Alternative methadone treatment is not more effective than conventional methadone treatment, as originally hypothesized. However, some patients may benefit more from alternative methadone treatment than conventional methadone treatment. Additional research is necessary to determine characteristics that identify patients who might benefit from alternative methadone treatment.

Adult↗
PubMed1997

Systemic morphine-induced Fos protein in the rat striatum and nucleus accumbens is regulated by mu opioid receptors in the substantia nigra and ventral tegmental area.

To characterize how systemic morphine induces Fos protein in dorsomedial striatum and nucleus accumbens (NAc), we examined the role of receptors in striatum, substantia nigra (SN), and ventral tegmental area (VTA). Morphine injected into medial SN or into VTA of awake rats induced Fos in neurons in ipsilateral dorsomedial striatum and NAc. Morphine injected into lateral SN induced Fos in dorsolateral striatum and globus pallidus. The morphine infusions produced contralateral turning that was most prominent after lateral SN injections. Intranigral injections of [D-Ala2, N-Me-Phe4, Gly-ol5]-enkephalin (DAMGO), a mu opioid receptor agonist, and of bicuculline, a GABAA receptor antagonist, induced Fos in ipsilateral striatum. Fos induction in dorsomedial striatum produced by systemic administration of morphine was blocked by (1) SN and VTA injections of the mu1 opioid antagonist naloxonazine and (2) striatal injections of either MK 801, an NMDA glutamate receptor antagonist, or SCH 23390, a D1 dopamine receptor antagonist. Fos induction in dorsomedial striatum and NAc after systemic administration of morphine seems to be mediated by dopamine neurons in medial SN and VTA that project to medial striatum and NAc, respectively. Systemic morphine is proposed to act on mu opioid receptors located on GABAergic interneurons in medial SN and VTA. Inhibition of these GABA interneurons disinhibits medial SN and VTA dopamine neurons, producing dopamine release in medial striatum and NAc. This activates D1 dopamine receptors and coupled with the coactivation of NMDA receptors possibly from cortical glutamate input induces Fos in striatal and NAc neurons. The modulation of target gene expression by Fos could influence addictive behavioral responses to opiates.

Afferent Pathways↗
PubMedDate not supplied

[Sensation seeking and anhedonia in risk taking. Study of a population of bungy jumpers].

This study presents the investigation of the relations between sensation seeking (41) and anhedonia in 80 subjects who practice a risk taking sport, bengy jump. These relations were examined according to different variables which characterize the practice of bengy jump: the total number of previous jumps and the motivations to jump (1. personal motivation, 2. professional motivation--working in the jumping organization, and 3. group motivation--for example being leaded to jump by friends). We also assessed the use of psychoactive substances. All jumpers (men and women) have higher scores than control subjects in Thrill and adventure seeking dimension. In men, the more the subjects score on this dimension, the less they score on the physical anhedonia scale (8). In women, Experience Seeking and Boredom Susceptibility dimensions are positively correlated with physical anhedonia and with the number of jumps. Moreover, women with personal motivation are those who score the highest on Thrill and Adventure Seeking and Boredom Susceptibility dimensions. These results suggest that in women, sensation seeking through bengy jumping may be linked to a boredom tendency and driven by a need to compensate for a difficulty in experiencing emotions and sensations from common and mundane stimuli. In men, high frequency of bengy jumping was negatively related to the use of psychoactive substances, suggesting that bengy jump, in a compulsive form recalling an addictive behavior, is a specific and preferential way of stimulation seeking.

Adolescent↗
PubMedDate not supplied

The consistency of types of criminal behavior over preaddiction, addiction, and nonaddiction status periods.

Using self-report information provided by 250 male admissions to methadone maintenance/detoxification clinics in Baltimore and New York City, separate criminal typologies were derived for prior periods of addiction and nonaddiction in the community. Although far more crime was committed during periods of addiction, comparison of the typologies indicated highly consistent individual patterns regarding the kinds of crime that were committed over periods of addiction and nonaddiction. The association between early deviant behavior and later criminal involvement over an addiction career was determined by relating preaddiction characteristics to both the addiction and nonaddiction typologies. It was found that crime patterns established before addiction, although intensified by addiction, tended to persist throughout the addiction career. Correspondence between the present typology results and those found in an earlier Baltimore sample of 354 addicts was high with respect to both the number and descriptive characteristics of the types derived. Implications of this research with regard to the early identification of the most criminally prone individuals are discussed.

Baltimore↗
PubMed1993

[Comments on the definition of so-called "new addictions"].

To apply the term "addiction" to non-substantial addiction-like behavior is both problematic and useful. It is problematic because the uncritical application of the term has led to an inflation of addictions. If everything is called addiction the term is losing its predicative power and is getting meaningless. In the field of non-substantial addicted behavior we have been given the chance to study the phenomenon addiction in "pure" form without disturbing influences of any substance. To apply the term "addiction" to non-substantial addicted behavior is possible in principle. Von Gebsattel 1954 and Giese 1962 have already referred to this. However, it requires well-defined criterias. A strictly composition of the term would be recommendable.

Behavior, Addictive↗
PubMed1976

Criminal behavior patterns of female addicts: a comparison of findings in two cities.

A great deal of the literature on addiction is devoted to analyses of the relation between drugs of addiction and crime among males. The few studies which have undertaken to describe the relationship between crime and addiction in females have generally concluded that addicted females either become prostitutes or they commit crimes against property. This study of addicted female arrestees in Denver (N = 153) and Philadelphia (N = 227) concluded that the hypothesized either-or pattern of addicted female criminal behavior is overly simplistic. Rather, four criminal behavior patterns of female arrestees are found: (1) prostitutes without a history of serious crimes, (2) females with a history of serious crimes who are not prostitutes, (3) females who are both prostitutes and commit serious crimes, and (4) females who are not prostitutes and who commit only minor offenses. The utility of the four-pattern typology is borne out by analyses which indicate that these patterns are typical of different groups of female addicts and are not stages in a unitary socialization pattern involving drugs, prostitution, and crime.

Adult↗
PubMed2001

Shattered childhood: a key issue in suicidal behavior among drug addicts?

AIMS: To assess the relative importance of various adverse childhood experiences for the occurrence of later suicidal behavior in terms of experienced suicide attempts and suicidal ideation among drug addicts, and to assess possible gender differences in these associations. DESIGN: Cross-sectional survey. SETTING: Residential and outpatient treatment units for drug addicts in Norway. PARTICIPANTS: National sample of 800 drug addicts admitted to treatment in 1992-93. MEASUREMENTS: Self-reports of attempted suicide (life-time prevalence) and suicidal ideation (1 month prior to admission). Data collected from structured interviews with therapists. FINDINGS: A total of 38.0% of the drug addicts reported having attempted suicide once or several times; the proportion was higher among those who reported various adverse experiences during childhood (sexual or violent assaults, bullying, parents' alcohol abuse, parents' psychiatric problems, school adjustment problems and own psychiatric problems), and increased with number of areas of such adverse childhood experiences. Forty-two per cent of the clients reported suicidal ideation in the month prior to admission, displaying the same kind of associations with adverse childhood experiences, and also a significant association when controlling for previous suicide attempts. There were relatively small gender differences in self-reported suicidal behavior, the proportion being somewhat higher among women, but only among those with no or few adverse childhood experiences. CONCLUSIONS: Self-reported suicidal behavior and ideation among drug addicts is highly prevalent and more so with increasing number of areas of childhood adversities.

Adult↗
PubMed2006

Enriched environment treatment counteracts enhanced addictive and depressive-like behavior induced by prenatal chronic stress.

Prenatal stress can cause many long-term behavior changes in offspring, but whether prenatal stress can alter addictive behavior in offspring and postnatal enriched environment treatment (EE) can restore these changes are unknown. We reported here that prenatal chronic stress (10 unpredictable, 1 s, 0.8 mA foot-shocks per day during gestational days 13-19) enhanced morphine-induced (10 mg/kg, s.c., per day, 6 consecutive days) place preference. Moreover, prenatal chronic stress caused higher depressive-like behavior in forced swimming test in adult offspring. However, enriched environment housing treatment on postnatal days 22-52 counteracted both the abnormal behaviors alterations. This work observed a phenomenon that might contribute to the understanding of clinically important interactions among addiction, prenatal stress and enriched environment treatment. Postnatal enriched environment treatment might be an important therapeutic intervention in preventing the prenatal stress-induced addictive disorders.

Analysis of Variance↗