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PubMed2005

Risk profile of individuals who provide assistance with illicit drug injections.

BACKGROUND: Assisted injection is a common practice among injection drug users (IDU) that carries significant risk for health-related harm. However, little is known about the individuals who provide assistance with injections. METHODS: We evaluated factors associated with providing help injecting among participants enrolled in the Vancouver Injection Drug User Study (VIDUS) using univariate and logistic regression analyses. We also examined self-reported relationships between the provider and the receiver of assisted injection, if compensation was provided for assistance, and what type of compensation was given. RESULTS: Of the 704 IDU eligible for this analysis, 193 (27.4%) had provided help injecting during the last 6 months. Variables independently associated with providing help injecting included: lending one's own syringe (adjusted odds ratio [AOR] = 3.99, p = 0.004); frequent heroin injection (AOR = 3.75, p < 0.001); unstable housing (AOR = 2.15, p < 0.001); binge drug use (AOR = 2.01, p = 0.012); frequent cocaine injection (AOR = 1.95, p = 0.002); and frequent use of crack cocaine (AOR = 1.85, p = 0.002). Help was most often provided to a casual (47.2%) or a close friend (41.5%). Of the 96 (49.7%) individuals who received compensation for providing help, the most common forms of compensation were drugs (89.6%) and money (45.8%). CONCLUSION: Providing help injecting was common among IDU in this cohort and was associated with various high-risk behaviours, including elevated levels of syringe lending. These findings indicate the need for interventions that offset the risks associated with this dangerous practice.

Adult↗
PubMed2005

Community actions against alcohol drinking in Slovenia--a Delphi study.

AIM: To define the national strategy and public actions to reduce alcohol related harm, based on societal consensus. BACKGROUND: Alcohol abuse is an avoidable behaviour that can threaten health. In Slovenia, only a few public campaigns against drinking alcohol are under way. It is important to establish which community measures are acceptable to society in Slovenia in order to reduce alcohol-related risks. METHODS: A Delphi study with 45 professionals from different disciplines was conducted. Participants offered many suggestions to improve the current situation. After three rounds of questionnaires, 86 participant statements were accepted as a consensus. RESULTS: Actions such as: state monopolies, alcohol taxation, legislative restrictions on availability and purchase of alcohol, age-related restriction on sales, drink-driving laws, school-based alcohol education and media information campaigns are most likely to be achieved by consensus. The main target populations for implementation of alcohol-related educational programs are children, young people and employees. CONCLUSIONS: As a result of the study, a number of community actions against drinking alcohol that could be acceptable for society can now be suggested. They vary across different target populations, change agents (individuals, organizations and institutions) and methods of implementation.

Adolescent↗
PubMed2006

Social phobia, fear of negative evaluation and harm avoidance.

This naturalistic, prospective investigation examined the role of fear of negative evaluation and the personality trait of harm avoidance in the anxiety levels of treated social phobia patients. One hundred and fifty-seven patients with DSM-IV social phobia were assessed before starting treatment and were then followed for up to two years. As expected, greater fear of negative evaluation and higher scores of harm avoidance were associated with greater anxiety at the 6 month follow-up, and harm avoidance remained a significant predictor at 24 months. However, no evidence was found for an interaction between the personality and cognitive variables examined. The findings are discussed in terms of the relative independence of these factors, as well as their potential implications for the treatment of this disorder.

Adult↗
PubMed2005

Temperament, character and symptoms of anxiety and depression in the general population.

Few studies have investigated the relationship of temperament and character, as conceptualized in the Temperament and Character Inventory-Revised (TCI-R), to symptoms of depression and anxiety in the general population. In this study a random sample of subjects (20 to 70 years), in two Finnish cities, were surveyed with the TCI-R, Beck Depression and Anxiety Inventories, plus questions related to diagnosed lifetime mental disorders, health care use for psychiatric reasons during the past 12 months, and history of mental disorders in first-degree relatives. Altogether 347 subjects (38.6%) responded. Of the TCI-R dimensions, Harm Avoidance correlated with symptoms of depression (r(s)=0.555, p<0.001), anxiety (r(s)=0.560, p<0.001), self-reported lifetime mental disorder (r(s)=0.272, p<0.001), health care use for psychiatric reason during the past 12 months (r(s)=0.241, p<0.001) and family history of mental disorder (r(s)=0.202, p<0.001). Self-directedness correlated negatively with symptoms of depression (r(s)=-0.495, p<0.001), anxiety (r(s)=-0.458, p<0.001), lifetime mental disorder (r(s)=0.225, p<0.001) and health care use (r(s)=-0.135, p=0.013). Overall, Harm Avoidance and Self-directedness seem to associate moderately with depressive and anxiety symptoms, and somewhat predict self-reported use of health services for psychiatric reasons, and lifetime mental disorder. High harm avoidance may associate with a family history of mental disorder.

Adult↗
PubMed2005

The theoretical underpinnings of affective temperaments: implications for evolutionary foundations of bipolar disorder and human nature.

We sketch out putative evolutionary roles for affective temperaments within the theoretical framework of mood disorders conceptualized as extremes in an oligogenic model of inheritance, whereby the constituent traits in their dilute phenotypes confer adaptive advantages to individuals and/or their social group. Depressive traits, among other functions, would subserve sensitivity to the suffering of other members of the species, overlapping with those of the generalized anxious temperament, thereby enhancing the survival of not only kin but also other conspecifics. The pursuit of romantic opportunities in cyclothymia suggests that it may have evolved as a mechanism in reproductive success; cyclothymics' creative bent in poetry, music, painting, cooking or fashion design (among men, in particular) also appears useful for sexual seduction. Hyperthymic traits would lend distinct advantages in leadership, exploration, territoriality and mating. These are just some of the possibilities of the rich and complex temperamental traits subserving bipolarity within an evolutionary framework. We test selected aspects of these hypotheses with the use of correlations between the constituent traits of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS) and correlations between the TEMPS and the Temperament and Character Inventory (TCI). Such data support the counterbalancing protective influence of harm avoidance on the risk-taking behavior of cyclothymic individuals, in both men and women. Finally, we outline a hypothesis on the evolutionary function of anxious-depressive traits for women.

Affective Symptoms↗
PubMed2005

Personality of seasonal affective disorder analyzed by Tri-dimensional Personality Questionnaire.

BACKGROUND: Although there have been numerous reports in personality of mood disorders, there have been few reports in regard with personality of winter seasonal affective disorder (SAD). Furthermore, no reports have been published concerning summer SAD personality characteristics. Thus, this study was conducted to assess the personality of winter and summer SAD using Tri-dimensional Personality Questionnaire (TPQ) that have been used in a variety of mental disorders. METHODS: A total of 6135 Japanese were evaluated with TPQ, the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Self-rating Depression Scale (SDS). Winter, summer and non-SAD groups were classified by SPAQ. We compared the difference of personality trait among these three groups in consideration of gender, age and SDS score influence. RESULTS: Winter SAD demonstrated higher "Novelty Seeking" and "Harm Avoidance"; summer SAD showed higher "Harm Avoidance" than the non-SAD group. "Harm Avoidance" in both SAD groups was re-analyzed using SDS score as a covariate, and "Novelty Seeking" in winter SAD using age as a covariate. As a result, the significance of high "Novelty Seeking" and high "Harm Avoidance" in winter SAD was excluded. However, "Harm Avoidance" remained the significant difference between summer and non-SAD. LIMITATION: SAD was diagnosed only by SPAQ and not by interview. The state-dependency of "Harm Avoidance" was not confirmed in identical patients over lapse of time. CONCLUSION: Patients with winter SAD have high "Harm Avoidance" dependent on the depressive state that is in accordance with non-seasonal depression. Patients with summer SAD have high "Harm Avoidance" possibly independent from the depressive state.

Adolescent↗
PubMed2006

Self-defense injuries in homicidal deaths.

In order to determine specific patterns and distribution of defense wounds, this study was done on 162 homicidal deaths which showed defense wounds in 54 (33.3%) cases. Of these 54 victims, 85.2% were males and 14.8% were females. Maximum numbers of victims were in the age group of 21-40 years. In 68.5% of cases more than one assailant were involved. It was found that in 57.4% cases, sharp weapons were used, whereas, in 11.1% and 31.5% of victims, blunt weapons and multiple weapons, respectively, were used. Fatal wounds were seen most commonly on the head and neck region. In 40.7% of cases defense wounds were seen on left side only whereas in 37% cases both sides were involved. Victim's left forearm and hand were more commonly involved because these are nearest to the perpetrator and consistent with the preponderance of right handed individuals in the population.

Adult↗
PubMed2026

"It was good because they have a relationship with us": A qualitative study on low-threshold buprenorphine treatment at syringe services programs.

INTRODUCTION: Syringe service programs (SSPs) reach people who inject drugs with opioid use disorder (OUD) and are novel "low-threshold" venues to initiate buprenorphine treatment. The study investigated patients' experiences with SSP-initiated buprenorphine treatment, which could aid in improving buprenorphine treatment delivery at SSPs. METHODS: The study included 12 participants who completed qualitative exit interviews after a randomized controlled trial of buprenorphine treatment at SSPs. In the parent study, participants received buprenorphine treatment through an onsite model at an SSP or enhanced referral to a community health center based on the randomization sequence. Most participants started taking buprenorphine at home. Exit interviews included participants from both study arms, and the semi-structured interview guide focused on their experiences with clinicians, experiences initiating buprenorphine, prior experiences with OUD treatment, and perceptions about continuing buprenorphine treatment. Four researchers iteratively read, coded, and discussed each transcript, then they derived recurring themes using thematic analysis. RESULTS: Participants were mostly male, middle-aged, and 50% identified as Latino. Four main themes related to buprenorphine treatment initiation: 1) Onsite treatment facilitated buprenorphine prescription, but some participants also expressed a need for additional support; 2) Precipitated withdrawal complicated participants' buprenorphine initiation in both arms; 3) Participants largely experienced the SSPs as affirming and welcoming; and 4) Developing strong relationships with healthcare providers was critical to successful buprenorphine treatment initiation. CONCLUSIONS: The SSP-based model provided rapid access to buprenorphine prescriptions, but precipitated withdrawal was a common complication. Some participants desired additional support and guidance when they started taking buprenorphine at home. The findings point to a "low-threshold, high-touch" approach where participants receive expedited access to buprenorphine providers at SSPs but also additional support throughout the initiation process to avoid and/or manage precipitated withdrawal. Despite some challenges, SSP-based buprenorphine treatment was highly valued by study participants.

Humans↗
PubMed2006

The implementation of a harm minimisation model for the identification and treatment of over-the-counter drug misuse and abuse in community pharmacies in Northern Ireland.

OBJECTIVE: This study tested an intervention model which sought to minimise over-the-counter (OTC) drug misuse and abuse in community pharmacies. METHOD: Pharmacists in six community pharmacies in the Greater Belfast area volunteered to participate in the study. The intervention model consisted of client identification and recruitment, treatment and referrals, and finally follow-up data collection and outcome measurements. All pharmacists participated in semi-structured interviews to explore their views and experiences of the study. RESULTS: Pharmacists identified 196 cases of suspected abuse/misuse. Pharmacists approached 70 of the identified clients during the six-month study; some clients agreed to stop using the product of abuse/misuse, used an alternative, or had been switched to a maintenance prescription under general practitioner (GP) supervision. No client proceeded to completion of the follow-up phase (e.g. health-related quality of life). Analysis of the interviews revealed that pharmacists had encountered some difficulties in approaching potential clients, but had used skills gained in the study in other aspects of their practice. CONCLUSIONS: Some difficulties were encountered in implementing the harm minimisation model, but these may be alleviated by further training and greater collaborative working. PRACTICE IMPLICATIONS: Notwithstanding the challenges faced in the study, this approach to harm minimisation should be considered for wider implementation in community pharmacy.

Adult↗
PubMed2006

Relations of serotonin function to personality: current views and a key methodological issue.

Studies of biological underpinnings of personality suggest that serotonergic functioning relates to certain personality traits. However, how to interpret the findings depends partly on assumptions about how personality is organized. These assumptions are reflected in the assessment devices used and also in how the data are examined. Review of evidence to date appears to link serotonin function to impulsivity and, to some extent, to hostility. The relation of serotonin function to anxiety proneness is far more questionable. Indeed, when such a relation occurs, it often takes a form opposite to the direction argued by theory. It is recommended that research use measures that discriminate adequately among personality qualities reflecting incentive sensitivity, threat sensitivity, and impulsiveness. Indeed, it is highly desirable to examine facets of each of these qualities separately.

Anxiety↗
PubMed2002

Comparison of the effects of fluoxetine, imipramine and placebo on personality in atypical depression.

BACKGROUND: Atypical depression is associated with elevated rates of personality disorders. Studies have confirmed the efficacy of a several antidepressants in the treatment of atypical depression. Whether their pathological dimensions of personality diminish after benefitting from effective medication treatment is unclear. AIMS: To determine the extent that pathological dimensions of character improved among patients who benefitted from treatment. METHOD: One-hundred and fifty-four outpatients with DSM-IV Major Depression who met Columbia criteria for atypical depression were randomized to receive fluoxetine, imipramine or placebo for a 10-week double-blind clinical trial. The Temperament and Character Inventory (TCI) was administered at the initiation of treatment and 8 weeks later. Low scores on either of two Character dimensions (Self-Directiveness or Cooperativeness) indicate psychopathology. RESULTS: Responders had a substantial reduction in Harm Avoidance, but post-treatment scores remained significantly higher than the normal control group (NCG). Fluoxetine and Imipramine did not produce different changes on personality, except for Self-Transcendence. LIMITATIONS: High proportion of missing data, inadequate sample size, post-hoc analysis. CONCLUSIONS: Among responders, Self-Directiveness improved and normalized; Harm Avoidance also improved but did not normalize. These data suggests that effective treatments reduce some pathological personality traits as well as improving mood.

Adolescent↗
PubMed2005

The relationship of Kraepelian affective temperaments (as measured by TEMPS-I) to the tridimensional personality questionnaire (TPQ).

BACKGROUND: There is considerable uncertainty in the current literature about the relationship between personality dimensions and affective temperaments. METHOD: We compared-in a non-ill 14-26-year-old Italian student population of 1010-the affective temperaments of classic psychiatry conceived as subaffective traits [and measured through the Temperament Assessment of Memphis, Pisa, Paris and San Diego-Interview Version (TEMPS-I) in the Akiskal and Mallya Operationalization] with Cloninger's revised Tridimensional Personality Questionnaire (TPQ) deriving from the experimental psychology tradition. RESULTS: The Depressive Temperament (DT) and Harm Avoidance (HA), loaded positively on the same canonical variate, whereas the hyperthymic (HT) strongly, and Novelty Seeking (NS) moderately, loaded negatively. In contrast, the Cyclothymic Temperament (CT) loaded highly positively on a second variate, on which both Novelty Seeking strongly and Harm Avoidance moderately loaded positively. Reward Dependence (RD), Persistence (P), and Irritable Temperament (IT) did not significantly relate to any temperamental and personality constructs. At a subdimensional level of TPQ 'shyness with strangers', 'stoic rigidity', 'detachment', 'fear of uncertainty', 'reflection', and 'anticipatory worry' correlated best with the DT. 'Gregariousness', 'exploratory excitability', 'uninhibited optimism', 'attachment', 'confidence', 'extravagance', 'independence', 'vigor', and 'impulsiveness' correlated best with HT. Lastly, 'anticipatory worry', 'disorderliness', 'sentimentality', and 'fatigability' correlated best with CT. CONCLUSIONS: The data provide concurrent validity to TEMPS-I and, as earlier suggested by Cloninger, indicate that (as expected) high HA and DT are related. High NS is both related to the HT and CT, and (somewhat unexpectedly), the CT is related to high HA. In a more theoretical vein, hyperthymic-novelty seeker can be predicted to be overrepresented among those with high achievement; on the other hand, a moody, restless disposition (a cyclothymic-harm avoidant type) may engage in outrageous behavior and be liable to negative affective arousal. We submit that these considerations could shed some light on the origin of socially adaptive behavior ('sunny' or sanguine types) on the one hand, and borderline conditions, anxious-hostile bipolarity ('dark' types) on the other.

Adolescent↗
PubMedDate not supplied

[Injecting drug users from Eastern Europe in Barcelona, Spain].

From May 1999 to May 2001, we made contact with injecting drug users from Eastern Europe in the healthcare and prevention service of the Red Cross (servicio de atención y prevención sociosanitaria [SAPS]) in Barcelona (Spain). The users attended free therapeutic centers, but paid approximately 500 e for the trip. The users were aged between 18 and 30 years old and maintained family contact. The knew the risk of disease transmission, but often exchanged needles. The prevalence of hepatitis C (92%) and B (62%) was high but less than that of HIV (19%). If they did not stop taking drugs their return would be a failure and they would have difficulties in following methadone and antiretroviral treatments in their countries of origin. The healthcare provided in these centers should respond to user' needs: cultural mediation should be sought, as well as information from users' countries of origin. Centers receiving users from other countries should be supervised and alternatives should be designed for users who abandon treatment. International cooperation and programs to reduce the risk of drug consumption should be developed. Treatment should be prevented from becoming a business.

Adolescent↗
PubMedDate not supplied

Volition and alcohol-risk reduction: the role of action orientation in the reduction of alcohol-related harm among college student drinkers.

The present study examined the role of action orientation in health behavior change. Eighty-six binge drinking college students completed measures of alcohol use, alcohol-related consequences (e.g., driving drunk), motivation to change drinking, and action orientation. Alcohol use and consequences were reassessed 1 month later. Results showed that, although there was no significant change in alcohol quantity per occasion, students reported a significant decline in alcohol-related problems over time. Hierarchical regression analyses were conducted to examine whether action orientation was associated with changes in alcohol involvement. Controlling for alcohol problems and motivation to change at Time 1, those with higher dispositional action orientation showed fewer alcohol-related consequences at Time 2. These results suggest that those who are low in action orientation may have more difficulty enacting intentions to modify harmful health behaviors. The findings underscore the importance of volitional skills in interventions to promote change in health behavior.

Adolescent↗
PubMed2006

HIV seroprevalence among drug users: an analysis of selected variables based on 10 years of data collection in Porto Alegre, Brazil.

Data from five studies were pooled to describe associations between drug use and HIV. The Risk Assessment. Battery in Porto Alegre, Brazil, was used to collect data from 1449 subjects in 5 separate studies conducted between 1995 and 2004. The subjects were divided into categories based on their pattern of drug use: (1) injection drug users (IDUs), (2) crack smokers, (3) frequent drug users, and (4) infrequent cocaine/alcohol/marijuana users. The sample consisted primarily of young males with low education and income levels. Half of the subjects reported frequent condom use, and exchanges involving drugs, sex, and money were infrequent (although more common in groups 1 and 2). The overall seroprevalence was 20.6%, and the prevalence was different across the four groups, showing a linear decrease from group 1 (57.1%) to group 4 (11.7%). The IDU and crack-smoking groups showed similarities in their risk levels when compared with the other two groups, and individuals in group 1, 2, and 3 were more likely to report having had four or more sex partners. After controlling for all other risk factors, IDU, males having sex with males, and crack use were highly associated with HIV (OR 7.30, 95% CI: 5.10.10.40; OR 3.04, 95%CI: 1.89,4.80; OR 2.03, 95%CI: 1.40, 2.92, respectively). The findings confirm that poverty, low education, and IDU remain risk factors for HIV in Porto Alegre, Brazil, and the study identities crack smoking as a new risk factor.

Adult↗
PubMed2003

Brain function and personality in normal males: a SPECT study using statistical parametric mapping.

Understanding the differences between individuals' personality types at a functional brain level is now possible due to recent developments in both functional brain imaging and personality models. The psychobiological model for temperament and character offers one approach to exploring personality. This study uses SPECT imaging to investigate brain function in relationship to the personality traits in the Temperament and Character Index. A general linear model approach was implemented at a voxel-by-voxel level, using quartile groupings for the personality predictors. t contrasts were used to investigate significant clusters of activation or deactivation. The results show a number of significant relationships between personality traits and regional cerebral blood flow, which show distinct nonlinear trends. All seven of the Cloninger personality traits were significantly related to regional cerebral blood flow. The results suggest that differences in brain function in some regions may reflect differences in personality traits.

Adult↗