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PubMed2005

[Suicidal behavior in adolescents--psychopathology and addictive comorbidity].

Despite of the decreasing suicide rates, the number of suicide attempts--peculiarly in the adolescent population--shows a growing tendency. Due to the small amount of study results the problem remains hard to assess. Child and Adolescent Self harm in Europe (CASE) study, allows us to explore self-reported suicidal behavior among adolescents more exactly. This European multicentre study has a special focus on adolescent suicidal behavior (suicidal thoughts, ideation, deliberate self harm, suicide attempt) and other self destructive behavior (drug, alcohol) as well as psychopathological symptoms (anxiety, depression, impulsivity, aggression) and it also investigates coping strategies, life events and family background. In the representative school-based community study an anonymous, self-reported questionnaire were conducted with 4408 (males: 2388, females: 2020) 15 and 16 year-old pupils. Out of the 4408 pupils 7.8% (males: 4.6%, females: 11.6%) of the adolescents reported former suicide attempt, 1.6% of the boys and 3.6% of the girls reported about more than one suicide attempts. According to the statistical analysis the suicidal group greatly differs from the non-suicidal one. Suicidal adolescents were more likely to use alcohol, drugs or nicotine than their non-suicidal peers. Drug abuse was four times more common among suicidal boys, and five times more common among suicidal girls than in the non-suicidal group. 30% of the boys and 13% of the girls used more than one kind of drug. The use of ecstasy and sedatohypnotic drugs showed the most spectacular difference between suicidal and non-suicidal teenagers in both genders. Suicide attempters usually had higher scores in scales measuring anxiety, depression, impulsivity, while their self-esteem was significantly lower. The comparative analysis has revealed that suicide attempters compose a subgroup with more severe psychopathology (anxiety, depression, and impulsivity), lower self-esteem and ineffective coping strategies. Suicidal behavior frequently appeared with addictive problems. The results of our study may help in recognizing the role of risk factors coexisting with suicidal behavior and thus making it easier for schools to have adequate and effective prevention programs.

Adolescent↗
PubMed2006

Depot naltrexone in lieu of incarceration: a behavioral analysis of coerced treatment for addicted offenders.

This article is part of a series of articles examining a proposal to offer depot naltrexone to certain nonviolent opiate-addicted criminal offenders in exchange for release from incarceration or diversion from prosecution. This "negative-reinforcement" behavioral paradigm could have a better chance of success than what has heretofore been attempted with drug-abusing offenders. Traditional correctional efforts have been largely unsuccessful due to the complexities of implementation and the side effects of punishment. Although positive reinforcement can be more efficacious, it has often been strenuously resisted on the ground that it is inequitable to reward antisocial individuals for doing what is minimally expected of most citizens. Negative reinforcement steers between these hurdles by avoiding the iatrogenic effects of punishment, while also being palatable to stakeholders. More research is needed to identify the effects, costs, and side effects of negative-reinforcement arrangements for drug offenders. The current proposal provides an excellent platform for conducting this research because the target intervention (depot naltrexone) is demonstrably efficacious, nonpsychoactive, and has few, if any, side effects. Therefore, use of this medication would be unlikely to invoke the same types of legal and ethical objections that have traditionally been levied against the use of psychoactive medications with vulnerable populations of institutionalized offenders. Specific recommendations are offered for questions that must be addressed in future research studies.

Behavior Therapy↗
PubMed2002

The role of cortisol suppression on craving for and satisfaction from nicotine in high and low impulsive subjects.

The rewarding properties of drug self-administration have been shown to depend on mesolimbic dopamine release but also on the availability of corticosterone, as shown in rats. Since this became particularly evident when tested in rat strains bred for high (HR) and low (LR) reactivity to novel stimuli, the role of cortisol and personality in drug craving was investigated in 60 male nicotine-deprived smokers divided according to questionnaire scores into high and low impulsives, a dimension considered to represent HR/LR rats. They either received the peripheral cortisol blocker metyrapone (MET) or the centrally blocking substance dexamethasone (DEX) or placebo (n=20 each) and were then allowed to smoke. MET more than DEX reduced craving for cigarettes during deprivation. This was only observed in low impulsives while high impulsives developed low craving unmodified by blockade of cortisol. Satisfaction from smoking was less achieved with DEX than with MET and not modified by impulsivity. Differences between MET and DEX in influencing craving during deprivation and satisfaction from smoking were discussed on the basis of different glucocorticoid receptors. The mineralocorticoid receptor (MR) seems to be the 'turn on switch' and the glucocorticoid receptor (GR) the 'turn off switch' in mediating the rewarding properties of dopamine in drug self-administration.

Adult↗
PubMed2005

Perseverance of exploration in novel environments predicts morphine place conditioning in rats.

Reactivity to novelty has been related to operant drug self-administration but does not seem involved in the conditioned place preference (CPP). To further assess this issue our aims were to investigate: (1) the importance of the initial versus delayed activity in the novel environment to predict the CPP induced by morphine; (2) the separate contribution of trait anxiety in morphine CPP. Male Sprague-Dawley rats were exposed to a circular corridor for 30 min to assess reactivity to novelty and to the elevated plus-maze and the light-dark tests as measures of anxiety and morphine CPP was then studied (three pairings with 5 mg/kg s.c. morphine and three with saline). Delayed activity in the corridor (16-30 min) correlated positively with CPP score, whereas the initial activity (0-15 min) did not. High-responders (HR), those more active during the second half of the corridor, developed morphine CPP in contrast to low-responders (LR). Also, HR and LR did not differ in anxiety nor any plus-maze or light-dark test measure correlated with CPP behaviour. Enhanced vulnerability to develop morphine CPP is predicted by a higher delayed activity in a novel environment, regardless of anxiety.

Adaptation, Psychological↗
PubMed2005

The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism.

Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol. Six weeks after discharge from hospital, the patients were reassessed for relapse. Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers. The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes. PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.

Adult↗
PubMed1997

A meta-analysis of trials evaluating patient education and counseling for three groups of preventive health behaviors.

OBJECTIVES: To examine the overall effectiveness of patient education and counseling on preventive health behaviors and to examine the effects of various approaches for modifying specific types of behaviors. DATA SOURCES: Computerized databases (Medline, Healthline, Dissertation Abstracts, and Psychological Abstracts), bibliographies 1971-1994. Search terms (patient education, patient compliance, and self care) with modifiers (evaluation and specific preventive behaviors). STUDY SELECTION: Randomized and non-randomized controlled trials measuring behavior in clinical settings with patients without diagnosed disease. Abstracts and retrieved studies screened by multiple reviewers; 13% of retrieved studies met screening criteria. DATA EXTRACTION: Replicated coding by multiple observers. DATA SYNTHESIS: Behaviors were grouped based on whether the behavior is addictive and whether the desired change required subtraction of existing behaviors or adding new behaviors. The weighted average effect size from a random effects model for smoking/alcohol studies was 0.61 (CI = 0.45, 0.77), for nutrition/weight, 0.51 (CI = 0.20, 0.82) and for other behaviors, 0.56 (CI = 0.34, 0.77) indicating that the behavioral outcomes for these subgroups were significantly different from zero. Multiple regression models for the three groups indicated that using behavioral techniques, particularly self-monitoring, and using several communication channels, e.g., media plus personal communication, produces larger effects for the smoking/alcohol and nutrition/weight groups. CONCLUSIONS: Patient education and counseling contribute to behavior change for primary prevention of disease. Some techniques are more effective than others in changing specific behaviors.

Counseling↗
PubMed2002

Amphetamine-induced increases in extracellular dopamine, drug wanting, and novelty seeking: a PET/[11C]raclopride study in healthy men.

Eight healthy men underwent two positron emission tomography (PET) [11C]raclopride scans, one following placebo, the second following d-amphetamine (0.30 mg/kg, p.o.). PET data were analyzed using: (1) brain parametric maps to statistically generate regions of significant change; and (2) a priori identified regions of interest (ROI) manually drawn on each individual's co-registered magnetic resonance (MR) images. Compared with placebo, d-amphetamine decreased [11C]raclopride binding potential (BP) with significant effects in ventral but not dorsal striatum. Change in BP in the statistically generated cluster correlated with self-reported drug-induced 'drug wanting' (r = 0.83, p =.01) and the personality trait of Novelty Seeking-Exploratory Excitability (r = 0.79, p =.02). The same associations were seen in the manually drawn ROI in ventral striatum but not in dorsal putamen or caudate. Changes in extracellular dopamine (DA) did not correlate with mood. Mesolimbic DA might mediate interest in obtaining reward rather than reward, per se. Individual differences in amphetamine-induced DA release might be related to predispositions to drug and novelty seeking.

Adult↗