44 research outputs found
Therapist and computerâbased brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms
Background and AimsDespite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapistâdelivered BI (TBI) or computerâguided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time.DesignLatent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment.SettingHurley Medical Center Emergency Department (ED) in Flint, MI, USA.ParticipantsThe sample was 780 drugâusing adults (aged 18â60Â years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the HealthiER You study.Interventions and comparatorEDâdelivered TBI and CBIs involved touchscreenâdelivered and audioâassisted content. The TBI was administered by a Masterâsâlevel therapist, whereas the CBI was selfâadministered using a virtual health counselor. EUC included a review of health resources brochures in the ED.MeasurementsAssessments of alcohol use (10âitem Alcohol Use Disorders Identification Test), cannabis use (past 30âday frequency) and anxiety symptoms (Brief Symptom Inventoryâ18) occurred at baseline and 3â, 6â and 12âmonth followâup.FindingsTBI, relative to EUC, was associated with significant reductions in cannabis use [BÂ =Â â0.49, standard error (SE)Â =Â 0.20, PÂ <Â 0.05) and anxiety (BÂ =Â â0.04, SEÂ =Â 0.02, PÂ <Â 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (BÂ =Â â0.60, SEÂ =Â 0.19, PÂ <Â 0.01) and patients aged 18â25Â years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (BÂ =Â â0.78, SEÂ =Â 0.31, PÂ <Â 0.05). Results for CBI were nonâsignificant.ConclusionsEmergency departmentâbased therapistâdelivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152851/1/add14781.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152851/2/add14781_am.pd
Sexually Transmitted Infection History among Adolescents Presenting to the Emergency Department
BACKGROUND: Adolescents and young adults account for about half of the annual diagnoses of sexually transmitted infections (STI) in the United States. Screening and treatment for STIs, as well as prevention, are needed in health-care settings to help offset the costs of untreated STIs.
OBJECTIVE: Our aim was to evaluate the prevalence and correlates of self-reported STI history among adolescents presenting to an emergency department (ED).
METHODS: Over two and a half years, 4389 youth (aged 14-20 years) presenting to the ED completed screening measures for a randomized controlled trial. About half (56%) reported lifetime sexual intercourse and were included in analyses examining sexual risk behaviors (e.g., inconsistent condom use), and relationships of STI history with demographics (sex, age, race, school enrollment), reason for ED presentation (i.e., medical or injury), and substance use.
RESULTS: Among sexually active youth, 10% reported that a medical professional had ever told them they had an STI (212 females, 35 males). Using logistic regression, female sex, older age, non-Caucasian race, not being enrolled in school, medically related ED chief complaint, and inconsistent condom use were associated with increased odds of self-reported STI history.
CONCLUSIONS: One in 10 sexually active youth in the ED reported a prior diagnosed STI. Previous STI was significantly higher among females than males. ED providers inquiring about inconsistent condom use and previous STI among male and female adolescents may be one strategy to focus biological testing resources and improve screening for current STI
A Latent Profile Analysis of Aggression and Victimization across Relationship Types Among Veterans Who Use Substances
Objective: This study examined patterns of violence victimization and aggression in both intimate partner and non-partner relationships among veterans, and used latent profile analysis to identify subtypes of violence involvement.
Methods: Participants were 841 substance use treatment-seeking veterans (94% male) from a large VA Medical Center who completed screening measures for a randomized controlled trial. Self-report measures were: substance use, legal problems, depression, and violence involvement.
Results: Past year violence involvement, including both intimate partner (IPV) and non-partner (NPV) were common in the sample; although NPV occurred at somewhat higher rates. When including either IPV or NPV aggression or victimization, over 48% reported involvement with physical violence, 31% with violence involving injury and 86% with psychological aggression. Latent profile analysis including both aggression and victimization in partner and non-partner relationships indicated a four profile solution: no-low violence (NLV, n = 701), predominantly IPV (n = 35), predominantly NPV (n = 83), and high general violence (HGV, n = 22). Multinomial logistic regression analyses revealed that compared to the no-low violence group, the remaining three groups differed in demographics, depressive symptoms, alcohol and other drug use, and legal involvement. Individuals within each profile had different patterns of substance use and legal involvement with the participants with an HGV profile reporting the most legal problems.
Conclusions: IPV and NPV are relatively common among veterans seeking substance use treatment. Characteristics of violence and associated substance use, mental health, and legal difficulties may be useful in considering how to tailor substance use and mental health services
The daily association between affect and alcohol use: a meta-analysis of individual participant data
Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.The present study was funded by the Canadian Institutes of Health Research Grant MOP-115104 (Roisin M. OâConnor), Canadian Institutes of Health Research Grant MSH-122803 (Roisin M. OâConnor), John A. Hartford Foundation Grant (Paul Sacco), Loyola University Chicago Research Support Grant (Tracy De Hart), National Institute for Occupational Safety and Health Grant T03OH008435 (Cynthia Mohr), National Institutes of Health (NIH) Grant F31AA023447 (Ryan W. Carpenter), NIH Grant R01AA025936 (Kasey G. Creswell), NIH Grant R01AA025969 (Catharine E. Fairbairn), NIH Grant R21AA024156 (Anne M. Fairlie), NIH Grant F31AA024372 (Fallon Goodman), NIH Grant R01DA047247 (Kevin M. King), NIH Grant K01AA026854 (Ashley N. Linden-Carmichael), NIH Grant K01AA022938 (Jennifer E. Merrill), NIH Grant K23AA024808
(Hayley Treloar Padovano), NIH Grant P60AA11998 (Timothy Trull), NIH Grant MH69472 (Timothy Trull), NIH Grant K01DA035153 (Nisha Gottfredson), NIH Grant P50DA039838 (Ashley N. Linden-Carmichael),
NIH Grant K01DA047417 (David M. Lydon-Staley), NIH Grant T32DA037183 (M. Kushner), NIH Grant R21DA038163 (A. Moore), NIH Grant K12DA000167 (M. Potenza, Stephanie S. OâMalley), NIH Grant R01AA025451 (Bruce Bartholow, Thomas M. Piasecki), NIH Grant P50AA03510 (V. Hesselbrock), NIH Grant K01AA13938 (Kristina M. Jackson), NIH Grant K02AA028832 (Kevin M. King), NIH Grant T32AA007455 (M. Larimer), NIH Grant R01AA025037 (Christine M. Lee, M. Patrick), NIH Grant R01AA025611 (Melissa Lewis), NIH Grant R01AA007850 (Robert Miranda), NIH Grant R21AA017273 (Robert Miranda), NIH Grant R03AA014598 (Cynthia Mohr), NIH Grant R29AA09917 (Cynthia Mohr), NIH Grant T32AA07290 (Cynthia Mohr), NIH Grant P01AA019072 (P. Monti), NIH Grant R01AA015553 (J. Morgenstern), NIH Grant R01AA020077 (J. Morgenstern), NIH Grant R21AA017135 (J. Morgenstern), NIH Grant R01AA016621 (Stephanie S. OâMalley), NIH Grant K99AA029459 (Marilyn Piccirillo), NIH Grant F31AA022227 (Nichole Scaglione), NIH Grant R21AA018336 (Katie Witkiewitz), Portuguese State Budget Foundation for Science and Technology Grant UIDB/PSI/01662/2020 (Teresa Freire), University of Washington Population Health COVID-19 Rapid Response Grant (J. Kanter, Adam M. Kuczynski), U.S. Department of Defense Grant W81XWH-13-2-0020 (Cynthia Mohr), SANPSY Laboratory Core Support Grant CNRS USR 3413 (Marc Auriacombe), Social Sciences and Humanities Research Council of Canada Grant (N. Galambos), and Social Sciences and Humanities Research Council of Canada Grant (Andrea L. Howard)
A social media intervention for cannabis use among emerging adults: Randomized controlled trial.
Optimizing scalable, technology-supported behavioral interventions to prevent opioid misuse among adolescents and young adults in the emergency department: A randomized controlled trial protocol.
Associations among Pain, NonâMedical Prescription Opioid Use, and Drug Overdose History
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102230/1/ajad12055.pd