Personality disorders and smoking in Spanish general and clinical population

Background: There is consistent evidence about the relationship between smoking and mental health. This study compares the relationship between tobacco use and personality disorders (PDs) in Spanish adults from general and clinical population, taking into account nicotine dependence (ND), and the presence of any mental disorder. Method: The sample was made up of 1,079 smokers (519 from general population, 560 from clinical population). PDs were assessed by means of the International Personality Disorder Examination Questionnaire, Module DSM-IV. Results: Individuals seeking treatment to quit smoking had a higher likelihood of presenting a paranoid, schizoid, schizotypal, borderline, antisocial, and dependent PD compared to smokers from the general population. This likelihood was higher when ND was taken into account. Among smokers from the general population, ND was associated with a higher likelihood of presenting a borderline and dependent PD. Conclusions: A significant relationship between smoking and several PDs exist, especially in nicotine dependent smokers. Relevance of the findings regarding the influence of PDs in smoking cessation interventions is discussed

Trastornos de personalidad y consumo de tabaco en la población general y clínica española

Background: There is consistent evidence about the relationship between smoking and mental health. This study compares the relationship between tobacco use and personality disorders (PDs) in Spanish adults from general and clinical population, taking into account nicotine dependence (ND), and the presence of any mental disorder. Method: The sample was made up of 1,079 smokers (519 from general population, 560 from clinical population). PDs were assessed by means of the International Personality Disorder Examination Questionnaire, Module DSM-IV. Results: Individuals seeking treatment to quit smoking had a higher likelihood of presenting a paranoid, schizoid, schizotypal, borderline, antisocial, and dependent PD compared to smokers from the general population. This likelihood was higher when ND was taken into account. Among smokers from the general population, ND was associated with a higher likelihood of presenting a borderline and dependent PD. Conclusions: A signifi cant relationship between smoking and several PDs exist, especially in nicotine dependent smokers. Relevance of the fi ndings regarding the infl uence of PDs in smoking cessation interventions is discussedAntecedentes: existe evidencia sólida sobre la relación entre fumar y salud mental. Este estudio compara la relación entre consumo de tabaco y trastornos de personalidad (TP) en adultos españoles de población general y población clínica, teniendo en cuenta la dependencia de la nicotina (DN) y la presencia de algún trastorno mental. Método: la muestra estuvo formada por 1.079 fumadores (519 de población general, 560 de población clínica). Los TP se evaluaron con el cuestionario del International Personality Disorders Examination, Módulo DSM-IV. Resultados: los individuos que demandaron tratamiento para dejar de fumar tenían una mayor probabilidad de presentar un TP paranoide, esquizoide, esquizotípico, límite, antisocial y dependiente que los fumadores de población general. Esta probabilidad fue mayor cuando además existía DN. Entre los fumadores de población general, la DN se asoció con una mayor probabilidad de presentar un TP límite y dependiente. Conclusiones: existe una relación signifi cativa entre consumo de tabaco y varios TP, especialmente en fumadores dependientes de la nicotina. Se comenta la relevancia de los hallazgos respecto a la infl uencia de los TP en las intervenciones para dejar de fumarFunding for this study was provided by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (National Basic Research Projects). Project reference: PSI2008-02597/PSICS

Changes in the profiles of smokers seeking cessation treatment and in its effectiveness in Galicia (Spain) 2001–10

Background In recent years, the prevalence of daily smokers has decreased in all developed countries due to a great variety of factors. Despite this decrease, the effectiveness of clinical treatments has decreased and several studies report a change in smokers’ characteristics. The purpose of the present study is to analyze the changes in the characteristics of Spanish smokers who seek smoking cessation treatment between 2001 and 2010 and the changes in the effectiveness of such treatment. Methods The sample was made up of 870 smokers who sought psychological treatment for giving up smoking at the Smoking Cessation Unit in the Faculty of Psychology of the University of Santiago de Compostela (Spain) during the period 2001 to 2010. Results Smokers in the 2006–2010 group, compared to those in the 2001–2005 group, were older, smoked fewer cigarettes per day and of a brand with fewer mg/nicotine, had been smoking longer, were less motivated to give up smoking, and had more antecedents of depression. Quit rates were validated by testing smokers' carbon monoxide (CO) levels. Percentages of abstinence were higher in the 2001–2005 group than in the 2006–2010 group (58.7% vs. 52.15 at the end of treatment, p = 0.05); 30.8% vs. 24.2% at 6 months follow-up, p = 0.031; 27.5% vs. 22% at 12 months follow-up, p = 0.059). Although abstinence decreased more than 5% in the 2006–2010 group there were no differences between the two groups in nicotine dependence. Those participants who did not assist to the follow-up were considered smokers at pretreatment level. Conclusions In Spain there has been a qualitative change in the profile of the smokers seeking smoking cessation treatment. Treatment effectiveness has decreased, and the variables predicting intervention outcome have changedFunding for this study was provided by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (National Basic Research Projects). Project reference: PSI2008-02597/PSIC. The funding is for all the authorsS

Gender differences in personality patterns and smoking status after a smoking cessation treatment

Background The lack of conclusive results and the scarce use of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in the study of the relationship between smoking and personality are the reasons that motivated the study reported here. The aim of the present study was to analyze the influence of personality patterns, assessed with the MCMI-III, and of nicotine dependence on treatment outcomes at the end of the treatment and at 12 months follow-up in men and women smokers receiving cognitive-behavioral treatment for smoking cessation. Methods The sample was made up of 288 smokers who received cognitive-behavioral treatment for smoking cessation. Personality patterns were assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Abstinence at the end of the treatment and at 12-month follow-up was validated with the test for carbon monoxide in expired air. Results The results showed significant differences by personality patterns that predict nicotine dependence (Narcissistic and Antisocial in men and Schizoid in women). At the end of the treatment it is more likely that quit smoking males with a Compulsive pattern and less likely in those scoring high in Depressive, Antisocial, Sadistic, Negativistic, Masochistic, Schizotypal and Borderline. In women, it is less likely that quit smoking those with the Schizoid pattern. At 12 months follow-up it is more likely that continue abstinent those males with a high score in the Compulsive pattern. Furthermore, nicotine dependence was an important variable for predicting outcome at the end of the treatment and smoking status at 12 months follow-up in both men and women. Conclusions We found substantial differences by gender in some personality patterns in a sample of smokers who received cognitive-behavioral treatment for smoking cessation. We should consider the existence of different personality patterns in men and women who seek treatment for smoking cessationFunding for this study was provided by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (National Basic Research Projects). Project reference: PSI2008-02597/PSIC. Bárbara Piñeiro is the beneficiary of a Pre-Doctoral Research Training Grant (FPI) from the Ministry of Science and Innovation; reference BES-2009-012929S

Relapse in Smokers Who Quit with a Psychological Treatment: A Gender Issue?

Aunque contamos con tratamientos eficaces para la dependencia del tabaco, la recaída continúa siendo un fenómeno frecuente en aquellos que consiguen dejar de fumar. El objetivo del presente estudio fue analizar si existían diferencias en función del sexo en la curva de recaída en hombres y mujeres que participaron en un tratamiento psicológico cognitivo-conductual para dejar de fumar. La muestra estuvo formada por 266 personas (59.8 % mujeres) que dejaron de fumar al finalizar el tratamiento. Los resultados indicaron que a medida que se incrementaba el tiempo transcurrido tras la intervención, disminuía el porcentaje de participantes abstinentes. No obstante, no se encuentraron diferencias significativas entre hombres y mujeres en la curva de recaída, lo cual podría explicarse por la inclusión en el tratamiento de técnicas psicológicas eficaces para el afrontamiento de algunas de las principales causas de la recaída (e.g., estado de ánimo negativo). Dada la importancia que tiene la recaída en el proceso de dejar de fumar, es necesario profundizar en los distintos determinantes que la desencadenanAlthough we have effective treatments for tobacco dependence, relapse is a frequent phenomenon in those who quit. The aim of this study was to analyze whether there were differences by gender in the relapse curve in men and women who participated in a cognitive-behavioral smoking cessation treatment. The sample was composed of 266 individuals (59.8 % women) who were abstinent at the end of treatment. The results indicate that as time after the intervention increases, the percentage of abstinent participants decreases. However, no significant differences between men and women in the relapse curve were found, which could be explained by the inclusion of effective psychological tools to cope with some of the main causes of relapse (e.g., negative affect) in the treatment. Given the importance of relapse in the smoking cessation process, it is necessary to deepen in its triggersLa presente investigación ha sido financiada por el Ministerio de Economía y Competitividad (Proyecto número PSI2012-31196) y el Fondo Europeo de Desarrollo Regional (FEDER)S

Craving y abstinencia de la nicotina en fumadores españoles en un tratamiento para dejar de fumar

Craving and nicotine withdrawal syndrome (NWS) are components of the tobacco use disorder in DSM-5. They both appear after smoking cessation or an abrupt reduction in tobacco use, and they are associated with both short and long-term smoking-cessation outcomes. The aim of the present study was to examine the association of craving and withdrawal with smoking cessation at the end of the treatment and relapse at 3 months follow-up in a Spanish sample of smokers. The sample comprised 342 smokers (37.7% men; 62.3% women) receiving a cognitive-behavioral treatment for smoking cessation. The assessments of craving and withdrawal were conducted using the Minnesota Nicotine Withdrawal Scale. Abstainers at the end of the treatment, compared to non abstainers, showed significantly lower post-treatment withdrawal, and post-treatment craving. Furthermore, they had lower scores in pre-treatment nicotine dependence. Among abstainers, craving decreased significantly from pre-cessation levels, while in those participants who did not quit smoking it remained on the same levels. High nicotine dependence was a predictor of smoking at the end of the treatment, whereas high nicotine withdrawal predicted relapse at 3 months. Findings support the robust role of craving and NWS in smoking cessation and relapse, although they differ in their specific patterns of change over timeEl craving y el síndrome de abstinencia de la nicotina (SAN) forman parte del trastorno por consumo del tabaco en el DSM-5. Ambos aparecen tras dejar de fumar o tras una reducción brusca del consumo de tabaco, y están relacionados con los resultados de dejar de fumar a corto y largo plazo. El objetivo del presente estudio fue analizar la relación del craving y del síndrome de abstinencia con dejar de fumar al final del tratamiento y con la recaída a los 3 meses de seguimiento en una muestra de fumadores españoles. La muestra estaba formada por 342 fumadores (37,7% hombres; 62,3% mujeres) que recibieron tratamiento cognitivo-conductual para dejar de fumar. La evaluación del craving y del síndrome de abstinencia se realizó a través de la escala Minnesota Nicotine Withdrawal Scale. Los abstinentes al final del tratamiento, comparados con los no abstinentes, mostraron un síndrome de abstinencia y un craving significativamente menor al finalizar el tratamiento. Además, los abstinentes tenían puntuaciones menores en dependencia de la nicotina antes del tratamiento. Entre los abstinentes, el craving descendió significativamente desde los valores presentados antes de dejar de fumar, mientras que en los participantes que no dejaron de fumar los valores de craving permanecieron en los mismos niveles. La dependencia de la nicotina elevada fue el predictor de fumar al final del tratamiento, mientras que el síndrome de abstinencia de la nicotina elevado fue predictor de la recaída a los 3 meses. Los resultados apoyan el papel robusto del craving y del SAN en dejar de fumar y en la recaída, aunque difieren en sus patrones de cambio a lo largo del tiempoThis study was funded by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación), “National Program for Basic Research Projects” (PSI2008-02597/PSIC)S

La recaída en fumadores que dejan de fumar con un tratamiento psicológico: ¿una cuestión de sexo?

Aunque contamos con tratamientos eficaces para la dependencia del tabaco, la recaída continúa siendo un fenómeno frecuente en aquellos que consiguen dejar de fumar. El objetivo del presente estudio fue analizar si existían diferencias en función del sexo en la curva de recaída en hombres y mujeres que participaron en un tratamiento psicológico cognitivo-conductual para dejar de fumar. La muestra estuvo formada por 266 personas (59.8 % mujeres) que dejaron de fumar al finalizar el tratamiento. Los resultados indicaron que a medida que se incrementaba el tiempo transcurrido tras la intervención, disminuía el porcentaje de participantes abstinentes. No obstante, no se encuentraron diferencias significativas entre hombres y mujeres en la curva de recaída, lo cual podría explicarse por la inclusión en el tratamiento de técnicas psicológicas eficaces para el afrontamiento de algunas de las principales causas de la recaída (e.g., estado de ánimo negativo). Dada la importancia que tiene la recaída en el proceso de dejar de fumar, es necesario profundizar en los distintos determinantes que la desencadenan. Although we have effective treatments for tobacco dependence, relapse is a frequent phenomenon in those who quit. The aim of this study was to analyze whether there were differences by gender in the relapse curve in men and women who participated in a cognitive-behavioral smoking cessation treatment. The sample was composed of 266 individuals (59.8 % women) who were abstinent at the end of treatment. The results indicate that as time after the intervention increases, the percentage of abstinent participants decreases. However, no significant differences between men and women in the relapse curve were found, which could be explained by the inclusion of effective psychological tools to cope with some of the main causes of relapse (e.g., negative affect) in the treatment. Given the importance of relapse in the smoking cessation process, it is necessary to deepen in its triggers

How does family disorganization influence children’s drug use? A review

Desde hace tiempo sabemos que diversos aspectos del funcionamiento familiar pueden incidir de modo importante en el consumo de drogas de los hijos tanto promoviendo la protección y resiliencia como induciendo el riesgo hacia el consumo. Esta revisión analiza los estudios publicados en los últimos 30 años sobre la influencia de la desorganización familiar en el consumo de drogas de los hijos. En función de los resultados encontrados consideramos que las familias desorganizadas (caracterizadas por enfermedad mental de los padres, consumo de sustancias de los padres y/o familias no intactas) tienen más probabilidades de tener hijos consumidores de drogas, tanto legales como ilegales. Finalmente, señalamos la necesidad de mejorar la conceptualización y evaluación del término desorganización familiar, así como otras limitaciones metodológicas encontradas en los distintos estudios empíricos revisadosIt is well known that various aspects of family functioning can influence children’s drug use, both by promoting resilience and by increasing the risk of use. This review examines studies published in the last 30 years about the influence of family disorganization on children’s drug use. Based on the results, we consider that disorganised families (charactirezed by parents’ mental illness, parents’ substance use and/or non-intact families) are more likely to have children who are drug users, both legal and illegal. Finally, we stress the need to improve the conceptualization of family disorganization and its assessment, and point out other methodological limitations found in the empirical studies reviewedLa preparación de este artículo ha sido financiado en parte por la European Commission, Directorate General for Justice, con fondos del proyecto European Family Empowerment (JLS/DPIP/2008-2/112). Subvencionado también por la Delegación del Gobierno para el Plan Nacional sobre Drogas según la Orden SPI/1129/2011, de 15 de abril, y Orden SPI/2379/2011, de 24 de agostoS

Can we predict psychostimulant use in youths? A study with structural equation modeling analysis

Conocer qué factores predicen el consumo de psicoestimulantes en jóvenes es importante para el diseño de programas preventivos y para identificar a los jóvenes que tienen una mayor probabilidad de consumir y así evitar que aparezcan los problemas derivados de dicho consumo. El objetivo de este estudio fue analizar la relación entre la disponibilidad percibida, la percepción de riesgo, los rasgos de personalidad, los patrones de personalidad antisocial y el consumo de otras sustancias en la predicción del consumo de psicoestimulantes. La muestra estuvo formada por 1.177 jóvenes (584 varones y 593 mujeres) de entre 14 y 25 años en España, reclutados aleatoriamente, estratificados por consumo-no consumo de psicoestimulantes (cocaína o éxtasis) alguna vez en la vida. El path que mejor predijo el consumo de psicoestimulantes fue: rasgos de personalidad-patrones de personalidad antisocial- consumo de psicoestimulantes. El siguiente path fue: rasgos de personalidad- patrones de personalidad antisocial-consumo de psicoestimulantes. La percepción de riesgo y la disponibilidad percibida fueron significativas en la predicción pero aportaron una contribución menor. Los resultados de este estudio sugieren que el modelo evaluado es adecuado para la predicción del consumo de psicoestimulantes en jóvenes. Este modelo puede ser de utilidad para desarrollar estrategias preventivas y para identificar a aquellos jóvenes con riesgo de tener problemas relacionados con el consumo de drogasKnowing which factors predict the use of psychostimulant drugs among youths is important for designing preventive programs and the identification of youths with the highest probability of use, to avoid some of the problems that can be derived from it. The purpose of this study is to examine the relationship between perceived availability, risk perception, personality traits, antisocial personality patterns, and use of other substances in the prediction of psychostimulant use. The sample was composed by 1,177 youths (584 males and 593 females) aged 14 to 25 in Spain, recruited randomly, stratified by lifetime use- non use of psychostimulants (cocaine or ecstasy). The path which best predicts psychostimulant use is: Personality traits-legal substance use-cannabis use-psychostimulant use. The next path is: Personality traits-antisocial personality patterns-psychostimulant use. Risk perception and perceived availability were significant in the prediction, but made a smaller contribution. The results of this study suggest that the model evaluated can predict psychostimulant use in youths. This model can be seen as a useful tool for developing preventive strategies and for identifying those youths that are at risk for problems related to drug useThis research was supported by Xunta de Galicia, Servicio Galego de Saúde (SERGAS) by a cooperation agreement between Xunta de Galicia-SERGAS and University of Santiago de Compostela, SpainS

Drunkenness, driving and sexual relations in young cocaine and ecstasy users

Los accidentes de tráfico, las enfermedades de transmisión sexual y embarazos no deseados, las borracheras y el consumo de drogas (fundamentalmente psicoestimulantes) son algunos de los aspectos más negativos asociados al reciente fenómeno de salir de marcha. El objetivo del presente estudio es analizar en una muestra de 1214 jóvenes de 14 a 25 años (49.7% varones y 50.3% mujeres) si los consumidores de psicoestimulantes (cocaína y éxtasis) tienen mayor frecuencia de borracheras y de realización de conductas de riesgo en el ámbito de las relaciones sexuales y la conducción de vehículos y analizar el peso que estas conductas tienen para predecir los consumos de psicoestimulantes en el último año. Los resultados indican que los consumidores de psicoestimulantes se emborrachan con más frecuencia, es más probable que hayan visto a un familiar ebrio y tienen más conductas de riesgo relacionadas con la conducción y el mantenimiento de relaciones sexuales completas. Por lo tanto, los consumidores de cocaína y éxtasis son una población de riesgo a la que deben de ir dirigidas campañas de prevención específicas por el alto riesgo de las conductas que realizanTraffic accidents, sexually-transmitted diseases, unwanted pregnancies, drunkenness, and drug use (especially psychostimulants) are negative aspects associated with recreational nightlife. The aim of the present study is to analyze in a sample of 1214 young people (aged 15-25; 49.7% males, 50.3% females) whether psychostimulant users (cocaine and ecstasy) have a higher frequency of drunkenness and risk behaviours related to sex and to driving. We also analyze the importance of these behaviours in the prediction of psychostimulant use in the last year. The results indicate that psychostimulant users get drunk more frequently, are more likely to have seen a relative drunk, and present more risk behaviours in the contexts of driving and full sexual relations. Therefore, cocaine and ecstasy users are a risk population who need specific preventive programsS