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Henderson, Craig E.; Rowe, Cindy L.; Hawes, Sam W.; Liddle, Howard A. |
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Parenting practices as mediators of treatment effects in an early-intervention trial of multidimensional family therapy |
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2009 |
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The American Journal of Drug and alcohol Abuse |
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35 |
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4 |
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220-226 |
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adolescent; AOD abuse; family therapy; peer; mediation |
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Background: Contemporary intervention models use research about the determinants of adolescent problems and their course of symptom development to design targeted interventions. Because developmental detours begin frequently during early-mid adolescence, specialized interventions that target known risk and protective factors in this period are needed. Methods: This study (n = 83) examined parenting practices as mediators of treatment effects in an early-intervention trial comparing Multidimensional Family Therapy (MDFT), and a peer group intervention. Participants were clinically referred, low-income, predominantly ethnic minority adolescents (average age 14). Assessments were conducted at intake, and six weeks after intake, discharge, and at 6 and 12 months following intake. Results: Previous studies demonstrated that MDFT was more effective than active treatments as well as services as usual in decreasing substance use and improving abstinence rates. The current study demonstrated that MDFT improves parental monitoring—a fundamental treatment target—to a greater extent than group therapy, and these improvements occur during the period of active intervention, satisfying state-ofthe- science criteria for assessing mediation in randomized clinical trials. Conclusions and Scientific Significance: Findings indicate that change in MDFT occurs through improvements in parenting practices. These results set the foundation for examining family factors as mediators in other samples. |
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1097-9891 (electronic); 0095-2990 (paper) |
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50-11752 |
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59928 |
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Author |
Ullmann, Rainer |
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Geschichte der Substitutionsbehandlung in Deutschland |
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2011 |
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Akzeptanzorientierte Drogenarbeit = Acceptance-oriented drug work |
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8 |
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21.01.2011 |
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1-5 |
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treatment and maintenance; methadone maintenance; outpatient care; general practitioner; government and politics; history; Germany; drug substitution therapy |
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50-11719 |
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59926 |
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Gantner, Andreas; Spohr, Birgit; Bobbink, A. Jeanine; Becker, Harvey |
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Pendeldiplomatie im Quadrat : Multidimensionale Familientherapie (MDFT): ein systemischer Therapieansatz für Jugendliche mit Drogenproblemen und Verhaltensauffälligkeiten, deren Eltern und Bezugspersonen |
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2007 |
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Wiener Zeitschrift für Suchtforschung |
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30 |
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4 |
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13-26 |
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family therapy; adolescent; cannabis; parent; counseling; study; Europe; journal article |
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Angesichts des europaweit steigenden Behandlungsbedarfs für jugendliche Cannabisklienten und der wissenschaftlich belegten Effektivität der Multidimensionalen Familientherapie für jugendliche Drogenklienten wird im Rahmen der europäischen INCANT Studie die in den USA entwickelte Multidimensionale Familientherapie (MDFT) eingeführt und in fünf europäischen Ländern wissenschaftlich evaluiert. Die gleichzeitige Arbeit mit den Jugendlichen, den Eltern, der Familie und anderen relevanten Personen im sozialen Kontext der jugendlichen Klienten ist ein Schwerpunkt des systemischen multidimensionalen Therapieansatzes, der in diesem Beitrag vorgestellt und anhand beispielhafter Therapieverläufe nachvollziehbar gemacht wird. Erste klinische Erfahrungen aus der Studie lassen eine Bestätigung der hohen Wirksamkeit von MDFT erwarten. MDFT is a family based systemic treatment model for adolescent drug abuse and related behavior problems. The model has been tested in several U.S. RCT studies and is developed by Howard Liddle and colleagues at the “Center for Treatment Research on Adolescent Drug Abuse” (CTRADA), University of Miami Medical School. Since 2006 MDFT is being tested in an international multi-site randomized controlled trial (INCANT) in Europe. The work with family members and the extra familiar system in different settings are core pieces of the treat-ment, which will be demonstrated by examples of clinical cases. First experiences with MDFT from the German INCANT site show promising outcomes regarding the effectiveness of MDFT Treatment. |
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50-11750 |
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59927 |
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Kuepper, Rebecca; van Os, Jim; Lieb, Roselind; Wittchen, Hans-Ulrich; Höfler, Michael; Henquet, Cécile |
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Continued cannabis use and risk of incidence and persistence of psychotic symptoms : 10 year follow-up cohort study |
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Journal Article |
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2011 |
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British medical journal |
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342 |
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8 |
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AOD use, abuse, and dependence; AOD dependence; chemical addiction; cannabis; adolescence; AODR psychosis; risk factors; Germany |
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Objective To determine whether use of cannabis in adolescence increases the risk for psychotic outcomes by affecting the incidence and persistence of subclinical expression of psychosis in the general population (that is, expression of psychosis below the level required for a clinical diagnosis). Design Analysis of data from a prospective population based cohort study in Germany (early developmental stages of psychopathology study). Setting Population based cohort study in Germany. Participants 1923 individuals from the general population, aged 14-24 at baseline. Main outcome measure Incidence and persistence of subthreshold psychotic symptoms after use of cannabis in adolescence. Cannabis use and psychotic symptoms were assessed at three time points (baseline, T2 (3.5 years), T3 (8.4 years)) over a 10 year follow-up period with the Munich version of the composite international diagnostic interview (M-CIDI). Results In individuals who had no reported lifetime psychotic symptoms and no reported lifetime cannabis use at baseline, incident cannabis use over the period from baseline to T2 increased the risk of later incident psychotic symptoms over the period from T2 to T3 (adjusted odds ratio 1.9, 95% confidence interval 1.1 to 3.1; P=0.021). Furthermore, continued use of cannabis increased the risk of persistent psychotic symptoms over the period from T2 to T3 (2.2, 1.2 to 4.2; P=0.016). The incidence rate of psychotic symptoms over the period from baseline to T2 was 31% (152) in exposed individuals versus 20% (284) in non-exposed individuals; over the period from T2 to T3 these rates were 14% (108) and 8% (49), respectively. Conclusion Cannabis use is a risk factor for the development of incident psychotic symptoms. Continued cannabis use might increase the risk for psychotic disorder by impacting on the persistence of symptoms. |
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0959-535x; 0959-8146 |
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50-11711 |
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59925 |
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Hüsler, Gebhard; Plancherel, Bernard |
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Title |
Social integration of adolescents at risk : results from a cohort study |
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2007 |
Publication |
Vulnerable Children and Youth Studies |
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2 |
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3; 12/2007 |
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215-226 |
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target group; adolescent; high-risk youth; social integration; school; work; family; criminality; juvenile delinquency; AOD use; alcohol; tobacco product; illicit drug; cannabis; Switzerland |
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Using a sample of 614 youths, this study examined differences and similarities between adolescents at risk (age range 11-20 years), and their integration in school or vocational training. We found that mood states (depression, anxiety), secure self (self-esteem and self-efficacy), relationship with parents, delinquency and substance use (alcohol, tobacco and cannabis) were variables which largely influenced social integration (school, work) for youths with poor sociodemographic backgrounds. An important variable we introduced here was sociodemographic background, which investigated the social situation of a youth. We distinguished two different groups (good vs. poor sociodemographic background). There were important differences between both groups. Youths with a poor sociodemographic background scored higher in suicidality and health complaints. The most striking differences were in substance use and delinquency. The structural equation model showed that poor mood was related to substance use at the start. Important paths were found in mood states over time, as for substance use, but interactions between both variables were small. We ran different models (poor vs. good social background, Swiss vs. migrant youths), and concluded that secure self and good family relations protected against poor mood and substance use and both variables indirectly influenced integration 2-3 years later. |
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1745-0128 (Print); 1745-0136 (Online) |
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50-11662 |
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59923 |
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Schäffler, Florian |
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In die Jahre gekommen – ältere KonsumentInnen illegalisierter Drogen und ihre aktuelle Situation |
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Journal Article |
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2010 |
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Akzeptanzorientierte Drogenarbeit = Acceptance-oriented drug work |
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7 |
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20.11.2010 |
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54-60 |
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AOD user; elderly; old age; social work service; Germany |
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Vor dem Hintergrund des Wandels restriktiver Drogenpolitik, hin zu liberaleren Ansätzen, kommen mittlerweile immer mehr DrogenkonsumentInnen in ein höheres Lebensalter. Dies geht einher mit veränderten Lebensumständen und Bedürfnissen: Eine Situation, auf die weder Sucht- noch Altenhilfe vorbereitet sind. Welche Hilfen kann Soziale Arbeit durch bestehende Systeme leisten und welche Angebote müssen bereitgestellt werden? |
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German |
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1861-0110 |
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Call Number |
50-11645 |
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59922 |
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Kuendig, Hervé; Laflamme, Lucie; Gmel, Gerhard; Daeppen, Jean-Bernard; Hasselberg, Marie |
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Time of injury in light of prior-to-injury and usual alcohol consumption: an emergency department study |
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2010 |
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Open access emergency medicine |
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2; 16.08.2010 |
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61-66 |
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addiction; AOD use, abuse, and dependence; chemical addiction; alcohol; AOD consumption; AOD effects and consequences; injury; time of day; day of the week; public health; intervention (persuasion to treatment); emergency care; study; Switzerland; Lausanne |
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Purpose: To investigate how prior-to-injury and usual alcohol consumption relate to time of injury. Patients and methods: The associations between injury time of day and day of week and prior-to-injury (labeled as “acute”) alcohol intake and hazardous usual alcohol consumption (considered from the point of view of both heavy episodic drinking [HED] and risky volumes of consumption) are assessed using interview data from a randomized sample of 486 injured patients treated in a Swiss emergency department (ED; Lausanne University Hospital). Results: Acute consumption was associated with both injury time of day and day of week, HED with day of week only, and risky volume with none. Conclusions: Acute consumption and HED, but not risky volume of consumption, show specific time distributions for injuries. These findings highlight the potential importance of considering the time dimension of an injury when providing emergency care and have additional implications for interventions aimed at influencing the alcohol consumption of injured patients presenting to the ED. |
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1179-1500 |
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50-11640 |
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59920 |
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Kuendig, Hervé; Hasselberg, Marie; Laflamme, Lucie; Daeppen, Jean-Bernard; Gmel, Gerhard |
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alcohol and nonlethal injuries: a Swiss emergency department study on the risk relationship between acute alcohol consumption and type of injury |
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2008 |
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Journal of trauma : injury, infection, and critical care |
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65 |
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1 |
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203-211 |
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addiction; AOD use, abuse, and dependence; chemical addiction; alcohol; AOD consumption; AOD effects and consequences; injury; risk factors; public health; prevention; emergency care; study; Switzerland; Lausanne |
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BACKGROUND: Acute alcohol consumption has been reported to be an important risk factor for injury, but clear scientific evidence on issues such as injury type is not available. The present study aims to improve the knowledge of the importance of alcohol consumption as an injury determinant with regards to two dimensions of the type of injury, namely the nature and the body region involved. METHODS: Risk relationships between two injury type components and acute alcohol use were estimated through multinomial and logistic regression models based on data from 7,529 patients-among whom 3,682 had injury diagnoses-gathered in a Swiss emergency department. RESULTS: Depending on the type of injury, between 31.1% and 48.7% of casualties report alcohol use before emergency department attendance. The multinomial regression models show that even low alcohol levels are consistently associated with nearly all natures of injury and body regions. A persistent dose-response effect between alcohol levels and risk associations was observed for almost all injury types. CONCLUSIONS: The results highlight the importance and consistency of the risk association between low and moderate levels of acute alcohol consumption and all types of injury. None of the body regions and natures of injury could pride on absence of association between alcohol and injury. Public health, prevention, and care implications are considered. |
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0022-5282 |
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50-11639 |
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59919 |
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Kuendig, Hervé; Hasselberg, Marie; Gmel, Gerhard; Daeppen, Jean-Bernard; Laflamme, Lucie |
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Acute and usual drinking among emergency trauma patients: a study on alcohol consumption and injury patterns |
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2009 |
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Injury prevention |
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15 |
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4 |
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270-274 |
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addiction; AOD use, abuse, and dependence; chemical addiction; alcohol; AOD consumption; AOD effects and consequences; injury; risk factors; study; Switzerland; Lausanne |
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Objective: To investigate the relationship between usual and acute alcohol consumption among injured patients and, when combined, how they covary with other injury attributes. Methods: Data from a randomised sample of 486 injured patients interviewed in an emergency department (Lausanne University Hospital, Switzerland) were analysed using the χ2 test for independence and cluster analysis. Results: Acute alcohol consumption (24.7%) was associated with usual drinking and particularly with high volumes of consumption. Six injury clusters were identified. Over-representations of acute consumption were found in a cluster typical of injuries sustained through interpersonal violence and in another formed by miscellaneous circumstances. A third cluster, typical of sports injuries, was linked to a group of frequent heavy episodic drinkers (without acute consumption). Conclusions: Among injured patients, acute alcohol consumption is common and associated with usual drinking. Acute and/or usual consumption form part of some, but not all, injury clusters. |
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1475-5785 |
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50-11638 |
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59918 |
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Kuendig, Hervé; Hasselberg, Marie; Laflamme, Lucie; Daeppen, Jean-Bernard; Gmel, Gerhard |
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Acute alcohol consumption and injury : risk associations and attributable fractions for different injury mechanisms |
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Journal Article |
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Year |
2008 |
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Journal of studies on alcohol and drugs |
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69 |
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2; 03/2008 |
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218-226 |
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addiction; AOD use, abuse, and dependence; chemical addiction; alcohol; AOD consumption; AOD effects and consequences; AODR violence; injury; risk factors; prevention; intervention (persuasion to treatment); study; Switzerland; Lausanne |
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OBJECTIVE: Most studies on alcohol as a risk factor for injuries have been mechanism specific, and few have considered several mechanisms simultaneously or reported alcohol-attributable fractions (AAFs)-which was the aim of the current study. METHOD: Data from 3,592 injured and 3,489 noninjured patients collected between January 2003 and June 2004 in the surgical ward of the emergency department of the Lausanne University Hospital (Switzerland) were analyzed. Four injury mechanisms derived from the International Classification of Diseases, 10th Revision, were considered: transportation-related injuries, falls, exposure to forces and other events, and interpersonal violence. Multinomial logistic regression models were calculated to estimate the risk relationships of different levels of alcohol consumption, using noninjured patients as quasi-controls. The AAFs were then calculated. RESULTS: Risk relationships between injury and acute consumption were found across all mechanisms, commonly resulting in dose-response relationships. Marked differences between mechanisms were observed for relative risks and AAFs, which varied between 15.2% and 33.1% and between 10.1% and 35.9%, depending on the time window of consumption (either 6 hours or 24 hours before injury, respectively). Low and medium levels of alcohol consumption generally were associated with the most AAFs. CONCLUSIONS: This study underscores the implications of even low levels of alcohol consumption on the risk of sustaining injuries through any of the mechanisms considered. Substantial AAFs are reported for each mechanism, particularly for injuries resulting from interpersonal violence. Observation of a so-called preventive paradox phenomenon is discussed, and prevention or intervention measures are described. |
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0096-882x |
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50-11637 |
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59917 |
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