Association Between Number of Psychiatric Disorders and Violent Reoffending in Male Released Prisoners

Error bars are 95% CIs.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Probability of Violent Reoffending by Sex, Time After Release, and Psychiatric Disorder Status

Error bars are 95% CIs.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Psychiatric Disorders & Violent Reoffending: A National Cohort Study of Convicted Prisoners in Sweden

Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending.

We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers...

Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending in male and female prisoners, and these associations were independent of measured sociodemographic and criminological factors, and, in men, remained substantial after adjustment for unmeasured familial factors. However, findings differed between individual diagnoses and sex. We found some evidence of stronger effects on violent reoffending of alcohol and drug use disorders and bipolar disorder than of other psychiatric disorders. Alcohol use disorder seemed to have a greater effect in women than in men. The overall effects of psychiatric disorders did not differ with severity of crime. The hazard of violent reoffending increased in a stepwise way with the number of diagnosed psychiatric disorders. Assuming causality, up to 20% of violent reoffending in men and 40% in women was attributable to the diagnosed psychiatric disorders that we investigated.

Certain psychiatric disorders are associated with a substantially increased hazard of violent reoffending. Because these disorders are prevalent and mostly treatable, improvements to prison mental health services could counteract the cycle of reoffending and improve both public health and safety. National violence prevention strategies should consider the role of prison health.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Research Update on DWI Courts

Read document at: http://ht.ly/S1aBY HT https://twitter.com/_ALLRISE_

Special Services for Women in Substance Use Disorders Treatment: How Does the Department of Veterans Affairs Compare with Other Providers?

BACKGROUND:

Gender is an important consideration in the treatment of substance use disorders (SUD). Although the number of women seeking care through the Department of Veterans Affairs (VA) has increased dramatically, little is known about the capacity of the VA to meet the needs of women with SUD. We examined the prevalence of programs and key services for women in VA facilities in a survey of 14,311 SUD treatment facilities.

FINDINGS:

Approximately 31% of facilities had special programs exclusively for women. The VA had the lowest prevalence of programs for women, at 19.1%; however, the VA offered an average of 5 key services for women, which was significantly higher than the averages for other federal (n = 2), local (n = 4), and private for-profit (n = 2) facilities. Results were generally robust to multivariable adjustments.

CONCLUSIONS:

The VA should consider developing more SUD programs and groups exclusively for women, while maintaining ancillary services at their relatively abundant level. Gender-specific programs and groups could serve as points of referral to ancillary services for women veterans.

Via: http://ht.ly/RX7AJ

By: Heslin KC1, Gable A2, Dobalian A2.

• 1Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland. Electronic address: kevin.heslin@ahrq.hhs.gov.
• 2Veterans Emergency Management Evaluation Center, North Hills, California.

Patterns of Inhalant Use among Incarcerated Youth

Below: Plot of Polyinhalant Use Classes.

Note. (1) Airplane or model glue; (2) Anesthetic gases; (3) Freon; (4) Gas from whipping cream cans; (5) Butane; (6) "White-out" or another correction fluid; (7) Air Freshener; (8) Nail polish; (9) Nail polish remover; (10) Whippets; (11) Spray paint; (12) Gases from computer "duster" sprays; (13) Permanent markers; (14) Gasoline.

Inhalant use is especially prevalent among antisocial youth and can have serious health consequences. However, the extant literature has not investigated how use of various inhalants may co-occur among incarcerated youth. This study begins to address this gap in the literature by using latent class analyses to form distinct typologies of inhalant use. Study participants were residents (N = 723) of 27 Missouri Division of Youth Services facilities. Interviews assessed psychiatric symptoms, antisocial traits, delinquency, trauma, suicidality, and substance use behaviors. The mean age of the mostly male, ethnically diverse sample was 15.5 (S.D. = 1.2) years old. The study revealed the following classes of inhalant use: (1) severe polyinhalant use; (2) moderate polyinhalant use; (3) gas and permanent marker use; and (4) low-use. Compared to the low-use class, members of the severe polyinhalant use class had experienced more than double the rate of head injuries, the highest rates of traumatic experiences, and the highest rates of mental illness diagnoses. The gas and markers class had the highest rate of reporting hearing voices, followed by the severe polyinhalant use class, and the moderate polyinhalant use class. Results of this study underscore the need to address the high rate of head injuries and mental health diagnoses that contribute to severe polyinhalant use.

Read more at: http://goo.gl/k7i7W9 HT https://twitter.com/georgiastateu

The Social Construction of Violence among Northern Plains Tribal Members with Antisocial Personality Disorder and Alcohol Use Disorder

Below:  Northern plains AI-SUPERPFP sampling strategy

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.

Read more at:  http://ht.ly/QZHxx HT @UofOklahoma 

Patient Valuation of Primary Care-Based Treatment Options for Substance Use & Mental Health Disorders

Below:  Unadjusted self-reported willingness to enter treatment, by treatment type and price

Most individuals with substance use and mental health disorders do not receive treatment. If treatment options were more attractive, treatment rates might increase. Although the advantages of novel approaches, including primary care-based treatment and collaborative care in a primary care setting, have been documented, less is known about consumers’ valuation of these options. Contingent valuation methods were used to assess monetary valuation of these treatment types relative to usual care in specialty treatment using a national randomized experiment. Participants valued a primary care-based treatment visit over usual care by $9.00 and a collaborative care visit over usual care by $5.85.

Read more at:  http://ht.ly/QL716 HT @PennMedicine 

Identifying Binge Drinkers Based on Parenting Dimensions and Alcohol-Specific Parenting Practices: Building Classifiers on Adolescent-Parent Paired Data

Below:  The training set is composed of individuals with a known target behaviour (binge drinker or not) and with known variables (e.g., rules and communication). In one approach to build a classifier (on the left), the computer automatically and repeatedly devides the training (on the right). This specific approach produces a decision tree, where a path from the root to a target behaviour corresponds to successive cuts in the training set

Depending on the parenting dimension or practice, parents’ reports correctly identified the drinking behaviour of 55.8 % (using psychological control) up to 70.2 % (using rules) of adolescents. Adolescents’ perceptions were best at identifying binge drinkers whereas parents’ perceptions were best at identifying non-binge drinkers.

Of the parenting dimensions and practices, rules are particularly informative in understanding drinking behaviour. Adolescents’ perceptions and parents’ reports are complementary as they can help identifying binge drinkers and non-binge drinkers respectively, indicating that surveying specific aspects of adolescent-parent dynamics can improve our understanding of complex addictive behaviours.

Read at:   http://ht.ly/Qz5UP HT @MaastrichtU

Prevalence of Hospitalized Live Births Affected by Alcohol and Drugs and Parturient Women Diagnosed with Substance Abuse at Liveborn Delivery: United States, 1999–2008

Below:  Prevalence (per 10,000) on a natural log scale and Loess trend curves with 95% confidence interval for (A) live births affected by alcohol and drugs and neonatal drug withdrawal syndrome, and (B) maternal substance abuse at liveborn delivery: United States, 1999–2008.

From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid.

The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.

Read at:   http://ht.ly/Qz46f  HT @CSRIncorporated

Adolescent Substance Use: The Role of Demographic Marginalization and Socioemotional Distress

Below:  Conceptual model of relationships among race/ethnic marginalization, socioemotional distress, and substance use with student gender, race/ethnicity, and schoolwide race/ethnic diversity as moderators.

We investigated the links between race/ethnic marginalization (i.e., having few same-race/ethnic peers at school) and adolescents’ socioemotional distress and subsequent substance use (alcohol and marijuana) initiation and use. Data from 7,731 adolescents (52% females; 55% White, 21% African American, 16% Latino, 8% Asian American) were drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). In our path analysis model, we found that adolescents who were racial/ethnically marginalized at school (i.e., who had less than 15% same-ethnic peers) reported poorer school attachment, which was linked to greater depressive symptoms. More depressive symptoms were associated with higher levels of subsequent marijuana and alcohol use. These relationships showed some variation by students’ gender, race/ethnicity, and age. Findings suggest that the influence of school demographics extends beyond the academic domain into the health and well-being of young people.

Via:   http://ht.ly/QrTez   HT @UTAustin

Gendered Pathways: Violent Childhood Maltreatment, Sex Exchange, and Drug Use

Below:  Parameter Estimates for Direct-Indirect Effects Model in Women and Men

Note: Unstandardized regression weights (and standard errors) for women are left of the diagonal and in bold; estimates for men are right of the diagonal and in regular font. Correlations between the independent variables are not shown, but are similar to those reported in Table 1.

First, structural equation modeling revealed that childhood sexual and physical abuse were related to increased drug engagement in women and men, respectively, above the influence of early childhood contextual variables (e.g., neighborhood, family) and age. Second, sexual abuse was related to sex exchange, which in turn was related to drug use symptoms in women but not men.

These data provide empirical support for distinct trauma-related pathways to drug use problems in men and women, which has implications for gendered explanations and prevention approaches.

Via:   http://ht.ly/QngMt  HT @USouthFlorida 

Global Burden of Mental, Neurological & Substance Use Disorders

Below:  Absolute Disability-adjusted life years (DALYs) Attributable to Mental, Neurological, and Substance Use Disorders, by Age, 2010

Below:  Age-Standardized DALY Rates Attributable to Mental, Neurological, and Substance Use Disorders, by Region

Below:  Proportion of Global YLDs and YLLs Attributable to Mental, Neurological, and Substance Use Disorders, 2010

Results
In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson’s disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific.

Conclusion
Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the research necessary to develop better prevention and treatment options.

Via:  http://ht.ly/Qmgpt  HT @UQ_News

Alcohol Misuse in U.S. Women Veterans

Read at:  http://ht.ly/LmmPo HT @LosAngelesVA

Alcohol Dependence and Treatment Utilization in Europe

Below:  Prevalence of alcohol dependence diagnoses by GP or CIDI, stratified by age categories. Figure displaying age effect on alcohol dependence categories. Legend: (Blue bars) Diagnosis by GP, (Red bars) Diagnosis by CIDI, (Dashed line) Regression line GP diagnosis, (Continuous line) Regression line CIDI diagnosis

Alcohol dependence (AD) was prevalent among patients in European primary health care settings (8.7 %, 95 % confidence interval (CI): 8.1-9.3 %). Treatment rates were low (22.3 % of all AD cases, 95 % CI: 19.4-25.2 %). For both prevalence and treatment utilization, considerable country variations were observed. AD was associated with a number of socio-economic disadvantages (e.g. higher unemployment rate) and higher physical (e.g., liver disease, hypertension) and mental comorbidities (e.g., depression, anxiety). Liver problems, mental distress and daily amount of alcohol used were higher among treated versus untreated male patients with AD.

A minority of people identified as having AD received treatment, showing heavier drinking patterns and a higher level of co-morbidity. Different types of treatment, depending on severity of AD, should be considered.

Via:   http://ht.ly/Qgng7  HT @CAMHnews 

Tracking the When, Where, and With Whom of Alcohol Use: Integrating Ecological Momentary Assessment and Geospatial Data to Examine Risk for Alcohol-Related Problems

Below:  Social–ecological framework of drinking contexts and alcohol-related problems.

NOTES: 1 The characteristics listed in each box are provided as an example. They are not an exhaustive list of variables one might include in social–ecological models.

2 Macro- (e.g., alcohol outlet density) and micro-level drinking contexts (e.g., drinking location) are included in the model above, but we focus primarily on micro-level drinking contexts here.

Prevention researchers have found that drinking in different contexts is related to different alcohol problems. Where and with whom people drink affects the types of alcohol-related problems they experience. Consequently, identifying those contexts that result in the greatest number of problems provides a novel opportunity to target new prevention efforts aimed at those contexts. However, identifying these contexts poses methodological challenges to prevention research. To overcome these challenges, researchers need tools that allow them to gather detailed information about when and where people choose to drink and how contextual factors influence drinking risks. New data collection and analysis techniques, such as activity-space analysis, which examines movement through different contexts, and ecological momentary assessment, which captures microlevel contextual changes as individuals move through their days, can advance the field of alcohol studies by providing detailed information on the use of drinking contexts, particularly when combined. Data acquired through these methods allow researchers to better identify those contexts where and conditions under which drinking and problems related to drinking occur. Use of these methods will allow prevention practitioners to target prevention efforts to those contexts that place most drinkers at risk and tailor prevention efforts to each context for specific outcomes.

Via:   ht.ly/PfPwW HT @UCLALuskin