Dissertations / Theses on the topic 'Addiction relapse'
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Carter, Alexander James. "Struggling to hold addiction treatment talk and relapse in mind." Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/12761.
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Includes bibliographical references.Addiction is a common problem, as is relapse. People often struggle to come to terms with and manage the intoxicating effects of substances and consequently need treatment. This dissertation focusses on treatment talk as it relates to addiction counselling in a residential setting in order to understand relapse and the addict’s return to treatment. Current treatment approaches that address addiction comprise several evidence-based approaches and yet relapse rates remain high. Attempts to explain this phenomenon are varied and interventions tend to have a disease model approach in common with one another. Neurobiological and psychological theories of addiction are examined to understand this treatment conceptualization and consider its efficacy as a means of directing counselling interventions. Mentalization theory and critical discourse theory are used as a discursive lens in an attempt to understand these interventions and consider their shortcomings. In order to approach the question of relapse and addiction treatment, twenty interviews were conducted with clients and their counsellors - 10 dyads - who had completed residential addiction treatment for relapse. Counsellors and clients were interviewed and asked about their treatment experience, either as a client or clinician respectively. Both sets of participants were also asked about counselling as a relapse prevention intervention. Focus on the counselling relationship was in order to elicit talk about mental states related to treatment for addiction and relapse.
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Wong, Jamie Lynne. "Social Support as a Mediator Between Attachment and Relapse in women." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1870.
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Prescription pain medication abuse is a developing social problem in the United States. This quantitative study, grounded in attachment theory, examined relationships between attachment, perceived social support, and relapse. It was hypothesized that significant relationships existed between (a) attachment dimensions and relapse and (b) perceived social support and relapse. A further hypothesis was that perceived social support was a mediator in the relationship between attachment and relapse. Participants were 69 adult females, each of whom completed a demographic questionnaire; the Advanced Warning of Relapse (AWARE) Questionnaire; the Experiences in Close Relationships, Revised (ECR-R); and the Personal Resource Questionnaire (PRQ). A multiple linear regression was conducted to determine relationships between attachment and perceived social support on relapse. A mediation analysis was conducted to determine whether perceived social support was a mediator between attachment and relapse. Results identified that women with anxious styles of attachment have higher relapse potential and that women with higher levels of perceived social support appeared to have decreased attachment anxiety. Results indicated that women with increased attachment anxiety who also reported higher levels of perceived social support showed a reduced potential to relapse. This research contributes to positive social change by confirming the importance for health professionals to incorporate both attachment theory and the role of social support into treatment modalities to prevent relapse and to increase public awareness about these psychological factors of prescription pain medication addiction.
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Freiin, Von Hammerstein-Equord Cora Fee. "Mindfulness et addictions : évaluation du programme MBRP (Mindfulness-Based Relapse Prevention) chez des patients présentant une addiction avec ou sans substance." Thesis, Paris 10, 2018. http://www.theses.fr/2018PA100131.
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L’objectif de ce travail de thèse était d’évaluer la faisabilité, l’acceptabilité et de fournir des résultats préliminaires du programme MBRP (Mindfulness Based relapse prevention) pour le traitement des addictions. Dans un premier lieu ce travail nous a permis de démontrer que ce programme représentait un type de prise en charge thérapeutique acceptable et faisable pour le traitement du trouble de l’usage de l’alcool. La participation au programme augmentait le niveau de pleine conscience et de flexibilité psychologique et réduisait le craving. Ensuite, nous avons pu identifier que la pratique à domicile, occupant une place centrale dans les traitements basés sur la pleine conscience, était facilitée par la motivation initiale des participants et de leur sentiment d’auto-efficacité quant à la capacité de mettre en place une pratique, à l’inverse, l’impression de « mal faire » ou l’absence d’effets immédiats de la pratique présentait un frein à la pratique autonome. Nous avons également pu rendre compte de l’intérêt de ce programme pour le traitement du trouble lié à la pratique de jeu d’argent et de hasard. A travers nos résultats descriptifs, nous avons pu montrer que la méditation de pleine conscience était un outil dont la majorité des patients joueurs se saisissaient volontiers pour gérer les envies de jeu et l’impulsivité. Nous avons trouvé que la participation au programme a permis de réduire la pratique de jeu, les symptômes de jeu, le craving, ainsi que les symptômes dépressifs et anxieux et augmenter le niveau de pleine conscience. Par ailleurs nous avons pu montrer à travers un cas clinique, que l’association de la pratique de pleine conscience et de training cognitif, pouvait représenter une prise en charge complémentaire et augmenter le contrôle de soi, chez une patiente résistante aux TCC classiques. Nous avons également montré que l’initiation à la pleine conscience chez des soignants travaillant dans le domaine de l’addictologie a été très bien accueillie, qu’en moyenne ils ont participés à 4 séances sur 5 et qu’ils ont tous mis en place une pratique autonome après l’initiation en groupe. Pour finir nous avons validé le Transdiagnostic Craving Trigger Questionnaire (TCTQ) visant à évaluer les déclencheurs de craving, dans une population présentant un trouble de l’usage de l’alcool. Nos analyses ont montré une solution à trois facteurs, les émotions désagréables, les émotions agréables et les déclencheurs externes et pensées associées aux consommations. Finalement ce travail de thèse nous a permis de conclure que le programme MBRP est un programme qui a tout son intérêt pour le traitement des addictions avec ou sans substances. Nous avons pu montrer qu’il agissait sur des processus sous-jacents de cette pathologie tels que les affectes dépressifs et l’anxiété, qu’il permettait de réduire le craving et qu’il mobilisait des ressources telles que la flexibilité psychologique. Nous avons l’objectif de conduire des travaux supplémentaires afin de pouvoir statuer sur son efficacité en comparaison à une condition contrôleThe purpose of this work was to investigate feasibility, acceptability and preliminary outcomes of the MBRP (Mindfulness Based relapse prevention) program as a treatment of addictions. First, this work allowed us to establish that this program represented an acceptable and feasible therapeutic approach as a treatment for alcohol use disorders and that it increased the level of mindfulness and psychological flexibility and reduced craving. Secondly, we were able to identify that home practice, which is central to mindfulness-based treatments, was facilitated by the participants' initial motivation and their feeling of self-efficacy in terms of their ability to set up a practice, while the impression of "doing wrong" or the absence of immediate effects of the practice was a barrier to it. We have also been able to highlight the interest of this program as a treatment for gambling disorder. Through our descriptive results, we showed that mindfulness meditation was a tool that most gamblers readily used to manage craving and impulsive behavior. In addition, we found that participating in the program reduced gambling, gambling symptoms, craving, as well as depression and anxiety and increased mindfulness levels. In addition, we were able to show by examining a case report that the combination of the MBRP program and cognitive training could increase self-control in a patient who was resistant to conventional CBTs. We have also shown that the initiation to mindfulness among caregivers working in an addiction facility has been very well received. On average they participated in 4 out of 5 sessions and, all set up a personal home practice after the group initiation. Finally, we validated the Transdiagnostic Craving Trigger Questionnaire (TCTQ) to assess craving triggers in a population with an alcohol use disorder. Our analyses showed a three-factor solution, composed of unpleasant emotions, pleasant emotions and external triggers and associated thoughts. This thesis work allowed us to conclude that the MBRP program has a strong interest in the treatment of addictive disorders, with or without substances. We were able to show that it worked on underlying processes of this disorder, such as depression and anxiety, that it reduced craving and that it was a way of mobilizing resources, such as psychological flexibility. Our objective is to carry out further research which would allow us to state on its efficacy as compared to a control condition
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Girardeau, Paul. "Validation d’une stratégie de prévention de la rechute basée sur l’extinction des effets incitatifs de la cocaïne." Thesis, Bordeaux, 2015. http://www.theses.fr/2015BORD0257/document.
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L’addiction aux drogues d’abus se caractérise par une prise compulsive de drogue et par des épisodes récurrents de rechute après abstinence. Ces épisodes de rechute, parfois mortels, sont généralement précédés par un désir intense et irrépressible pour la drogue, appelé aussi craving. Bien que le rôle causal du craving dans la rechute reste encore à démontrer, la prévention du craving est devenue récemment un enjeu important des recherches clinique et préclinique. Chez l’homme l’amorçage du craving s’effectue après exposition ou réexposition à la drogue elle-même, à un stress, ou à des stimuli conditionnés à la prise de drogue. Chez l’animal, cet amorçage peut être modélisé par la reprise du comportement de recherche de drogue après arrêt du renforcement. Cette reprise peut être amorcée par les mêmes facteurs amorçant le craving chez l’homme, notamment par la réexposition à la drogue elle-même, ce qui suggère qu’elle exprime un état ressemblant au craving. Selon une hypothèse récente, l’amorçage du craving par la drogue serait dû à un conditionnement intéroceptif. Ce conditionnement se formerait au cours de l’acquisition où les animaux apprendraient à associer les stimuli intéroceptifs périphériques de la drogue avec la disponibilité du renforcement. Après arrêt du renforcement, la réexposition à ces stimuli intéroceptifs conditionnés provoquerait la reprise de la recherche de drogue en signalant (faussement) aux animaux le retour du renforcement. Cette hypothèse a permis le développement et la validation récente d’une stratégie anti-craving basée sur l’extinction de ces stimuli conditionnés de la cocaïne. Dans ce contexte, mon travail de thèse a eu pour but principal d’évaluer l’efficacité potentielle de cette stratégie à prévenir la rechute proprement dite, c’est-à-dire le retour aux niveaux de prise de cocaïne avant l’extinction. Ce travail a permis de démontrer : 1) qu’il est possible d’éteindre complètement l’amorçage du craving par la cocaïne chez l’animal ; 2) que cette extinction est accompagnée par une perte des réponses neuronales à la cocaïne dans les régions du cerveau causalement impliquées dans l’amorçage du craving (i.e., cortex préfrontal prélimbique et partie « core » du noyau accumbens); 3) mais que malgré nos attentes initiales, l’extinction complète et prolongée de l’amorçage du craving par la cocaïne n’a aucun effet préventif majeur sur la rechute, suggérant une dissociation entre craving et rechute, du moins chez l’animal ; enfin, 4) que cet échec relatif est dû en grande partie à l’existence d’une forme résiduelle de recherche de cocaïne résistante à l’extinction, fréquemment rapportée dans la littérature mais généralement ignorée. Cibler cette résistance à l’extinction afin de l’éradiquer devrait représenter un enjeu majeur pour la recherche future dans le domaineCraving often precedes relapse into cocaine addiction. This explains why considerable research effort is being expended to try to develop anti-craving strategies for relapse prevention. Recently, we discovered using the classic reinstatement model of cocaine craving that the reinstating or priming effect of cocaine can be extinguished with repeated priming – a phenomenon dubbed extinction of cocaine priming. Such extinction has been interpreted as evidence that the priming effect of cocaine on reinstatement of cocaine seeking depends on an interoceptive drug conditioning mechanism whereby the interoceptive cues of cocaine become reliable conditioned Pavlovian predictors of the availability of cocaine reinforcement. Regardless of the underlying mechanisms, however, extinction of drug priming has been proposed as a potential cocaine exposure therapy for relapse prevention that may complement other, more traditional exteroceptive cue exposure therapies. The goal of my PhD thesis was to measure the potential beneficial effect of this novel extinction strategy on subsequent relapse (i.e., return to the pre-extinction pattern of cocaine self-administration once the drug is made again available after extinction). Overall and contrary to our initial hope, extensive and complete extinction of cocaine priming had no major impact on relapse. This lack of effect occurred despite evidence for post-extinction loss of neuronal responsiveness to cocaine priming in brain regions causally involved in cocaine-induced reinstatement (i.e., the anterior cingulate and prelimbic prefrontal cortex, and the core of the nucleus accumbens). An effect of extinction of cocaine priming on relapse was only observed when cocaine was available for self-administration under more demanding conditions. However, this effect was modest and short-lived. Finally, we were able to trace the origin of our failure to prevent relapse to an extinction-resistant form of cocaine seeking that is commonly reported, though often overlooked, in other reinstatement studies. We propose that this behavior should become a novel target for future preclinical research on anti-craving strategies for relapse prevention
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Hamilton, Jennifer Julie. "Deep Brain Stimulation of the Nucleus Accumbens for the Treatment of Cocaine Addiction." Thesis, University of Canterbury. Psychology, 2014. http://hdl.handle.net/10092/9213.
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With approximately 7% of the adult population reporting to have taken illicit substances over the course of a year and the chronically relapsing nature of substance use disorders there is a great need for effective forms of treatment and therapies to reduce relapse. Deep brain stimulation (DBS) is a process of neuromodulation where electrodes are implanted in a target region to modulate the electrophysiological activity of the target region. DBS has been postulated as a potential therapy for treatment-refractory addiction, with a great deal of focus on the nucleus accumbens (NAc). Forty male Long Evans rats were implanted with unilateral stimulating electrodes within the right NAc prior to exposure to chronic cocaine self-administration (0.5 mg/kg/infusion). Following self administration, the animals were withdrawn from cocaine and treated with 14 consecutive days of sham, low frequency (LF, 20 Hz) or high frequency (HF, 160 Hz) stimulation sessions (30 min/day). The animals underwent drug seeking tests on days 1, 15 and 30 of the withdrawal phase with context-induced relapse paired with a drug challenge (5 mg/kg i.p). Relapse rates were highest on day 15 after withdrawal, with both LF and HF attenuating cocaine during this drug-seeking test, however this was not the case for tests on days 1 and 30. Motivation to respond for saccharin solution (0.1 %) remained intact following both LF and HF stimulation intake sessions. These results demonstrate that unilateral DBS of the NAc effectively attenuated cocaine-seeking following chronic exposure to stimulation although these beneficial effects appeared to diminish following cessation of daily treatment with stimulation. The results obtained in this experiment provide support for DBS as a potential therapy for patients with treatment-resistant cases of substance use disorders.
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Orejarena, Maria Juliana. "Neurobiological mechanisms involved in MDMA-Seeking behaviour and relapse." Doctoral thesis, Universitat Pompeu Fabra, 2010. http://hdl.handle.net/10803/7229.
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(+) 3,4-metilendioximetanfetamina (MDMA), popularmente conocida como "éxtasis", es una droga susceptible de producir adicción en algunos individuos. Actualmente es consumida principalmente por adolescentes y jóvenes. Los particulares efectos psicoactivos inducidos por la MDMA, permiten distinguirlo de manera clara de otros psicoestimulantes o compuestos alucinógenos. Esta droga actúa principalmente activando el sistema dopaminérgico y serotonérgico en los circuitos neurales de placer. Sin embargo, los mecanismos neurobiológicos implicados en las propiedades adictivas de esta droga no han sido aún esclarecidos. El trabajo presentado en esta Tesis Doctoral ha puesto de manifiesto algunos aspectos claves de estos procesos que eran desconocidos hasta el momento. Hemos encontrado que el receptor de serotonina 5-HT 2A participa de forma critica en las propiedades reforzantes de la MDMA, contrario a lo observado en el caso de otros psicoestimulantes. Además, el bloqueo farmacológico de este receptor puede prevenir la reinstauración de la búsqueda de la MDMA, desencadenada por un estímulo o clave previamente asociado a su consumo. Estos efectos pueden ser debidos al bloqueo del control excitatorio que normalmente ejercen estos receptores sobre los niveles de dopamina en estructuras mesolímbicas, como ha sido revelado en nuestros estudios de microdiálisis. Hemos demostrado también que la MDMA puede actuar como clave interoceptiva y desencadenar la recaída a la búsqueda y consumo de cocaína. Adicionalmente, nuestros estudios han mostrado que tanto la activación del sistema dopaminérgico mesolímbico, como los cambios en la expresión génica en diferentes ´areas cerebrales que ocurren tras la administración de la MDMA, dependen de si el sujeto participa de manera activa en el consumo de esta droga, o si por el contrario la recibe de forma pasiva. En conclusión, este trabajo resalta la importancia de los procesos de aprendizaje y memoria sobre las propiedades reforzantes/recompensantes de la MDMA. Además, nuestras investigaciones aportan nuevas evidencias en relación a la participación del sistema serotonérgico en la búsqueda y recaída al consumo de esta droga.(+) 3,4-methylenedioxymethamphetamine (MDMA), commonly known as "ecstasy", is currently a highly consumed drug with liability to produce addiction in some individuals. MDMA induces unique psychoactive effects that clearly distinguish it from hallucinogenic or psychostimulant drugs. MDMA mainly enhances the activity of both the serotonergic and the dopaminergic system in the esolimbic brain reward pathways. However, the neurobiological mechanisms underlying its possible addictive properties are still not fully understood. In the present work, we have contributed to this subject by establishing that the serotonin 5-HT2A receptor, in contrast to what has been observed for other drugs of abuse, is critical for MDMA-induced reinforcement. Moreover, the pharmacological blockade of this receptor can prevent cue-induced relapse. This effect is possibly mediated by its excitatory control over basal and MDMA-induced increase in midbrain dopamine, as supported by our microdialysis data. Furthermore, we have also shown that MDMA can act as an interoceptive cue to induce relapse to cocaine-seeking behaviour. Additionally, we demonstrated differential changes at the level of the dopaminergic brain reward pathway and gene expression changes in different brain areas, following self-administeredMDMAin comparison to passive administration. These results underpin the impact of a learning component in the rewarding/reinforcing properties of MDMA, and provide new evidence for the serotonergic involvement in MDMA-seeking behavior and relapse.
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Blume, Jenna. "An Attitude of Gratitude| How a Grateful Disposition Impacts Relapse During Recovery from Drug and Alcohol Addiction." Thesis, The Chicago School of Professional Psychology, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1568606.
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Consistent with the contemporary positive psychology movement, dispositional gratitude has gained considerable empirical evidence as a valuable emotion in increasing an individual's subjective well-being; however, gratitude has not yet been validated as a contributing factor to sobriety in individuals in recovery from drug and alcohol addiction. In the current study, participants were self-selected outpatients and staff members in recovery at a drug and alcohol addiction treatment center. The researcher assessed respondents' psychological symptoms, coping skills, dispositional gratitude, experience of relapse or abstinence, and demographic influences. Results indicated a significant negative correlation between gratitude and relapse, suggesting that a grateful disposition has emotional and psychological benefits for individuals in recovery from substance addiction. Additional findings revealed that the coping strategy of using alcohol or other drugs to feel better was statistically significant and made the strongest unique contribution to relapse; coping strategies including gratitude and religion/spirituality, although not statistically significant, each contributed less to the variance in relapse amongst participants. Finally, results suggest that education made the strongest unique contribution to relapse, which was statistically significant, while annual household income made less of a contribution and was not statistically significant. Research limitations, clinical implications, and future directions for the field are discussed.
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Matendechere, Elizabeth Nanjala. "A Correlational Study on Self-Forgiveness and the Risk of Relapse in Adults Recovering from Alcohol Addiction." Thesis, Northcentral University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10844068.
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Self-forgiveness is an emotion focused coping mechanism that increases positive emotions and behaviors. Self-forgiveness has been found to be moderated by guilt and shame in support of Hall and Finchman’s theory on the emotional components of self-forgiveness. Men and women recovering from alcohol addiction have been found to struggle with shame and guilt, however, little is understood about this association. This quantitative correlational non-experimental research study investigated the relationship between self-forgiveness and risk of relapse in adults who were recovering from alcohol abuse, how shame and guilt moderated this relationship and how this relationship differed by gender. Anonymous surveys were conducted in two treatment centres and two Alcoholic Anonymous recovery meetings in the city of Calgary. Participants completed a demographic questionnaire, The Heartland Forgiveness Scale, Alcohol Risk of Relapse Scale, and the Guilt and Shame Proneness Scale. Multiple regression and moderation analyses were conducted to test the study hypotheses. Self-forgiveness was found to have a non-significant relationship with risk of relapse (β = .040, p < .720) and the scores did not differ by gender [Male (β = –.061, p < .641), and Female (β = –.0.17, p < .937)]. Shame (F (3, 79) = .614, p = .608), and guilt (F (3, 79) = 7.244, p = .000) did not have a moderating effect on the relationship between self-forgiveness and the risk of relapse. When shame and guilt interacted with self-forgiveness in predicting risk of relapse, the results did not differ by gender [Male (F (4, 55) = 5.770, p = .001), and female (F (4, 18) = .580, p = .681)]. However, a result not hypothesized in the study was found among male participants that guilt was predictive of risk of relapse ( F (3, 56) = 7.595, p = .000). This study highlights the impact of maladaptive guilt that maintains the cycle of addiction. Clinicians can utilize this knowledge to employ strategies of eliminating maladaptive guilt in psychotherapy. Further research is needed to determine if these results could be replicated with other demographic groups to identify other plausible mechanisms between self-forgiveness at risk of relapse.
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Krowka, Jessica Ann. "The Lived Experience of Recovery From Heroin Addiction." University of Akron / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=akron1555951788174113.
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Li, Chen. "Attenuated Cocaine Seeking After Adolescent-Onset of Cocaine Self-Administration in Male Rats: Behavior, Environment, and Genes." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/biology_diss/100.
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Recreational drug use peaks in the developmental stage of adolescence in humans. In this dissertation, we used a rodent model of adolescence and behavioral assessments of intravenous (i.v.) cocaine self-administration and reinstatement of cocaine-seeking to explore age differences in these cocaine-related behaviors, and then tested for the influence of environmental enrichment and for correlations between behavior and expression of plasticity genes. Although taking similar amount of cocaine, male rats trained to self-administer cocaine during adolescence (adolescent-onset) showed attenuated cue-induced reinstatement of cocaine seeking compared with adults. This attenuated cue-induced reinstatement did not generalize to a natural reward, sucrose pellets. Then we asked whether the attenuated reinstatement may be due to rapid developmental re-organization of reinforcement circuits (high plasticity) in adolescent-onset groups. To stimulate or inhibit neuroplasticity, subjects experienced environmental enrichment or impoverishment during abstinence. Environmental manipulations had no effect in adolescent-onset groups, whereas the enriched environment attenuated cue-induced reinstatement in adults compared with their impoverished counterparts. Thus, we turned to internal factors that may contribute to age-differences in reinstatement of cocaine seeking. Using in situ hybridization to quantify the mRNA for two neuroplasticity-related genes, activity-regulated cytoskeletal-associated gene (arc) and brain-derived neurotrophic factor (bdnf), we identified that overall, arc expression in the nucleus accumbens (NAc) and bdnf expression in the medial prefrontal cortex (mPFC) was higher in adolescent-onset than in adult groups. Together our data suggest that adolescence in rodents may be a period of relative biological resistance to some long-term drug effects.
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Luu, Shirley, and Mersiha Selmanovic. "Min själ ville inte använda, men min kropp viker sig själv." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-27031.
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The purpose of this study has been to gain an understanding of how drug addicts get out of an addiction from the perspective of people who have previously been addicted to narcotics. To achieve the purpose of this study we interviewed former addicts and social workers whose work is to help drug addicts. The interviews with the informants have been semi structured where as we had prepared some open questions but also as the interviews went on we thought of follow up questions to ask. The analysis was conducted with three theories: the turning point, natural recovery and social bond. The results show that there are different ways to reach a turning point when you decide to quit the habit and then there are various factors that facilitate a person of getting out of an addiction that also prevent relapse. Furthermore, the results show that their own perspective on what mattered the most during their way out of an addiction was the support of people who had gone through the same process of changing their lifestyle. They found that fellowship is essential to recovery and relapse prevention.
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Bailey, Beth A., and Andrea D. Clements. "Postpartum Smoking Relapse: The Role of Family in the Health Behavior Choices of New Mothers." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7250.
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Wahler, Elizabeth A. "THE RELATIONSHIP OF SOCIAL STRESS, ECONOMIC HARDSHIP, AND PSYCHOLOGICAL DISTRESS TO ADDICTION SEVERITY AMONG KENTUCKY SUBSTANCE ABUSE TREATMENT PARTICIPANTS." UKnowledge, 2012. http://uknowledge.uky.edu/csw_etds/1.
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Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up addiction severity in a large sample of Kentucky substance abuse treatment participants (N = 1123). A conceptual model is tested to determine if social characteristics along with psychological distress, perceived stress, and economic hardship are predictors of substance use and follow-up addiction severity. In addition, since recovery support, efficacy, and self-control have been previously identified as mediators in the stress and relapse processes these factors were included as mediators in the model tested. The conceptual model was tested with three outcome variables, substance use between baseline and 12-month follow-up, follow-up alcohol addiction severity, and follow-up drug addiction severity. Bivariate and multivariate analyses, including logistic regression and ordinary least squares regression, were used to test conceptual models with the full sample and also with a subsample with baseline substance use indicative of potential substance dependence. Findings indicated that significance of predictors varied depending on outcome variable, although recovery support, efficacy, and self-control were significant predictors of all three dependent variables. Findings for each outcome variable are discussed, as well as limitations of the present study, implications for social work practice, and implications for future research.
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Steele, Teren Palm. "Relapse and spirituality spiritual well-being and quality of life as a critical factor in maintaining recovery from alcohol addiction /." Online version, 1999. http://www.uwstout.edu/lib/thesis/1999steele.pdf.
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Mauriz, Carlos Alberto. "Causes of substance abuse relapse among Mexican American and Anglo males." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2092.
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Lewis, J. Ben. "POLYAMINE MODULATION IN ALCOHOLISM: EXAMINATION USING A NOVEL SCREENING PROCEDURE DESIGNED TO PREDICT ANTI-RELAPSE AND NEUROPROTECTIVE EFFICACY." UKnowledge, 2011. http://uknowledge.uky.edu/gradschool_diss/851.
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Alcohol dependence is a major public health concern. Despite the FDA’s approval of multiple anti-relapse drugs, relapse rates remain unacceptably high. Furthermore, cognitive deficits among chronic drinkers are evident and are suggested to contribute to relapse risk. Current evidence suggests that several critical features of alcoholism and alcohol-associated neurodegeneration are mechanistically linked to glutamatergic actions; specifically, they appear positively affected by glutamatergic inhibition, particularly inhibition via polyamine modulation of a subpopulation of n-methyl-d-aspartate receptors. The current project was designed to evaluate the performance of two putative polyamine modulators (JR-220 and CP-101,606) in a variety of screens designed to identify the potential to reduce withdrawal severity, neurotoxicity and relapse risk. Screens included a complex organotypic screen designed to assess neuroprotective potential (Experiment 1), a simple behavioral screen designed to assess withdrawal severity (Experiment 2) as well as several more complex behavioral screens designed to examine cue-conditioning during withdrawal (Experiment 3), relapse behavior (Experiment 4), stress-associated consumption (Experiment 5) and binge-like consumption (Experiment 6). An additional open field experiment (Experiment 7) was conducted in order to address interpretational issues concerning activity in Experiments 2-6. Finally, as a first step in moving beyond simple screening, we expanded our binge screen to adhere more closely to an established, validated model of binge consumption (Experiment 8). While some interpretational issues were noted, taken together, the results from these experiments provide strong evidence for both drugs as potential pharmacotherapies for alcoholism and further implicate polyamines and NR2B subunits as critical mechanisms in ETOH consumption and withdrawal.
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Tham, Johanna. "Ett liv utan missbruk - och sex? Hållbar behandlingsvård för kvinnor." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26055.
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The aim of this study was to examine the concept of sex, sexuality and sexual health and its significance to drug and alcohol addiction treatment for women. More specifically its aim was to find out if social workers and professionals within addiction treatment services ought to support women in creating sustainable sexual relations in the drug free context and if so what the support should consist of. The study was based on recent scientific articles and literature that were analysed through thematic content analysis. The themes that were identified and that were recurring throughout the material were how social structures impact addiction treatment for women as well as their sexual health and how professionals within addiction treatment need to incorporate this knowledge in their practice to support patients to a sustainable drug-free life. The analysis was based on sexual script theory to further the knowledge of what meaning sexuality and relationships have for addiction recovery. The sexual script theory also illustrates what impact narratives have on patients in treatment that are moving between a context with substance abuse and a drug free context. The conclusions made were that sex, sexuality and sexual health are significant matters for addiction treatment since addressing these topics can prevent relapse in patients. Professionals can support women in creating a sustainable relation to sex, sexuality and sexual health by incorporating positive perspectives on sex through conversations in treatment programs. Discussions that raise awareness of how sex and addiction is influenced by social structures, educative conversations on the connection between body, desire and pleasure as well as supporting patients in recognizing which sexual situations are a risk for relapse can make addiction treatment more effective.
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Miles, Olivia. "Intra-cellular mechanisms by which PAC1 receptor activation mediates stress-induced reinstatement to drug-seeking." ScholarWorks @ UVM, 2018. https://scholarworks.uvm.edu/graddis/897.
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The abuse of and addiction to drugs of abuse, such as tobacco, alcohol, opioids, and illicit drugs, are growing global problems that affect the welfare of individuals and societies worldwide. The National Institute of Drug Abuse estimates the annual cost of substance abuse to be over $740 billion in costs related to drug intoxication, withdrawal and relapse. A primary challenge in the treatment of substance abuse is the tendency of users to relapse following acute or extended periods of abstinence; on average over 60% of substance abusers will return to drug use within a year of receiving treatment, many relapsing following stressful life events. Central to the successful treatment of drug addiction is understanding the cellular mechanisms by which relapse episodes occur. Current data suggest that the activation of pituitary adenylate cyclase activating peptide (PACAP) systems in the bed nucleus of the stria terminalis (BNST) is an important event underlying stress-induced reinstatement to drug-seeking in a rodent model of stress-induced relapse.
In conjunction with immunohistochemistry and pharmacological treatments, we used this behavioral model of stress-induced relapse to evaluate PACAP and PACAP type-1 receptor (PAC1-R) signaling in stress-induced reinstatement to cocaine seeking. Activation of the PAC1 receptor appears to be critical to stress-induced reinstatement, as the selective PAC1-R agonist, maxadilan, produced reinstatement behaviors in the absence of stress. Moreover, BNST pretreatment with either mitogen activated protein kinase-ERK (MEK) or endocytosis inhibitors to block extracellular signal-related kinase (ERK) signaling attenuated stress-induced reinstatement. Furthermore, BNST phosphorylated ERK (pERK) expression, mediated by PAC1-R activation, is substantially potentiated in cocaine-experienced animals after stressor exposure, in a manner that is dependent on endosomal signaling and MEK activity.
These data suggest that the activation of a PAC1 signaling cascade is a key event underlying stress-induced reinstatement. Furthermore, this data may suggest a permanent change in the BNST PACAP system (sensitization) following cocaine exposure.
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Tammar, Raghdah. "Les croyances associées à l'alcool et leur lien avec les expériences traumatiques et certains troubles psychologiques en Arabie Saoudite : étude exploratoire." Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0510.
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Introduction: Souvent, les recherches sur ce sujet se réalisent dans un environnement de consommation légal. Pourtant, le cas de l'Arabie saoudite devrait donner des résultats différents. pour la théorie cognitive, la dépendance chimique consiste en une forte interaction entre les cognitions (pensée, croyance, schéma), valeur, opinion, attente, supposition, attitude, émotions, connexion familiale et sociale, impact social et procédure naturelle et physiologique. En s’intéressant à explorer ces croyances dans une société interdisant l'alcool et à présenter un protocole d'évaluation complet adapté à cette culture. Méthode: L’étude inclue 144 sujets, séparés en 3 groupes selon la dépendance et le sexe. Résultats: Les positives croyances liées à l'alcool sont plus élevées chez les alcooliques alors qu'il n'y a pas de différence liée au sexe. Une corrélation positive entre le craving et la rechute. Le niveau de trauma est plus élevé chez les alcooliques et positivement lié à la rechute. Conclusion: Les croyances liées à l’alcool comme toutes les variables precitées ont une rôle essentiel dans la compréhension et le traitement de ce problèmeIntroduction: Mostly, the researches about this subject are done in legal alcohol consumption environment. Therefore the case of Saudi Arabia should give different results. Regarding cognitive theory, chemical dependence consists of a strong interaction between cognitions (thoughts, convictions, schemas), values, opinions, expectations and suppositions attitudes; emotions; familial and social connections; social impacts; and natural and physiological procedures. We are interested in exploring these beliefs in a society that forbids alcohol and presenting a complete evaluation protocol adapting to Saudi culture. Method: We studied 144 subjects, separated into 3 groups depending on addiction and gender. Results: Higher positive believes related to alcohol in alcoholics while there is no difference between men and women. A positive correlation between craving and relapse. The traumatic experiences are higher in alcoholics and positively correlated with relapse. Conclusion: The beliefs related to alcohol consumption beside all other variables that are mentioned above have a vital role in the comprehension and the treatment of this issue
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Taylor, Leigh H. "The Mediating Role of Social Support and Self-Efficacy on the Relationship Between Trauma and Post-Treatment Substance Use Among Low-Income Women." Case Western Reserve University School of Graduate Studies / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1497526979343182.
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Nicolas, Céline. "Étude des modifications à long terme induites par la prise chronique de cocaïne : approches anatomique, métabolique et comportementale." Thesis, Poitiers, 2014. http://www.theses.fr/2014POIT2334/document.
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L'addiction aux drogues est une pathologie psychiatrique chronique qui représente un problème de santé publique majeur. Malgré des avancées importantes permettant de mieux comprendre les modifications cérébrales induites par les drogues d'abus, les thérapies restent encore limitées. Ainsi, l'étude des processus cérébraux qui sous-tendent les risques de rechute à long terme semble être centrale à l'élaboration de nouvelles stratégies thérapeutiques. Une partie de cette thèse vise à déterminer les modifications cérébrales induites à long terme lors du sevrage, suite à une prise chronique de cocaïne. Notre première étude a révélé une réduction de la densité vasculaire cérébrale lors du sevrage précoce, exclusivement localisée dans le cortex cingulaire. Dans la seconde étude, nous avons mis en évidence des modifications du métabolisme cérébral et étudié leur évolution lors du sevrage. Après un mois de sevrage, période où l'on trouve le phénomène d'incubation du « craving », nous avons mis en évidence une réduction du métabolisme cortical et striatal alors que l'amygdale se voit hyperactivée témoignant d'une dérégulation des fonctions cérébrales. Enfin, nous avons caractérisé le mécanisme sous-jacent à l'effet « anti-craving » de l'environnement enrichi (EE). Nous avons émis l'hypothèse que l'EE agirait comme une récompense alternative pour diminuer la recherche de cocaïne, ainsi nous avons testé les effets de l'exposition au sucrose et à l'exercice physique sur le comportement de recherche de drogue. Nous avons montré que l'accès à une récompense alternative pendant le sevrage ne permet pas de réduire la recherche de cocaïne suggérant que l’EE n'agit pas exclusivement comme une récompense alternativeDrugs addiction is a chronic brain disorder representing a major public health problem. Although important advances allowed a better understanding of the cerebral modifications induced by chronic exposure to drugs, the therapies still nowadays limited. Therefore the investigation of cerebral processes that underlie the persistent risks of relapse, seem to be crucial to offer new therapeutic strategies. A part of this thesis aims at investigating the cerebral modifications induced in a long term during the withdrawal, due to a chronic voluntary intake of cocaine. In our first study we found a reduction of the density of cerebral vessels during the early withdrawal selectively localized in the cingular cortex. In our second study we found that cocaine intake leads to modifications of cerebral metabolism that evolve during the withdrawal. After one month of withdrawal, at a time when the phenomenon of incubation of craving is found, we found a decrease in cortical and striatal metabolism and a hyperactivation of the amygdala which demonstrates a persistent disregulation of brain functioning. Finally, in our third study, we tried to dissect the mechanism underlying the anti-craving effect of the enriched environment (EE). We hypothesized that the EE acts as an alternative reward to decrease the cocaine seeking behavior. Thus we tested the effects of exposure to sucrose or the physical exercise on relapse to cocaine. We demonstrated that the access to an alternative reward during the withdrawal does not allow reducing cocaine seeking which suggests that the EE does not act exclusively as an alternative reward
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Davis, Andrew J. "A Mixed-Method Study of the Effects of a Mindfulness-Based Relapse Prevention Aftercare Program on Clients with Opioid Addiction in a Court-Ordered Population." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1596059927076454.
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Shahrokh, Bahram Edward Kaikhosrow. "The Experience of Relapse After Long-term Sobriety and Subsequent Return to Sobriety." Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1560629709925552.
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Bunting, Amanda Marie. "POLYSUBSTANCE OPIOID USE IN A JUSTICE-INVOLVED POPULATION: AN ANALYSIS OF PATTERNS AND REENTRY OUTCOMES." UKnowledge, 2019. https://uknowledge.uky.edu/sociology_etds/42.
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The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by the Gelberg Behavioral Model of Vulnerable Populations.
This project utilizes secondary data from the Criminal Justice Kentucky Treatment Outcome Study, a Kentucky Department of Corrections funded two-wave longitudinal study of individuals who participated in substance abuse treatment programming while incarcerated. Latent profile analysis is used to determine the patterns of pre-incarceration opioid PSU in aim 1. Analyses for aims 2 and 3 examine PSU profiles, along with variables drawn from the Behavioral Model for Vulnerable Populations, in order to predict important reentry outcomes of relapse and health service utilization 12-months post-release in a series of logistic regressions.
Six unique profiles of opioid PSU were found among the current justice-involved population, which faced disproportionate risk of adverse outcomes at follow-up. Findings indicate heterogeneity of opioid use among a justice-involved population. The role of mental and physical health in PSU severity is also highlighted. Further, results from post-release analyses indicate that a continuum of risk exists among PSU such that PSU patterns are unique and important predictors of post-release outcomes which can be used to inform interventions during incarceration. The importance of accounting for vulnerability as conceptualized in the Behavioral Model for Vulnerable Populations is also discussed.
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Bain, Katherine Alison. "Chased by the dragon the experience of relapse in cocaine and heroin users /." Diss., Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-10192004-100341.
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Keramati, Mohammadmahdi. "A homeostatic reinforcement learning theory, and its implications in cocaine addiction." Thesis, Paris 5, 2013. http://www.theses.fr/2013PA05T027/document.
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Cette thèse est composée de deux parties. Dans la première partie, nous proposons une théorie pour l'interaction entre l'apprentissage par renforcement et les processus de régulation homéostatique. En fait, la régulation efficace de l'homéostasie interne et la défendre contre les perturbations a besoin des stratégies comportementales complexes pour obtenir des ressources physiologiquement épuisés. À cet égard, il est essentiel que les processus cérébraux de régulation homéostatique et les processus d'apprentissage associatifs travaillent de concert. Nous proposons une théorie computationnelle normative pour régulation homéostatique par l'apprentissage associatif, où la stabilité physiologique et l'acquisition de récompense s'avèrent les mêmes objectifs, réalisables simultanément. En théorie, le cadre résout la question de longue date de la façon dont le comportement manifeste est modulée par l'état interne, et comment les animaux apprennent à agir de manière prédictive pour empêcher des défis homéostasie potentiels (répondre par anticipation). Il fournit en outre une explication normative pour choix intertemporel, aversion au risque, la concurrence entre les systèmes de motivation, et le manque de motivation pour l'injection intraveineuse de produits alimentaires. Neurobiologiquement, la théorie suggère une explication pour le rôle de l'interaction par orexine entre les circuits hypothalamiques et les noyaux dopaminergiques du mésencéphale, comme une interface entre les états internes et les comportements motivés. Dans la deuxième partie de la thèse, nous utilisons le modèle présenté dans la première partie, comme base du développement d'une théorie de la dépendance à la cocaïne. Nous soutenons que la dépendance à la cocaïne provient du système de régulation homéostatique être détourné par les effets pharmacologiques de la cocaïne sur le cerveau. Nous démontrons que le modèle réussit à expliquer une variété des aspects comportementaux et neurobiologiques de la dépendance à la cocaïne , à savoir la grandissant de l’administration de cocaine sous les conditions de long accès a cocaïne, fonction dose-réponse pour la cocaïne , rechute à l'addiction à la cocaïne provoquée par amorçage, et l'interaction entre la disponibilité du récepteur de la dopamine D2 et dépendance à la cocaïneThis thesis is composed of two parts. In the first part, we propose a theory for interaction between reinforcement learning and homeostatic regulation processes. In fact, efficient regulation of internal homeostasis and defending it against perturbations requires complex behavioral strategies to obtain physiologically-depleted resources. In this respect, it is essential that brains homeostatic regulation and associative learning processes work in concert. We propose a normative computational theory for homeostatically-regulated reinforcement learning (HRL), where physiological stability and reward acquisition prove to be identical objectives achievable simultaneously. Theoretically, the framework resolves the long-standing question of how overt behavior is modulated by internal state, and how animals learn to predictively act to preclude prospective homeostatic challenges (anticipatory responding). It further provides a normative explanation for temporal discounting of reward, and accounts for risk-aversive behavior, competition between motivational systems, taste-induced overeating, and lack of motivation for intravenous injection of food. Neurobiologically, the theory suggests a computational explanation for the role of orexin-based interaction between the hypothalamic circuitry and the midbrain dopaminergic nuclei, as an interface between internal states and motivated behaviors. In the second part of the thesis, we use the HRL model presented in the first part, as the cornerstone for developing an Allostatic Reinforcement Learning (ARL) theory of cocaine addiction. We argue that cocaine addiction arises from the HRL system being hijacked by the pharmacological effects of cocaine on the brain. We demonstrate that the model can successfully capture a wide range of behavioral and neurobiological aspects of cocaine addiction, namely escalation of cocaine self-administration under long- but not short-access conditions, U-shaped dose-response function for cocaine, priming-induced reinstatement of cocaine seeking, and interaction between dopamine D2 receptor availability and cocaine seeking
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Plaza-Zabala, Ainhoa 1982. "Involvement of the hypocretin/orexin system in the addictive properties of nicotine." Doctoral thesis, Universitat Pompeu Fabra, 2012. http://hdl.handle.net/10803/116732.
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Hypocretin-1 and hypocretin-2, also known as orexin-A and orexin-B, are 2 neuropeptides that are exclusively expressed by a small subset of neurons of the lateral hypothalamic area. Despite their restricted expression pattern, hypocretin-containing axons project widely throughout the brain and exert their physiological functions acting on 2 G protein coupled receptors, hypocretin/orexin receptor-1 and hypocretin/orexin receptor-2. Initially, the hypocretin system was related to the regulation of sleep/wake cycles and feeding behavior. Nevertheless, a growing body of evidence has accumulated over the last decade indicating a role for these neuropeptides in drug addiction. In the present thesis, we have evaluated the involvement of hypocretin transmission in the addictive properties of nicotine, the main psychoactive component that sustains tobacco addiction, by using behavioral and biochemical approaches. Our results indicate that hypocretin peptides, mainly through their actions upon hypocretin receptor-1, influence the severity of nicotine withdrawal and modulate the relapse to nicotine-seeking after prolonged periods of abstinence. Given the importance of withdrawal and relapse on the pathophysiology of nicotine addiction, we propose hypocretin receptor-1 as a promising therapeutic target for the development of novel smoking cessation therapies.
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Serre, Fuschia. "Application de la méthode d'évaluation en vie quotidienne (EMA) à l'étude du craving : influence des stimuli conditionnés et relation avec l'usage de substances." Thesis, Bordeaux 2, 2012. http://www.theses.fr/2012BOR22010/document.
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Le craving est considéré comme une composante centrale de l’addiction, potentiellement impliquée dans les processus de rechute, et influencée par de nombreux facteurs. Les études ayant examiné le lien entre craving et rechute montrent cependant des résultats contradictoires. Ces divergences pourraient s’expliquer par les limites méthodologiques rencontrées pour évaluer le craving de façon rétrospective ou pour l’induire expérimentalement en laboratoire. La méthode EMA (Ecological Momentary Assessment) utilise des technologies mobiles afin d’évaluer les sujets dans leur environnement naturel et de récolter des données en temps réel. Cette approche est particulièrement intéressante pour étudier les fluctuations rapides du craving, capturer l’influence des variables environnementales, ainsi que pour examiner le lien prospectif entre plusieurs variables. L’objectif général de cette thèse était d’utiliser la méthode EMA afin d’examiner en vie quotidienne le craving, ses modérateurs, et son lien avec l’usage de substances chez des sujets dépendants débutant une prise en charge pour une addiction à une substance. L’analyse de la littérature révèle que la majorité des études EMA examinant le craving concerne le tabac et l’alcool, et que peu d’études ont examiné ce phénomène pour des substances illégales. La partie expérimentale de cette thèse a permis de 1) démontrer la faisabilité et la validité de la méthode EMA chez des sujets dépendants, quelle que soit la substance de dépendance (tabac, alcool, cannabis ou opiacés), 2) montrer un lien prospectif unidirectionnel entre l’intensité du craving et l’usage de substances pour les 4 groupes de substances, et 3) mettre en évidence une augmentation du craving face à des stimuli conditionnés (cues) rencontrés en vie quotidienne, augmentation d’autant plus importante qu’il s’agissait de cues individuels (personnels à chaque sujet). Cette étude démontre l’intérêt de la méthode EMA dans l’étude des addictions, souligne le rôle du craving dans les processus de rechute, et encourage le développement de protocoles d’extinction de la réactivité aux cues centrés sur des cues individuels propres à chaque sujetCraving is a central component of addiction, involved in relapse process and under the influence of many factors. However, studies examining the link between craving and relapse have revealed some contradictory results. These inconsistencies could be due to limits encountered to assess craving in laboratory or clinical settings. Ecological Momentary Assessment (EMA) methods use mobile technologies to assess subjects in their daily life, and collect data in real time. EMA is particularly well suited to assess fluctuations of craving, capture influence of environmental moderators, and examine prospective link between variables. The objective of this thesis was to use EMA to examine craving, its moderators, and its link with substance use in daily life among substance-dependent outpatients evaluated at treatment intake. Review of the literature revealed that majority of EMA studies examining craving concerned tobacco and alcohol, but only few examined illegal substances. The experimental part of this thesis 1) demonstrated that EMA methods are feasible and provide valid data in individuals with dependence for different types of substances (tobacco, alcohol, cannabis, opiates), 2) showed a prospective unidirectional association between craving and subsequent substance use in the 4 groups of substances, and 3) confirmed that conditioned stimuli (cues) encountered in daily life are associated with an increase of craving intensity, and showed that individual personalized cues elicit a more robust effect on craving compared to standard cues. These results highlight the relevance of using EMA methods to study addiction, suggest that craving has a key place in the relapse process, and encourage to develop tailorised extinction protocols centered on individual cues rather than standard non-specific cues
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Penzlin, Ana Isabel, Kristian Barlinn, Ben Min-Woo Illigens, Kerstin Weidner, Martin Siepmann, and Timo Siepmann. "Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-230932.
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Background:
A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence.
Methods:
We conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training using bivariate and multivariate regression analyses.
Results:
Out of 48 patients who participated in the RCT, 27 patients (9 females, ages 42.9 ± 8.6, mean ± SD) completed our one-year follow-up. When including in the analysis only patients who completed follow-up, the rate of abstinence tended to be higher in patients who underwent HRV-biofeedback 1 year earlier compared to those who received rehabilitative treatment alone (66.7% vs 50%, p = ns). This non-significant trend was also observed in the intention-to-treat analysis where patients who did not participate in the follow-up were assumed to have relapsed (46,7% biofeedback vs. 33.3% controls, p = ns). Neither cardiac autonomic function nor psychometric variables were associated with abstinence 1 year after HRV-biofeedback.
Conclusion:
Our follow-up study provide a first indication of possible increase in long-term abstinence after HRVbiofeedback for alcohol dependence in addition to rehabilitation.
Trial registration: The original randomized controlled trial was registered in the German Clinical Trials Register (DRKS00004618). This one-year follow-up survey has not been registered.
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Voigt, Thomas J. K. Jr. "Learning as it relates to addiction recovery| A case study of the learning experiences of men in a faith-based addiction recovery program." Thesis, Northern Illinois University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3611362.
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This case study is about learning as it relates to addiction recovery within the Men's Ministry (a pseudonym) program at an urban, faith-based mission, hereafter referred to as WCM (an acronym). The program is free and long-term residential. Its purpose is to be a "life transformation ministry for troubled men whose lives are out of control as a result of drugs, alcohol or some other destructive behavior pattern."
The study examines the described experiences of 13 WCM residents from the perspectives of two researchers: Cranton and DiClemente. Cranton's work explains change through adult learning, which can be transformative. DiClemente's work describes steps of change of becoming addicted and of recovering from addiction.
At my request, the chaplain at WCM selected Men's Ministry residents willing to share their life experiences as part of this study. During three 90-minute interviews based on Seidman's interview model, 13 residents shared their experiences before WCM in the first interview, their experiences at WCM in the second interview, and reflections on the first two interviews in the third interview.
The research questions that guided the study were (a)-How did the subjects in this faith-based addiction recovery program describe their own learning? and (b)-What were the subjects' perceptions of changes they experienced while in this faith-based addiction recovery program?
Participants' descriptions resulted in four conclusions: Multiple formal activities affected each participant; informal learning occurred throughout the WCM facility; participants' descriptions of changes at WCM resulted in recognition of changes throughout their prior lives; there was no single description by participants of a change, or a motive for change, at WCM.
Implications for future research include conducting longitudinal studies of this program's graduates, conducting studies with different participants to compare to this study, analyzing subsets of the data obtained, determining the indicated key programmatic elements, conducting studies about nonfaith-based residential substance addiction recovery programs to compare to this study.
Implications for practice include seeking adult educator's advice about including adult learning principles in substance addiction recovery, using adult educators as instructors in substance addiction recovery, and co-ordinating all practice activities with research findings.
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Phillips, Kristina T. "Applying the Relapse Model to Harm Reduction: The Development and Evaluation of the Harm Reduction Self-Efficacy Questionnaire." Connect to this title online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1131342662.
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Mancino, Samantha 1987. "Involvement of the endogenous opioid and cannabinoid systems in addictive like-behaviours." Doctoral thesis, Universitat Pompeu Fabra, 2016. http://hdl.handle.net/10803/565773.
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The increase incidence of obesity and eating disorders represents a major health problem in developed countries. The low rate of success of treatments to prevent or reverse obesity, and overeating that causes it, highlights the important behavioural alterations that are associated to this disease. These alterations seem to be mediated by modifications in the reward circuits that mimic changes occurring during addictive behaviour. Moreover, like drugs of abuse, obesity is associated with abnormal intake habits when maintaining diet that can endure vulnerability to relapse. In the present thesis, we have first investigated the involvement of the endogenous opioid system in the neurobiological mechanism underlying drug and food reinstatement, as a potential therapeutic target in these behavioural disorders. Moreover, we have investigated the relationships between overeating and behavioural addiction. Indeed, we have demonstrated that repeated operant training with palatable food promotes behavioural alterations, as well as epigenetic, proteomic and structural plasticity changes in the reward circuit reminiscent to those observed with drugs of abuse. Finally, we identified the cannabinoid receptor 1 and the delta opioid receptor as common neurobiological substrates underlying these alterations.El aumento de la incidencia de la obesidad y de los trastornos de la alimentación representa un importante problema de salud en los países desarrollados. La baja tasa de éxito de los tratamientos disponibles para prevenir o revertir la obesidad y el fácil acceso a la comida obesogenica que lo causa, destacan la necesidad de encentrar dianas terapéuticas eficaces. Las importantes alteraciones conductuales que se asocian a esta enfermedad parecen estar mediadas por modificaciones en los circuitos de recompensa que imitan los cambios que ocurren durante el comportamiento adictivo. Por otra parte, al igual que las drogas de abuso, la obesidad se asocia con hábitos de ingesta anormales que pueden incrementar la vulnerabilidad a la recaída de búsqueda de comida. En la presente tesis, hemos investigado primero la implicación del sistema opioide endógeno en el mecanismo neurobiológico que subyace a la recaída del comportamiento de búsqueda de drogas y comida como una posible diana terapéutica en estos trastornos del comportamiento. En segundo lugar, hemos investigado las relaciones entre la sobre ingesta de comida palatable y la adicción conductual. De hecho, hemos demostrado que el entrenamiento operante repetido con comida palatable promueve alteraciones de la conducta, así como cambios epigenéticos, proteómicos y de plasticidad estructural en el circuito de la recompensa que recuerdan a los observados con las drogas de abuso. Es destacable señalar que hemos identificado el vii receptor cannabinoide 1 y el receptor delta opioide como sustratos neurobiológicos comunes que subyacen a estas alteraciones.
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Quinn, Rikki Kate. "Understanding striatal neuroadaptations in addiction-relapse vulnerability." Thesis, 2016. http://hdl.handle.net/1959.13/1349956.
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Research Doctorate - Doctor of Philosophy (PhD)Addiction is a cyclical disorder associated with rigid, habit like behaviour and a high propensity to relapse into drug seeking. Up to 90% of addicts will relapse during in their treatment, posing a substantial clinical hurdle to recovery. Currently, few pharmacotherapies are available to aid in recovery from drug seeking and prevention of relapse. The lack of effective treatment options is a product of our limited understanding of the persistent neuroadaptations that render individuals vulnerable to addiction and relapse. The striatum is a critical brain region involved in regulation of many facets of addiction-like behaviour, including reinforcement of conditioned stimuli and regulation of habit-like behaviour. Importantly, the striatum can be divided into four functionally heterogenous subregions: the nucleus accumbens shell (NACsh) and core (NACc) and the dorsomedial (DM) and dorsolateral (DL) striatum. A number of studies have identified changes in synaptic plasticity processes in these regions following illicit drug use. However, the molecular mechanisms that contribute to synaptic plasticity are yet to be fully elucidated. This thesis aimed to uncover the role of a number of critical synaptic plasticity associated genes in the development of addiction. Moreover, I aimed to understand the role of miRNA regulation of these genes, and how these changes in molecular substrates may contribute to addiction vulnerability. I first investigated the role of the mTOR complex 1 (mTORC1) in regulation of cocaine taking, withdrawal and reinstatement of drug use. mTORC1 is a serine threonine kinase involved in the translation of several synaptic plasticity proteins, including AMPAR subunits and CAMKIIα, and has been previously implicated in addiction behaviour. I observed that withdrawal from cocaine taking increased mTORC1 activity in the NAC. Moreover, inhibition of mTORC1 using rapamycin decreased the expression of addiction-like behaviour, while reducing markers of mTORC1 activity. Intra-cerebroventricular injection of rapamycin also decreased the motivation to consume cocaine measured using progressive ratio (PR) testing. Furthermore, inhibition of mTORC1 in the NACsh reduced PR responding as well as cue-induced reinstatement of drug seeking. These addiction behaviours were reduced by systemic administration of rapamycin. Critically, decreased expression of indices of mTORC1 activity were evident in the NAC, but not DS. Together these experiments demonstrate a key role for mTORC1 expression in the NAC but not DS in the regulation of addiction-like behaviour. Importantly, it has been shown that mTOR and other synaptic plasticity genes are altered in the striatum of rats that show evidence of addiction vulnerability. However, the mechanisms contributing to these changes are unclear. Thus, the second aim of this thesis was to assess the role of miRNA in the regulation of these critical synaptic plasticity genes. miRNA are short, non-coding RNA molecules that negatively regulate gene expression. I assessed the expression of miRNA in the striatal subregions and their role in regulation of synaptic plasticity genes. Previous evidence suggests that there is a global downregulation of synaptic plasticity genes, including mTOR, Arc and Drd1, in the striatum of addiction-vulnerable animals compared to resilient controls. However, the results of my first study showed that decreased mTORC1 in the NACsh reduced indices of addiction. Critically, this demonstrates a temporal time course for expression of these genes. As such, I developed a novel method of identifying addiction vulnerable animals throughout the course of the addiction cycle. I found that during the drug-taking phase of addiction cycle, cocaine self-administering rats had altered expression of key miRNA, including miR-101b, miR-137, miR-132 and miR-212 in the striatal subregions. However, there were few changes between vulnerability groups. In contrast, there was a significant increase in the expression of these miRNA in the striatal subregions of addiction vulnerable rats compared to resilient controls following cocaine reinstatement. Importantly, miR-212 has been implicated in the regulation of compulsive cocaine use. Moreover, miR-101b has been previously shown to regulate mTOR, and was found in the current thesis to regulate Drd1 expression. These results suggest that miRNA are involved in the regulation of key synaptic plasticity genes involved in control of addiction relevant behaviour. Overall, the results of this thesis demonstrate a critical role for synaptic plasticity genes including mTOR, Arc and Drd1 and their miRNA regulators in the development of addiction. My findings have helped to elucidate the molecular changes in the striatal subregions that may contribute to addiction vulnerability and an increased propensity to relapse in addicted individuals.
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MATOUŠKOVÁ, Zdeňka. "Případová studie dopadů závislosti na alkoholu." Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-188879.
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The title of the thesis is The Case Study of Impact of Alcohol Addiction and it follows the series of life situations which occurred during a relatively short period of time in the case of a man who was abstaining for a long time. The subject of this thesis is a study of people with this disease who may be more susceptible to the pitfalls of life, and therefore cannot adequately respond to the crisis. The aim of this thesis was to find out whether an abstaining person could withstand the adversity and if not what field of human life was threatened. The main aim of the thesis was to outline the period shortly after being released from work. The introduction of the theoretical part deals with the definition of expressions such as alcohol addiction, theories and factors of addiction. Other part of the thesis deals with the consequence of long-term alcohol drinking and that both somatic, mental and also social which the long-term alcohol addiction brings. The conclusion of the theoretical part is supplemented with the interpretation of expressions such as a relapse or a recurrence and further it deals with issue of the failure to comply with abstinence together with the recommendation of possible ways how to refuse the alcohol. The empirical part of the thesis is processed by the method of quantitative research by means of questioning the method of narrative interview. The data was elaborated in the form of grounded theory method and afterwards it was evaluated by means of axial coding and all was divided into four time periods through which the client went and by which he was affected. The main research question was How can the change of job influence the mental and health conditions and what is the risk of relapse in the case of an abstaining person? Individual research questions were three. The first one related to observation of the change of managing of life situations during the period of the therapy and shortly after the therapy. The second question applies to the issue of managing of life situations which occurred within resocialization at work and the respondent found here a new way which means he found a new job and a residence outside his home within resocialization. The last research question solved managing of life situations after releasing from job when a client was unemployed for some time and the job which was recommended to him was financially undervalued. I found out by the carried out research that it is not possible to make conclusions how to manage crisis situations in the case of people with addicted behaviour. It is the individual matter of each person how he can withstand with life obstacles. The results of this thesis can be benefit for other clients with whom I will work while performing my job.
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Brown, Amanda Louise. "Molecular correlates of dopamine signalling in addiction vulnerability." Thesis, 2011. http://hdl.handle.net/1959.13/932650.
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Research Doctorate - Doctor of Philosophy (PhD)The work presented in this thesis takes a unique approach to extend our understanding of the molecular signatures within the dopamine signalling system that are associated with the development of addiction-like behaviours and relapse to drug-seeking. This study integrates a self-administration animal model, which closely recapitulates behaviours observed in human addiction, with targeted gene expression analysis. By adapting procedures from Deroche-Gamonet et al. (2004), the model employed here characterises individual behavioural differences to determine whether animals are addiction and relapse-vulnerable or –resilient. Dysregulation of synaptic plasticity and its associated processes are thought to be involved in long-term relapse susceptibility. Therefore, using these behaviourally phenotyped animals, the expression of a selected set of synaptic plasticity-related genes was assessed in the ventral and dorsal striatum, and in midbrain dopamine neurons, which project to these striatal subregions. The striatum and midbrain are brain regions critically implicated in the development of addiction and relapse. The first part of the studies focussed on the striatum. Within this region, it was found that transcript levels for dopamine receptors, and several genes encoding proteins that affect or are involved in the synaptic plasticity processes of long-term potentiation and depression, were significantly lower in addiction and relapse-vulnerable animals compared to -resilient controls. These synaptic plasticity related transcripts included: ionotropic α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) and group I metabotropic glutamate receptors, protein kinase C and cGMP-dependent protein kinase II. The mammalian target of rapamycin (mTOR) and the activity-regulated cytoskeletal (Arc) genes, which encode proteins involved in the regulation of AMPA receptor subunit composition, also displayed reduced expression in the ventral and dorsal striatum of addiction and relapse-vulnerable animals. Furthermore, expression of the transcript encoding the upstream regulator of mTOR, phosphatidylinositol 3 kinase (PI3K), was also decreased. In the second major part of the studies, the midbrain dopamine neurons, which provide dopaminergic input to both the dorsal and ventral striatum, were the focus. To allow examination of the molecular profile of synaptic plasticity-related transcripts specifically within these dopamine neurons, a novel immuno-laser-microdissection method had to be developed xi and validated, that made possible the identification and extraction of dopamine neurons from surrounding brain tissue. This high-salt buffer protocol yielded a sample that not only retained its RNA integrity, a prerequisite to allow meaningful interpretation of genomic investigations, but it also contained an enriched and relatively pure population of dopamine neurons. This methodology was then applied to midbrain cryosections obtained from rats phenotyped for addiction and relapse-vulnerability. Distinct profiles were observed following qPCR based gene expression analysis, when addiction and relapse-vulnerable animals were compared to –resilient animals. Most notable, was a change in the expression of the transcript encoding for brain derived neurotrophic factor, BDNF, a known addiction-related signalling molecule. Within VTA dopamine neurons, BDNF gene expression was significantly lower, whereas within SN dopamine neurons, it was significantly higher in vulnerable rats relative to resilient controls. Additionally, transcripts encoding for AKT - a key modulator within the PI3K-AKT-mTOR signalling pathway that is implicated in addiction, and for the dopamine D2 receptor, were significantly lower in the SN dopamine neurons of the addiction and relapse-vulnerable rats. Remarkably, despite indistinguishable cocaine consumption between relapse-vulnerable and –resilient rats, addiction-like behaviours were only evident in the –vulnerable group. Also, altered molecular profiles were identified two months after the start of cocaine abstinence, suggesting that they likely reflect persistent neuroadaptive changes rather than direct actions of the drug. Furthermore, the studies presented in this thesis are the first to utilize a model that behaviourally phenotyped animals as relapse-vulnerable or -resilient to examine the long-lasting expression of synaptic plasticity-related genes in both the ventral and dorsal striatum and, additionally, in specifically isolated VTA and SN dopamine neurons using immuno-laser-microdissection. Importantly, it should be noted that these data demonstrating altered gene expression within the dorsal striatum and SN dopamine neurons support emerging evidence of a crucial role for the dorsal striatum in the compulsive drug-taking behaviours and habitual components of addiction. By employing an approach that incorporates individual differences to elucidate underlying neural correlates, the work presented in this thesis is an important addition to the field as it endeavours to further our understanding of the neurobiology of addiction and relapse, and provide novel targets for future and potentially more efficacious pharmacotherapies.
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Johnson, Sarah Anne. "Behavioural and Neuronal Correlates of Long-term Contextual Memory for Cocaine: Relevance to Craving and Relapse." Thesis, 2014. http://hdl.handle.net/1807/65673.
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Relapse is the single greatest barrier to recovery from addiction. Long-term memories for drug experience and associated contextual cues can provoke craving and resumption of drug use, particularly when a reminder of a highly charged context is encountered. In this thesis, three key questions related to the maintenance of long-term memory for drug-associated contexts are addressed: (1) Are Pavlovian conditioned associations between cocaine experience and the context in which it occurred maintained in long-term memory after extended periods of abstinence? (2) Are regions of the mesocorticolimbic circuitry, namely the nucleus accumbens and amygdala, differentially activated by retrieval of Pavlovian conditioned associations as time passes after cocaine experience? (3) Do neurons of the nucleus accumbens and amygdala show changes in dendritic architecture that reflect the impact of chronic cocaine exposure, which may underlie the maintenance of Pavlovian and/or instrumental drug-conditioned associations? Results confirm that Pavlovian conditioned memory for a cocaine-associated context is maintained in the long-term, becoming increasingly resilient over time. However, maintenance of these contextual associations is not accompanied by gross changes in dendritic architecture in neurons of the nucleus accumbens or amygdala within the timeframe examined. Nonetheless, these brain regions, along with the prefrontal cortex, are differentially activated by retrieval of Pavlovian conditioned associations after brief versus extended periods of abstinence. Together, these results emphasize a distinct contribution of Pavlovian memory processes, beyond instrumental and operant drug memory processes, in the long-term maintenance of addiction.
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Kubátová, Michaela. "Analýza metod a realizace prevence relapsu ve vybrané terapeutické komunitě." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-346798.
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The aim of this qualitative study was to map the preparation and process of relapse prevention programs in therapeutic community for treating addictions in Czech republic called Magdaléna o.p.s.. The next aim was to describe the specifics of these programs and analyse methods that are mostly applied. For fullfilling these aims, four methods were chosen: analisys of documents, semistructured interwiews with the members of the team of therapists, observation of the researcher in the specific relapse prevention program during her internship and one semistructured interview with client of this therapeutic community. The final number of respondents for this research was four therapists and one client. Three metodic relapse prevention documents were analysed and for setting the final outcomes of this research were also used the outputs from the observation of the researcher from the specific relapse prevention program. Based on this research it was found out, that the specific relapse prevention programs in Magdaléna have been part of the long-term structured schedule of the treatment. This program is on the schedule once per week in duration of one hour and it is managed by one of the therapists. The program have been carried out in group and it is always based on one specific topic. Educational and...
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Eliášová, Barbora. "Potřeby osob závislých na návykových látkách k udržení úspěšné abstinence v následné péči." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-343069.
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The topic Needs of people addicted to drugs and alcohol to maintain succesful abstinence in aftercare was chosen. Aftercare is an important part of addiction treatment, but often overlooked and unused. The aim is to clarify the needs of abstinent persons addicted to alcohol and other non-alcohol drugs and their subsequent comparison. The thesis is divided into two parts, theoretical and practical. The theoretical part deals with the development of addiction, its diagnosis, description of drugs and treatments options. Chapters dealing with treatment are thoroughly discussed because of the individual usage during the treatment of addiction. Aftecare of addicted people and problems with relapse take place in this part of work. The second part deals with research focused on identifying the needs of addicted people to drugs and alcohol to maintain successful abstinence and their subsequent comparison. Clarifying of these needs can serve as a recommendation to other abstaining people or as a support to services in the system of aftercare to successful abstinence nowadays. KEYWORDS Addiction, addictive substances, drug addiction treatment, abstinence, relapse, aftercare for drug and alcohol rehab
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Hronková, Veronika. "Jak bývalí uživatelé drog vnímají období své závislosti." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-313980.
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Subject: How a drogue ex-user see a period of his addiction. Abstract: The work focus on the actual situation of ex-users. These people were fighting with an addiction and now they are a part of the majority society. The qualitative research, inspired by a grounded theory, try to approach their point of view. What they think about their past and how do they see their relations with a family, friends and a vicinage. Not just in that period but nowadays as well. Relationships with home-folks are stigmatized by a degree of drug addiction. The smaller addiction the smaller losses. Once a drug user is falling down into the drug trap, the losses depend on how deep he will fall. On the bottom there are no friends, no family, just nothing. Some of the drug users do not fall to the bottom, they do their decision earlier. We call that decision a break point ( a moment when they decide to abstain). A break point comes individually and it is connected to an "interior border" of each person. Anyway, it is a moment, when an individual concerned decide to live a different way. It is a very intense moment and very fundamental for a abstinence success. We have used an interview to study not just this phenomenon. During the interview we tried to find out how a life looks with and without an addiction. Key words: addiction,...
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Garrun, Candice. "Service users' and service providers' understandings of addiction and their impact on treatment plans and treatment outcomes." Thesis, 2012. http://hdl.handle.net/10539/10990.
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The word addiction is almost immediately associated with notions of drug dependency and alcoholism, and drug addiction is often referred to as a pandemic that affects individuals, families, communities and society at large. Aetiological approaches to understanding and treating addiction have changed dramatically throughout history, and currently the most contemporary approach is that of the disease model which views addiction as an illness rather than as a ‘badness’. While the underpinnings of Narcotics Anonymous’ 12 step philosophy employs non-specific drug language as it views all drugs as having the capacity to become addictive, and while it does not distinguish between the capacity for substances and certain behaviours to become addictive, activities such as overeating, having sex and gambling are yet to be classified as legitimate addictions by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). As a result, it appears as if some confusion exists as to whether these behaviours should be classified as impulse control disorders or as genuine addictions due to the various similarities they share in common with substance based disorders. The research conducted explored how people recovering from addiction, as well as how people working with addiction understand addiction and multiple dependency, together with the factors that contribute to relapse and the ability to abstain. Various 12 Step meetings from a variety of 12 Step Fellowships were attended and members were invited to participate in the study. Ultimately seventy eight participants completed a self developed questionnaire which was utilised to assess how people recovering from addiction understood addiction and multiple dependency and the factors that contribute to relapse and the ability to abstain. Quantitative data were analysed via descriptive and inferential statistics. Furthermore twenty participants working with addiction were interviewed with the use of a semi structured interview schedule in order to explore their perceptions around addiction and the factors that contribute to relapse and sobriety. Qualitative data were analysed using thematic content analysis.
Results indicated that the majority of recovering addicts and professionals working with addiction understand addiction as a disease. However, discrepancy was apparent with regards to whether or not all recovering addicts have the same disease and subsequently whether all addictions can be treated in the same manner. The above result suggested that there was no standardised, uniform way in which the disease model is understood and interpreted. Factors such as cross addiction, resistance to change and issues relating to the maintenance of change were identified as issues that contribute to relapse, while factors such as aftercare, following the 12 step programme and support were identified as the main aspects that contribute to sobriety. No statistical significance was noted between participants who had relapsed as opposed to those who had not for variables of sensation seeking, impulsivity and perceived stress (which may have been as a result of small sample size). Deeper understanding of the disease model together with broader application of it, and a focus on appropriate training and more comprehensive assessment could perhaps see a reduction in high rates of relapse and recidivism more commonly known as the ‘revolving door syndrome’.
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Ying-ZaiChen and 陳映在. "Efficacy of the Relapse Prevention Coping Skills Training Program for Internet Gaming Addiction among Adolescents: 8-Month Follow-Up and Moderating Variables." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/am4a6c.
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碩士國立成功大學
行為醫學研究所
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SUMMARY This study used that data set of grants to Professor Huei-Chen Ko, supported by the Ministry of Science and Technology (NPS101-2511-S-468-002-MY3) to further evaluate the efficacy of relapse prevention coping skills training group (RPCSTG) for IGA among high-risk junior high school students in a randomized control trial up to eight-month follow-up, and moderating roles of gender, IG addiction level, and IG accessibility. 87 high risk students were screened and assigned randomly to counseling and guidance as usual group (CGG, n = 42) and RPCSTG (n = 45). Both groups were trained with six weekly 90-minutes sessions. The IGA severity, IG daily usage time, IG use positive outcome expectancy, IG refusal self-efficacy and IG accessibility were assessed for both groups at baseline, immediately after the intervention and eight-month follow-up (F/U). The intent-to-treat and generalized estimating equation (GEE) analyses on the longitudinal data (including all randomized participants, n=87) was performed. Comparing to CGG, the RPCSTG had greater decreased in IGA score during post-test and eight-month F/U, high risk percent rate of IGA during eight-month F/U, IG usage time during post-test, and better effect in the rate of IG usage greater than two hours per day in eight-month F/U. The group x time interactions on positive outcome expectancy and refusal self-efficacy of IG were not significant in post-test and eight-month F/U. However, the RPCSTG had greater increases in the refusal self-efficacy of IG in eight-month F/U. The analyses on moderating effects showed that male-RPCSTG had greater reduction in IGA during post-test and eight-month F/U and in daily IG usage time in post-test. Female-RPCSTG’ daily IG usage time and IGA had higher decreases than female-CGG in eight-month F/U. Higher IGA severity-RPCSTG’ daily IG usage time had higher reduction than in post-test. Higher IG accessibility-RPCSTG had greater decreased in IGA levels in post-test and F/U. RPCSTG had greater improvement in IGA levels and IG usage time compared to those in CGG. However, there were no better time effects on the improvement of positive outcome expectancy and refusal self-efficacy while the RPCSTG had greater enhancement in the IG refusal self-efficacy in eight-month F/U the intergroup differences did not reach significance. Moreover, the moderating roles of gender, IGA severity and IG accessibility should be considered in the future studies with larger sample size. Keywords: relapse prevention, coping skills training, internet gaming addiction INTRODUCTION Junior high school students had been reported to have higher internet games (IG) use frequency and internet gaming addiction (IGA) prevalence. Though IGA was association with positive effects, IG overuse was increasingly recognized to be related to multiple functional impairment. The prevention and intervention program of IGA among adolescents has become an important issue. The efficacy studies on IGA intervention program remains limited, and there is few studies investigate moderating variables with randomized control, long-term follow-up. In Ko's study, the efficacy of relapse prevention (RP) coping skills training programs was examined among adolescents with high-risk IGA in a randomized control trial ( grants to Professor Huei-Chen Ko, supported by the Ministry of Science and Technology and entitled Preventive Education on internet addition and its effectiveness for junior high school students in Taiwan, NPS101-2511-S-468-002-MY3). The present study used that data set to further evaluate the efficacy of relapse prevention coping skills training group (RPCSTG) for IGA among high-risk junior high school students in a randomized control trial up to eight-month follow-up, and moderating roles of gender, IG addiction level, and IG accessibility. METHOD Ko's study was approved by the Research Ethics Committee of Asia University, Taiwan. Students were recruited from two junior high schools in two city, By using Ko’s DSM-5 Internet Gaming Addiction Scale, 87 high risk students were screened and assigned randomly to an counseling and guidance as usual group (CGG, n = 42) and relapse prevention coping skills training group (RPCSTG, n = 45). Both groups were trained with six weekly 90-minutes sessions. The IGA severity, IG daily usage time, IG use positive outcome expectancy, IG refusal self-efficacy and IG accessibility were assessed for both groups at baseline, immediately after the intervention and eight-month follow-up (F/U). The intent-to-treat analysis on the longitudinal data (including all randomized participants, n=87) was performed. The missing responses among pre-test were imputed by total mean, among pose-test with subgroup mean, and among the eight-month follow-up test by the post-test data. To analyze continuous and dichotomous outcome measures over time, the generalized estimating equation (GEE) was carried out with the reference standard of time of pre-test, and the comparative group with the CGG. RESULTS Groups had no intergroup difference on the pretest levels of IGA, IG usage time per day (mean minutes and greater than two hours), positive outcome expectancy of IG and refusal self-efficacy of IG. GEE showed that the group x time interactions on IGA scores were significant during post-test and eight-month F/U. Further analyses indicated that RPCSTG had greater improvement in IGA levels compared to those in CGG. The group x time interaction on usage time was significant in post-test, but not in eight-month F/U. The group x time interaction on the rate of IG usage greater than two hours per day was not significant in post-test, but was significant in eight-month F/U. The RPCSTG had greater decreased in IG usage time compared to CGG in post-test and better effect in the rate of IG usage greater than two hours per day in eight-month F/U. The group x time interactions on positive outcome expectancy and refusal self-efficacy of IG were not significant in post-test and eight-month F/U. However, the RPCSTG had greater increases in the refusal self-efficacy of IG in eight-month F/U. The analyses on moderating effects of gender showed that among male students, the RPCSTG had greater reduction in IGA during post-test and eight-month F/U and in daily IG usage time in post-test. However, female-RPCSTG’ daily IG usage time and IGA had higher decreases than female-CGG in eight-month F/U. The analyses on moderating effects of IGA severity revealed that high IGA severity students, RPCSTG’ daily IG usage time had higher reduction than in post-test. The analyses on moderating effects of IG accessibility displayed that among students with the higher IG accessibility level, the RPCSTG had greater decreased in IGA levels compared to CGG in post-test.and F/U. DISCUSSION The randomized control trial with eight-month follow-up showed that RPCSTG had greater improvement in IGA levels and IG usage time compared to those in CGG. However, there were no better time effects on the improvement of positive outcome expectancy and refusal self-efficacy while the RPCSTG had greater enhancement in the IG refusal self-efficacy in eight-month F/U the intergroup differences did not reach significance. Moreover, the moderating roles of gender, IGA severity and IG accessibility should be considered in the future studies with larger sample size.
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James, Morgan. "The role of cocaine- and amphetamine- regulated transcript (CART) and orexin in drug- seeking and addiction-related behaviours." Thesis, 2014. http://hdl.handle.net/1959.13/1042341.
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Research Doctorate - Doctor of Philosophy (PhD)Over the past decade, two hypothalamic neuropeptides, cocaine- and amphetamine- regulated transcript (CART) and orexin (hypocretin), have been shown to play important roles in regulating addiction-relevant behaviours, including ‘reinstatement’ of drug-seeking, a model of relapse-like behaviour. Interestingly, CART generally opposes the rewarding effects of psychostimulant drugs such as cocaine and negatively regulates reinstatement of drug-seeking. In contrast, orexin generally promotes reinstatement of cocaine seeking. Despite intense interest in CART and orexin as potential novel targets for pharmacotherapies designed to treat cocaine addiction, very little is known as to where in the brain these peptides act to regulate addiction-relevant behaviour. The work presented in this thesis investigated the paraventricular thalamus (PVT) as a potential important site of convergence for CART and orexin signaling in the regulation of reinstatement behaviour. As a first step, I provide evidence that PVT signaling is important for reinstatement behaviour. In Chapter 1, I present data demonstrating that activation of PVT, as gauged by levels of Fos-protein, a marker of neuronal activity, is strongly correlated with cocaine reinstatement elicited by drug-associated cues. In Chapter 2, I show that intra-PVT injections of tetrodotoxin (TTX), a sodium-channel blocker, attenuated drug-primed reinstatement of cocaine seeking. Taken together with evidence implicating the PVT in stress responsivity, these findings point to the PVT as an important substrate that may be common to all forms of reinstatement (cue-, drug- and stress-induced). In Chapter 2 I also show that microinfusions of the CART peptide directly into the PVT attenuated drug-primed reinstatement, suggesting that CART acts in this region to negatively regulate cocaine-seeking behaviour. In contrast, data presented in Chapter 3 suggests that orexin signaling in the PVT is not important for reinstatement behaviour, as intra-PVT injections of the orexin receptor-1 antagonist SB-334867 had no effect on cocaine seeking elicited by drug cues. This Chapter raises the possibility that orexin receptor-2 signaling in the PVT may be more important in reinstatement behaviour. Subsequent studies in Chapter 3 point to the importance of orexin signaling in the ventral tegmental area (VTA) in regulating reinstatement behaviour. Intra-VTA infusions of SB-334867 significantly attenuated cue-induced reinstatement of cocaine seeking without having any effect on spontaneous locomotor activity. These findings are further explored in Chapter 4, where I show that intra-VTA SB-334867 administration altered the activity of key drug-seeking substrates, including the PVT. I also present evidence that intra-VTA SB-334867 treatment does not affect reinstatement responding for a natural reward, suggesting that at low doses, SB-334867 can reduce drug seeking but not affect normal motivated behaviour. This Chapter also summarises the findings from each of the former chapters and discusses the implications of these findings in the context of the existing literature relating to the role of hypothalamic peptides in regulating drug-seeking behaviour. In the final chapter of this thesis, I focus on the orexin system as a possible neurobiological link between addiction and stress-related disorders such as depression and anxiety. In this chapter (Chapter 5), I show that animals exposed to early life stress exhibit hypoactivity of the orexin system following exposure to an additional stressor in adulthood. These findings are consistent with recent clinical evidence of reduced orexin activity in depressed patients. Interestingly, findings in this chapter also demonstrate that access to voluntary wheel running, an intervention known to have beneficial effects for depressive-like symptomology, protected against changes in orexin function and stress-related behaviour in male rats, but not female rats. Whilst these findings represent only the first step in our understanding, they point to the possibility that dysregulated orexin function may represent a neurobiological factor contributing to the high comorbidity of addiction and stress-related disorders.
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Van, der Westhuizen Marichen Ann. "Aftercare to chemically addicted adolescents : practice guidelines from a social work perspective." Thesis, 2010. http://hdl.handle.net/10500/4034.
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The susceptibility of adolescents to chemical addiction has become a major international concern. Approximately 25% of people in Central Asia and Eastern Europe who inject chemical substances are under the age of 20 years (Youth at the United Nations, 2006), while up to 75% of unintentional injuries among adolescents in America are related to substance abuse (Page & Page, 2003:196). On the national level, approximately 25% of adolescents under the age of 20 are involved in substance abuse (Western Cape Department of Social Services and Poverty Alleviation Transformation Plan, 2006:13). Focusing on the Western Cape, a report from the South African Epidemiology Network (2007:3) highlights that the youngest patient in in-patient treatment was nine years of age, and among 2 798 persons who received in-patient treatment, 27% were under the age of 20, more than any other age group in treatment.
Treatment of adolescent chemical addiction should include preparation for treatment, treatment, and also aftercare services to ensure that the addicted adolescent develops skills to maintain sobriety (Meyer, 2005:292-293). Section Six of the South African Prevention and Treatment of Drug Dependency Act (1992) prescribes that chemically addicted persons should have access to professional aftercare services to ensure that treatment is not terminated prematurely. The motivation for this study was based on the fact that, despite this statutory requirement, the Western Cape Drug Forum (2005:3) identified the need for the development of aftercare services in 2005, indicating the lack of focus on aftercare as part of treatment. This concern was confirmed by practitioners in the field of adolescent chemical addiction and findings resulted from previous research regarding relapse experiences of chemically addicted adolescents (Van der Westhuizen, 2007:129-130).Social Work
D. Phil. (Social Work)
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Van, der Westhuizen Marichen Ann. "Exploring the experiences of chemically addicted adolescents regarding relapsing after treatment." Diss., 2007. http://hdl.handle.net/10500/1821.
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Against the background of an increase in the demands for treatment of adolescent chemical addiction, as well as the persistently high relapse rate, the significant impact on the development and well-being of chemically addicted adolescents needs to be considered by the social work profession, in order to plan effective intervention strategies. The purpose of this research study was to explore and describe the experiences of chemically addicted adolescents who had relapsed after in-patient treatment. Subsequently, the researcher aimed to generate guidelines and recommendations for social workers, in order to prevent relapse. A qualitative research approach was employed. The researcher made use of descriptive, exploratory and contextual research designs.
The study was conducted at adolescent in-patient treatment centres in the Western Cape, South Africa. Data was collected through semi-structured interviews. Interviews were tape-recorded and transcribed, and field notes were taken to record the data. The sample selected from the population of chemically addicted adolescents in the Western Cape who relapsed after in-patient treatment was selected through the purposive sampling technique. Tesch's framework for data analysis (in Creswell, 2003) was employed, and data verification was conducted through Guba's model (in Krefting, 1991:214-222). The research results, concluding guidelines and recommendations are being disseminated by means of this written report.Social Work
M. Diac. (Social Work)
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Maternová, Marcela. "Fenomén alkoholismu a možnosti sociální práce." Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-329302.
Full textAbstract:
This diploma thesis explores the phenomenon of formation and development of alcohol dependence. In the first series focuses on the historical description, which demonstrates considerable anchored in the life of our ancestors already. It also defines the concept of addiction, its causes and consequences, whether psychological, medical or social. Its objective is to describe the possibilities of social work in this phenomenon. defines therefore primarily targets and understanding of social work and consequently specifics of client alcoholism. An important element is the role of the social worker in the client's motivation to change, which uses Nešpor's model of spontaneous changes in motivation. Then, on the basis of available social services selects several most suitable, which can help to improve the client's situation. Has an essential role in this issue also primary prevention, ie it discusses the methodology, target groups, focusing on adolescents and the focus is on the firm role of the family. Finally contains some official documents on primary prevention, which are discussed current issues of primary prevention practice and subsequent survey, mapping aspect of social workers on the incidence risk of alcohol dependence among adolescents attending social facilities.