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Ursule, Géraldine. "Grossesse et addictions". Antilles-Guyane, 2010. http://www.theses.fr/2009AGUY0301.
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De nos jours, les femmes en age de procreer consomment de plus en plus de toxiques s'exposant a tous les risques inherents a de telles conduites. D'ailleurs la consommation feminine de toxiques s'avere de plus en plus importante et plus precoce en terme d'age de la premiere experience. Par consequent, une vulgarisation de la consommation de toxiques par des femmes enceintes est a deplorer. Ceci est une realite usuelle, non anodine et complexe. Bon nombre adoptent un comportement polytoxicomaniaque en fumant des cigarettes, du cannabis, en buvant de l'alcool, en fumant du crack, ou en consommant de la cocaine , heroine, amphetamines et d'autres substances bien qu'elles soient enceintes. De plus, certaines ignorent leur etat gravide. La grossesse est un moment particulierement important et privilegie dans la vie d'une femme provoquant de profonds bouleversements physiques et psychiques. Ainsi, elle est source de vulnerabilite. Elle peut se reveler des plus perilleuses chez des femmes abusant de substances. En effet, elles exposent leur foetus a de serieuses complications a court, moyen et long terme comme la mort in utero et la prematurite. De nombreuses inquietudes demeurent quant a ces grossesses a risque. Le but de la these est la mise en place d'un outil de depistage en maternite. Seule une approche multidisciplinaire de cette problematique peut s'averer fructueuse. La premiere partie traite, a travers une revue de litterature de l'addiction, puis de la grossesse sous addiction la seconde partie consiste en la presentation d'un cas clinique. La troisieme partie propose la mise en place d'un questionnaire de depistageNOWADAYS, WOMEN WHO CAN PROCREATE TAKE INCREASINGLY DRUGS EXPOSING THEMSELVES TO RISKS DUE TO SUCH BEHAVIORS. MOREOVER, FEMALE CONSUMPTION OF DRUGS PROVE TRUE MORE AND MORE IMPORTANT AND MORE EARLY FOR THE FIRST EXPERIMENT. ACCORDINGLY, A DISPERSION OF DRUGS CONSUMPTION BY PREGNANT WOMEN IS TO BE DEPLORED. THIS IS A COMMON NOT SAFE AND COMPLEX REALNESS. A LOT OF THEM ADOPT DRUGS ADDICTION BEHAVIORS SMOKING CIGARETTES, MARIHUANA, DRINKING ACOHOL, TAKING CRACK, COCAINE, HEROIN, AMPHETAMINES AND OTHER SUBSTANCES IN SPITE OF THEY ARE PREGNANT. SOME DOESN'T KNOW THEIR GRAVID STATE. PREGNANCY IS A PARTICULARLY IMPORTANT AND PRIVILEDGE MOMENT IN A WOMEN LIFE CAUSING DEEP PHYSICAL AND PSYCHIC DISRUPTIONS. THUS IT IS SOURCE OF VULNERABILlTY. IT CAN REVEAL IT VERY PERILOUS FOR WOMEN TAKING SUBSTANCES. INDEED, THEY EXPOSE THEIR FOETUS TO SERIOUS COMPLICATIONS AT SHORT-TERM, MID-TERM, LONG-TERM LIKE DEATH IN UTERO AND PREMATURITY. A MESS OF FEAR ARE BEING LEFT REGARDING THESE RISKY PREGNANCIES. THE THESIS GOAL IS THE SETTING UP OF SCREENING TOOL IN MATERNITY. ONLY A MULTISCIPLINARY APPROACH OF THIS PROBLEMATIC CAN COME TRUE SUCCESSFULL. THE FIRST PART DEALS,TROUGH A REVIEW OF LITERATURE, WITH ADDICTION, AND ADDICTION AND PREGNANCY. THE SECOND PART PRESENTS A CLiNICAL CASE. THE THIRD PART PROPOSES THE REALISATION OF A SCREENING QUESTIONNAIRE
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Ane, Mohamed. "La prévention familiale des addictions". Thesis, Artois, 2018. http://www.theses.fr/2018ARTO0101/document.
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Notre objectif principal dans ce travail consiste à analyser les facteurs associés à la consommation problématique d’alcool, de tabac ou de cannabis, et aux rôles respectifs des lois et de la communication intrafamiliale des dangers liés à leur usage. Globalement, la norme et le contrôle parental jouent un rôle déterminant dans l’usage de ces trois substances par les 15-25 ans et sont souvent associés à l’intention de rester non-consommateur de tabac, de retarder l’initiation du cannabis et aux intentions de diminuer le nombre de verres bu au cours d’une même soirée ainsi que les alcoolisations ponctuelles importantes (API) fréquentes chez les plus jeunes (15-17 ans). En outre, nos résultats montrent que le sujet relatif aux dangers des drogues comme le cannabis est bien discuté dans les familles mais pas de façon récurrente et que cette discussion est fortement liée au genre. Nos analyses suggèrent la nécessité de lutter contre le tabagisme quotidien des 15-17 ans car toutes les actions prises permettront in fine de lutter contre l’initiation précoce du cannabis. Concernant les non-consommateurs comme les consommateurs de cannabis et d’alcool (API), les efforts de prévention à l’expérimentation et, à la diminution ou à l’arrêt de l’usage devraient être axés prioritairement sur l’amélioration des compétences parentales et sur la résistance à la pression des pairsOur main goal in this work is to analyze the factors linked with the controversial consumption of alcohol, tobacco or marijuana and to analyze the role of laws and of the inner family communication about the risk of their use.Norms and parental control have generally a determining role in the use of those three illegal substances in the 15-25 years group. They are usually linked to the idea of remaining clean, I.E, not consuming tobacco and delaying the first contact with marijuana. And to the intention of decreasing the number of glasses during a party as well as the frequent consumption of alcohol which is quite common among the youngers (15-17 years old). Beside this idea, our research shows that topics dealing with alcohol, drugs and tobacco are discussed within the family circle, but are not a repetitive phenomenon. That type of discussion has to do with gender. Our analyses suggest the idea of fighting against the daily consumption of tobacco among youth (15-17 years old). Because all the precautions taken would therefore allow to fight against an early consumption marijuana. For those who do not consume alcohol and drugs, efforts put on prevention and on the decrease or the total absence of their use should be narrowed down on peer pressure and the improvement of parental skills on the issue
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Granjon, Anne. "Histoire de l'approche psychanalytique des addictions". Paris 7, 1997. http://www.theses.fr/1997PA070076.
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Absent du vocabulaire dans les annees 70, la notion d'addiction est aujourd'hui largement utilisee en psychiatrie et en psychopathologie ou elle tend a supplanter celle de toxicomanie. L'addiction designe un champ de dysfonctionnements psychiques a l'origine de troubles dans la sphere orale (toxicomanies, alcoolisme, anorexie, boulimie), et dans la sphere comportementale (pratique excessive du travail, sexualite debridee, passion du jeu). Tous ces errements ont en commun le recours a l'acte, la dependance, la mise en scene du corps et la proximite de la mort. Les conduites addictives au sens qui vient de leur etre donne, ont existe de tous temps, comme en temoignent les ecrits des philosophes, des historiens ou des medecins, mais elles ne sont devenues un reel probleme pour ces derniers qu'a partir du 18e siecle pour plusieurs raisons : les progres de la medecine, les changements socio-economiques entraines par l'industrialisation et le bouleversement de la conception du monde provoquee par le progres scientifique. Au 19e siecle, pinel integre les addictions dans la nouvelle classe des nevroses, esquirol, dans celle des monomanies, tandis que lasegue rapproche hysterie et anorexie. Magnan, legrain et janet assimilent les addictions a des impulsions et obsessions dont ils rapportent l'etiologie a la degenerescence pour les deux premiers et a une baisse de la tension psychologique pour le troisieme. Au 20e siecle, l'avenement de la psychanalyse marque un nouveau tournant dans l'histoire des addictions. Freud ne leur a pas consacre d'article mais il les a evoquees a propos de la sexualite infantile, de la melancolie, des relations amoureuses ou des nevroses actuelles par exemple. Apres la publication des trois essais en 1905, les pionniers de la psychanalyse, abraham, ferenczi et tausk, ont degage plusieurs themes : effondrement des sublimations, homosexualite, narcissisme, fixation/regression qui ont ete repris et synthetises a la periode suivante. Apres 1920, la question de la melancolie, du surmoi, de la pulsion de mort, de la relation d'objet et de l'acte ont ete au coeur de la reflexion des analystes sur les addictionsMissing from the vocabulary in the seventies, the notion of addiction is nowadays widely used in psychiatry and psychopathology where it tends to replace the notion of drug addiction. Addiction designates a field of psychic dysfunctions which bring about troubles in the oral sphere (drug addiction, alcoholism, bulimia, anorexia), and in the behavioural sphere (excessive practice of working, of sexuality and gambling). All these troubles have in common the recourse to acting, the dependency, the exhibition of the body, and the proximity of death. If such behaviours have always existed as writings of philosophers, historians and doctors show it, they have only become a rea problem from the medical point of view in the 18th century. Several reasons explain that : the progress of medicine, the socio-economical changes and the evolution of the conception of the world. In the 19th century pinel integrates addictions into the new class of neuroses and esquirol into the monomanias. Lasegue compares hystery and anorexia. Magnan, legrain and janet assimilate addictions to impulsions and obsessions. Magnan and legrain refer the etiology of addictions to a degenerating process while janet refer it to a lowering of the psychologic tension. In the 20th century, le coming of psychoanalysis marks a new turn in the history addictions. Freud has written no article on them but he has spoken of them while dealing with the sexuality of the child, with melancholia, with love relations for example. After the publication of les trois essais sur la theorie de la sexualite in 1905, pioneers of psychanalysis, abraham, ferenczi and tausk have raised several questions concerning the addictions : homosexuality, narcissism, fixation/regression. After 1920, the questions of melancholia, of the death instinct, of acting and of object relation have been to the heart of the reflexion of analysts on the subject
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Bou, Serhal Rola. "Addiction à l’internet et aux smartphones chez les étudiants universitaires et sa corrélation avec d’autres addictions". Electronic Thesis or Diss., Strasbourg, 2023. http://www.theses.fr/2023STRAJ138.
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Dans l’objectif d’étudier le changement du comportement vis-à-vis de l’internet et des smartphones durant le confinement, et de comprendre l’impact du covid-19 sur le bien-être, les troubles liés à l’usage de substances, et le trouble de la dépendance à l’internet, deux études transversales en ligne étaient menées au Liban et en France. Les résultats ont montré le changement vers un usage problématique de l’internet et des smartphones durant le confinement. Le temps en ligne et des activités spécifiques prédisaient ce changement de comportement. Le bien-être n’était pas un facteur modérateur de l’impact du covid-19 sur les dépendances. Les facteurs prédicteurs du bien-être, de la dépendance à la nicotine, à l’alcool, et aux substances, et de l’usage problématique de l’internet et des smartphones étaient présentésTo assess the internet and smartphones behaviour change during confinement, and to understand the impact of covid-19 on wellbeing, substance use disorder, and internet addiction disorder, two cross sectional online studies were conducted in Lebanon and France. Results showed a change towards a problematic use of internet and smartphones during confinement. The time passed online, as well as certain specific activities predicted this behaviour change. Wellbeing was not a mediator of the effect of covid-19 infection on addictions. Predictors of wellbeing, nicotine abuse, alcohol dependence, substances abuse, and problematic internet and smartphone use were presented
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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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Nickerson-Smith, Rhonda. "Coming home, spiritual journeyers recovering from addictions". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0024/MQ52000.pdf.
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Lang, Brent Alan. "Lay Perceptions of Behavioral and Substance Addictions". Bowling Green State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1447711322.
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Dunlap, Amy L. "Women with Addictions' Experience in Music Therapy". Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1483647124948226.
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Charbonneau, Philippe. "Traitement des addictions à l'aide du psychodrame". Thèse, Université du Québec à Trois-Rivières, 2011. http://depot-e.uqtr.ca/2052/1/030188007.pdf.
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Malkus, Amy J. "Multicultural Proficiency: Practical Applications with Addictions Clients". Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/4323.
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Malkus, B. M., e Amy J. Malkus. "Using the DSM-IV-TR in Addictions". Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/4322.
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Malkus, Amy J. "Multicultural Proficiency: Practical Applications with Addictions Clients". Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/4317.
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Alencar, Rodrigo. "A fome da alma: psicanálise, drogas e política na modernidade". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-07022017-105533/.
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A relação entre drogas e psicanálise tem um entrelaçamento desde o início do projeto freudiano. A criação da psicanálise se deu logo após o envolvimento de Freud com a polêmica da cocaína e seus decorrentes embates políticos. Nessa época, questões ligadas à moralidade e ao papel da ciência em nossa sociedade começavam a entrar em xeque, por consequência do avanço tecnológico e da preocupação com a gestão dos hábitos de populações que viviam em um mundo imerso em novas possibilidades de satisfação, comercializadas enquanto soluções para o enfrentamento do mal-estar da civilização. Nossa pesquisa busca apresentar quais fatores presentes na constituição do sujeito moderno contribuem para a formação do problema das adicções, assim como mostrar que a abordagem da psicanálise sobre o assunto pode ter ignorado aspectos fundamentais para o enfretamento do problema. Por meio da teoria pulsional de Freud e da teoria de sujeito desenvolvida por Jacques Lacan, realizamos uma leitura crítica das proposições fundamentais da psicanálise sobre as drogas, a saber, a noção de autoerotismo e também a droga como elemento antissocial. Como fundamentação desta crítica, propomos uma leitura do superego presente nas adicções enquanto mecanismo integrante do que Marshall Berman cunhou de desenvolvimento fáustico. A leitura de Berman nos proporciona uma visão na qual os efeitos colaterais do desenvolvimento capitalista repercutem nas adicções enquanto problema social, possibilitando identificar como o papel das drogas em nossa sociedade possui aspectos ignorados pela formulação da teoria psicanalítica até então. Dentre esses aspectos, identificamos os lugares do trabalho e das condições sociais como fatores fundamentais no entendimento das adicções. Como resposta às teorias existentes e como proposição clínica, recorremos à formulação teórica de Nathalie Zaltzman sobre o que a mesma denominou de pulsão anarquista, constructo o qual a psicanalista direciona à clínica de situações limite. Por fim, apresentamos algumas vinhetas clínicas que servem de suporte para as reflexões e rearranjos teóricos na abordagem psicanalítica sobre o tema. Passagens que foram extraídas de experiências de trabalho no âmbito da saúde pública e em atendimentos em consultório particular compõem as modulações transferenciais, categorias que utilizamos para compreender as diferentes configurações de demandas clínicas em torno da questão das drogas e seus possíveis direcionamentos. Com o suporte das vinhetas clínicas, pudemos apontar os limites que se situam entre as drogas e os profissionais que acolhem os pacientes com essa demanda, estabelecendo uma interpretação do fenômeno da fissura, no qual a satisfação tóxica pode até ser imprescindível, mas não é suficienteThe relationship between drugs and psychoanalysis has an interlacing since the beginning of the Freudian project. The creation of psychoanalysis occurred right after the involvement of Freud with the controversy of cocaine and its resulting political clashes. At that time, issues of morality and the role of science in our society began to come into question, as a result of technological advancement and the concern for the management of habits of populations that lived in a world steeped in new possibilities of satisfaction, sold as solutions to face the malaise of civilization. Our research aims to show which factors present in the constitution of modern subject contribute to the formation of the addictions problem, as well as show that the approach of psychoanalysis on the subject may have ignored key aspects to face the problem. Through the drive theory of Freud and the theory of subject developed by Jacques Lacan, we conducted a critical reading of the fundamental propositions of psychoanalysis on drugs, namely, the notion of self eroticism and also the drug as an anti-social element. In support to this criticism, we propose a reading of the superego present in addictions as an integral mechanism that Marshall Berman coined the Faustian development. The Berman reading gives us a vision in which the side effects of capitalist development have repercussions on addictions as a social problem, making it possible to identify that the role of drugs in our society has aspects that were overlooked by the formulation of psychoanalytic theory so far. Among these aspects, we have identified the places of work and social conditions as key factors in the understanding of addictions. In response to existing theories and as a clinical proposition, we used the theoretical formulation of Nathalie Zaltzman about what she called the anarchist drive, construct which the psychoanalyst directs to the limit situations clinic. Finally, we present some clinical vignettes that support the reflections and theoretical rearrangements in the psychoanalytic approach to the subject. Passages that were extracted from work experience in the field of public health and in private practice care compose the modulations transference, categories that we use to understand the different settings of clinical demands on the issue of drugs and their possible directions. With the support of clinical vignettes, we could point out the limits that are among the drugs and the professionals who receive patients with this demand, establishing an interpretation of the phenomenon of craving, in which the toxic satisfaction may even be essential, but is not enough
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Ho, Victoria. "Exploring the Challenges and Stressors of Working as an Addictions Counsellor". Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/22689.
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This qualitative study explored the challenges and stressors that are experienced by addiction counsellors in providing substance abuse treatment. In order to tap into rich and descriptive information on occupational stress in the addictions field, a modified grounded theory focused on conceptual ordering (Corbin & Strauss, 1998) was used for the research design. Participant sample consisted of 10 addiction counsellors who were recruited using purposeful selection from addiction treatment centres in Ontario, Canada. Data collection was conducted through face-to-face interviews using semi-structured, open-ended questions. Four major categories emerged from the data analysis using systematic thematic analysis: 1) Sources of Stress, 2) Signs and Consequences of Stress, 3) Stress Management and Intervention, and 4) Resiliency Against Stress. Results from this study contribute to the understanding of occupational stress in addictions counsellors. Implications for addiction organizations, educators, and counsellors are discussed.
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Tidmarsh, Alan. "An exploration of focusing-oriented therapy for addictions". Thesis, University of East Anglia, 2013. https://ueaeprints.uea.ac.uk/48047/.
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This study aims to provide the first systematic explication of focusing-oriented therapy for clients with addiction. It begins with basic principles from the Philosophy of the Implicit – experience, interaction, focaling and carrying forward - outlining their significance in psychopathology and therapy. General focusingoriented therapy is examined in terms of five client tasks and four therapist responses. A focusing-oriented view of addiction is then developed in terms of phenomena that, socially and personally, deal with unacceptable experience through ‘process-skipping, ‘flailing’ and the use of a ‘carapace.’ Three core tasks of focusing-oriented therapy for recovery are proposed. These help a client stand aside from the addictive carapace, carry forward underlying existential dilemmas and discover a new way of being-in-the-world. Five further recovery ‘avenues’ are identified using experiential aspects of mainstream treatments for addiction and experiential recovery tasks are suggested for them. These understandings of addiction and focusing-oriented therapy for recovery are illustrated in two substantial case studies of therapy in a mainstream drug and alcohol treatment agency. Proposals are made suggesting a greater significance for experiential therapy in addiction treatment.
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Becoña, Iglesias Elisardo, e Guadalupe Luis Armando Oblitas. "The psychology of health and addictions: therapeutic perspective". Pontificia Universidad Católica del Perú, 2003. http://repositorio.pucp.edu.pe/index/handle/123456789/101835.
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The addiction subject is nowadays a valid one, as well as in the past century. Not only because of the increase of people that are addict, but also because of the important effects that cause on people and their environments. There are many theoretical perspectives to approach the addiction problem, but the most convenient because of its therapeutic results is the one that issupported by the psychology of health. lt is based on the integral approach to the person. This paper describes a general therapeutic scheme to work with addicts from the cognitive behaviora lperspective.El tema de las adicciones sigue tan vigente como en el siglo pasado, no solo por el incremento del número de personas que lo padecen sino también por las importantes secuelas que produceen el individuo y en su entorno. Existen diferentes enfoques teóricos para abordar la problemáticade las adicciones, sin embargo el que nos parece más conveniente por sus resultados terapéuticos es el que proviene desde la Psicología de la salud, basado en un enfoque integral en el abordaje del sujeto. El artículo fundamentalmente describe un esquema terapéutico general de su aplicación a los adictos, desde el enfoque cognitivo-conductual.
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Lukasiewicz, Michael. "Addictions et doubles diagnostics dans les prisons françaises". Paris 6, 2009. http://www.theses.fr/2009PA066194.
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Maletska, A. V., Nataliia Oleksyivna Slyvka e V. O. Samsonyuk. "Diagnostic value of micronuclei assay in chemical addictions". Thesis, Abstract Book. International medical science student congress. - Turkey, 13-15 may 2016, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/11621.
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Capon, Hannah Rachel. "Therapist discourse in manualised therapy for alcohol addictions". Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/6359/.
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In the context of the rising agenda of evidence based practice, the use of treatment manuals is now common in psychotherapeutic treatments for addiction and other mental health issues. There is debate amongst clinicians and researchers regarding the trade-off between the costs and benefits of manuals; and differing opinions regarding the importance of treatment fidelity. One concern that clinicians often raise is the effect that manuals have on clinical judgement and responsivity, and one benefit that researchers raise is the standardisation of treatment. The purpose of this study was to consider how therapists enact the delivery of manualised through analysing the discourses used. Particular attention was given to how therapists attempted to facilitate behaviour change using both adherent and non-adherent techniques, and how therapists addressed the expression of client emotions. Two types of manualised alcohol addiction therapy sessions were investigated in this study; Motivational Enhancement Therapy, and Social Behaviour and Network Therapy, both taken from the large scale UK Alcohol Treatment Trial (UKATT research team, 2005). A discursive psychology informed analysis was conducted, spanning nineteen therapy sessions with six therapist-client dyads. The interpretative repertoires that therapists used to promote behaviour change were: therapist actions are responsible for enabling change, clients are responsible for changing their own behaviour, and therapeutic alliance is required for change. These were enacted through the following discursive practices: being paternalistic, being critical, persuading, lecturing, using humour, being collaborative, acting as benevolent expert and constructing oneself as a powerful expert. Therapists managed adherence to the manuals and responsivity to the clients in differing ways; at times prioritising one over the other, at other times attending to both, and at other times attending to neither. Therapists responded to clients’ expression of emotions in a variety of ways categorised under two themes of acknowledging and avoiding. The analysis highlighted the variability of therapist responses within both manualised therapies, which is discussed in further detail. The clinical implications, opportunities for further research, and limitations of the study are discussed.
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Malkus, Amy J. "Show Me the Money: Grant Writing for Addictions". Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/4316.
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Malkus, Amy J. "Show Me the Money: Grant Writing for Addictions". Digital Commons @ East Tennessee State University, 2004. https://dc.etsu.edu/etsu-works/4319.
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Dice, Tammi F., Kristy Carlisle e Rebekah Byrd. "Students’ Perspectives of Experiential Learning in an Addictions Course". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5815.
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Substance use disorder practitioners may identify as individuals in recovery, while others may have never experienced the challenge of abstinence. Without this lived experience, it may be difficult to accurately empathize with clients in recovery. Experiential learning is a way for students to live through an exercise in abstinence. The value of utilizing experiential learning for skill development and application of theory is established. However, there is no empirical research examining the use of experiential learning with undergraduate substance use disorder practitioner trainees not in recovery from addiction as a means to increase their ability to empathize with clients’ experiences. This article explored the impact of an experiential learning assignment in an undergraduate addictions course. A qualitative analysis of students’ written reflections revealed four primary themes. Authors offer suggestions for substance use disorder educators and recommendations for future research.
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Boniface, Sadie. "Finding the missing units : identifying under-reporting of alcohol consumption in England". Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1409260/.
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Background: Under-reporting of alcohol consumption is a widespread and persistent problem in surveys worldwide. For Great Britain in 2010, 56% of alcohol sold was reported consumed. Under-reporting occurs for reasons, including, but not limited to: selective reporting, mode effects, recall bias, and under-estimation. Methods: Secondary analyses of Health Survey for England (HSE) 2008 (n=9,608) and General Lifestyle Survey (GLF) 2008 data (n=12,490) to estimate population level alcohol consumption with under-reporting taken into account. Secondary analyses of the HSE 2011 (n=3,774) to highlight possible risk factors for under-reporting of alcohol consumption in retrospective interview compared with prospective drinking diary. Qualitative semi-structured interviews (n=10) with HSE 2011 drinking diary participants to identify further potential risk factors. Self-completion questionnaire and pouring task with a convenience sample (n=283) to explore under-estimation of home drinking. Results: After accounting for under-reporting, 40% men and 30% women drank above weekly guidelines, an increase of over 10% points (GLF 2008). On the heaviest drinking day in the last week 75% men and 80% women drank above daily limits, compared with around half in the original survey (HSE 2008). Risk factors for prospective diary measures exceeding those of the retrospective interview were: weekly alcohol intake, number of drinking days, drinking a combination of drink types, and drinking exclusively in licensed premises (HSE 2011). Qualitative interviews identified having a non-routine drinking pattern and not using alcohol units to track consumption as linked to drinking more in the prospective diary than expected. The pouring task did not identify systematic under-estimation of a usual glass; however under-estimation was associated with increasing volume poured. Conclusions: Under-reporting of alcohol consumption has implications for public health research and policy. In three studies, alcohol-related factors were associated with under-reporting of alcohol consumption whereas demographic and social factors were not. Targeted interventions and policies may reduce under-reporting.
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Paraherakis, Antonios. "Substance-related disorders and associated psychopathology : predicting addictions treatment outcome". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0001/MQ44241.pdf.
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Hodgson, Maggie. ""Cross-addictions of gambling, alcohol and drugs in Aboriginal communities"". School of Native Human Services, 1997. http://142.51.24.159/dspace/handle/10219/468.
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Over the past twenty years, Native Canadians or Aboriginal people have enjoyed considerable progress in the development of sobriety. That is the good news. The bad news is that there has not been similar success in the area of other addictions, particularly gambling. Statistics exist which reveal the negative effects of gambling on Native people.
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Hewitt, A. J. "After the fire : post traumatic growth in recovery from addictions". Thesis, University of Bath, 2007. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.527506.
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Growth in response to trauma (Posttraumatic growth – PTG) has been established in a number of studies, though only two (Hewitt 2004, McMillen et al 2001) are directly related to the traumatic experience of addiction to drugs and alcohol. This study built on previous work by the author (Hewitt 2002, 2004) that established that addiction could be seen as a trauma, and that both negative and positive effects could result from the experience. This research sought to explore the experience of posttraumatic growth in recovery from addiction. The aim was to clarify more explicitly the experiences of some of the people who reported PTG in relation to addiction, increasing our awareness and understanding of some of the outcomes, strategies and processes involved, and the implications of these findings. The research comprised two studies. In the first, the experience of 16 people who felt they had PTG effects resulting from their previous addiction to drugs or alcohol was analysed using Grounded Theory. In the second study, the experience and views of another three people who fulfilled the same criteria but in addition were also ‘experts’ in this area were analysed using Interpretative Phenomenological Analysis. Combining the data analysis from both studies described a uniquely personal overall process of individuation, with growth along a developmental continuum from addiction recovery to thriving resulting from the deliberate use and generation of recovery capital and growth capital. There were a large range of positive feedback loops that supported this growth, and meaning was of central and ongoing importance. The study findings were compared to the wider PTG literature and found to have much in common, further supporting the view that addiction can be seen as a stressor in PTG terms, and suggesting that there may be much theory and practice from the PTG field that can be applied to the area of addiction recovery. Limitations of the study are discussed, and recommendations made for further testing of the model developed within the thesis in order to examine its generalisability, as well as for study and theory development, and for the development of policy and practice relating to promoting recovery from addictions and subsequent growth.
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Taïeb, Olivier. "Les histoires des toxicomanes : narrations et lectures dans les addictions". Paris 13, 2006. http://www.theses.fr/2006PA131034.
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Objectifs : Face à la multiplicité des discours et des histoires sur la toxicomanie, cette recherche a pour objectifs (1) de décrire les modèles explicatifs des patients toxicomanes avec une méthode issue de l’anthropologie médicale et de la psychiatrie transculturelle (Kleinman), (2) de définir les facteurs (sociodémographiques, migratoires et psychiatriques) dont dépendent ces modèles et (3) de montrer, en s’appuyant principalement sur la notion d’identité narrative de Ricœur, que les patients tentent ainsi de mettre en intrigue leurs histoires de vie. Patients et méthode : 70 patients présentant une dépendance actuelle à des drogues selon le DSM-IV ont été évalués à l'hôpital Avicenne, en Seine-Saint-Denis, par un entretien comprenant l’Explanatory Model Interview Catalogue (Weiss) et d’autres instruments. Résultats : Les modalités d’expression de la souffrance, les représentations des troubles, les théories étiologiques et les itinéraires thérapeutiques sont hétérogènes. Une isomorphie est retrouvée entre modalités d’expression de la souffrance, profil de sévérité de l’addiction et théories étiologiques montrant la circularité de la causalité. Causes et conséquences sont souvent indiscernables dans les discours. Les ressemblances entre les récits des patients et la littérature spécialisée sur les addictions illustrent ce que Ricœur a appelé le cercle de la mimèsis. Discussion : Les enjeux psychopathologiques de l’hétérogénéité des modèles explicatifs sont à prendre en compte dans les rencontres thérapeutiques, ces modèles ne devant être ni réifiés ni figés pour être accessibles au changement. A partir de la théorie narrative de Ricœur et de théories de la lecture, est mise en avant l’idée que les patients doivent être considérés comme narrateurs et personnages de leurs histoires de vie (mimèsis I et II) mais aussi comme lecteurs d’histoires multiples et lecteurs de leurs propres troubles (mimèsis III). Les patients ont donc besoin du secours de la littérature au sens large pour rendre intelligible leur vie et construire leurs identités. L’appropriation de cette littérature doit rester critique pour éviter l’errance entre plusieurs modèles identificatoires, la menace de la perte d’identité ou le repli identitaireObjectives: In the face of many discourses and stories on drug addiction, the present study has three objectives: (1) to describe drug addicts’ explanatory models with an approach from medical anthropology and transcultural psychiatry (Kleinman), (2) to know sociodemographic, migration and psychiatric factors which influenced it, and (3) to show that drug addicts attempt to plot their life histories according to Ricoeur’s notion of narrative identity. Patients and method: 70 patients with a current drug dependence according to DSM-IV have been assessed in Avicenne Hospital, in Seine-Saint-Denis (France), by the Explanatory Model Interview Catalogue (Weiss) and other instruments. Results: Patterns of distress, perceived causes and help-seeking behaviours are heterogeneous. Patterns of distress, dimensions of addiction severity, and perceived causes are isomorphic. This result shows the circularity of causality. Causes and consequences are frequently indiscernible in patients’ discourses. Similarities between patients’ narratives and specialized literature illustrate Ricoeur’s circle of mimesis. Discussion: Psychopathological issues of the heterogeneity of explanatory models have to be taken into account in treatment. From Ricoeur’s and other authors’ narrative theories, the idea that patients are not only narrators and characters in their life histories (mimesis1 and 2) but also readers of numerous stories and of their own illness (mimesis3) is proposed. Patients have particular need of the help of literature, in a broad sense, in order to make their lives intelligible and to construct their identities. The value and the risks of a non-critical appropriation of this literature are discussed. Indeed, patients may hesitate between several identification models, loss of identity or identity withdrawal
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Puertolas, Christian. "La honte : sa place dans l'approche psychothérapique psychanalytique des addictions". Bordeaux 2, 1997. http://www.theses.fr/1997BOR2M047.
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Haylett, Samantha Angelina. "The applied psychology of addictive orientations : studies in a 12-step treatment context". Thesis, University of Kent, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.344102.
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The clinical data for the studies was collected at The PROMIS Recovery Centre, a Minnesota Model treatmentc entre for addictions,w hich encouragesth e membership and use of the 12 step Anonymous Fellowships, and is abstinence based. The area of addiction is contextualised in a review chapter which focuses on research relating to the phenomenon of cross addiction. A study examining the concept of "addictive orientations" in male and female addicts is described, which develops a study conductedb y StephensonM, aggi, Lefever, & Morojele (1995). This presents tudy found a four factor solution which appeared to be subdivisions of the previously found Hedonism and Nurturance factors. Self orientated nurturance (both food dimensions, shopping and caffeine), Other orientated nurturance (both compulsive helping dimensions and work), Sensation seeking hedonism (Drugs, prescription drugs, nicotine and marginally alcohol), and Power related hedonism (Both relationship dimensions, sex and gambling. This concept of "addictive orientations" is further explored in a non-clinical population, where again a four factor solution was found, very similar to that in the clinical population. This was thought to indicate that in terms of addictive orientation a pattern already exists in this non-clinical population, and that consideration should be given to why this is the case. These orientations are examined in terms of gender differences. It is suggested that the differences between genders reflect power-related role relationships between the sexes. In order to further elaborate the significance and meaning behind these orientations the next two chapters look at the contribution of personality variables and how addictive orientations relate to psychiatric symptomatology. Personality variables were differentially, and to a considerable extent predictably involved with the four factors for both males and females.C onscientiousnesws as positively associatedw ith "Other orientated Nurturance" and negatively associated with "Sensation seeking hedonism" (particularly for men). Neuroticism had a particularly strong association with the "Self orientated Nurturance" factor in the female population. More than twice the symptomatology variance was explained by the factor scores for females than it was for males. The most important factorial predictors for psychiatric symptomatology were the "Power related hedonism" factor for males, and "Self oriented nurturance" for females. The results are discussed from theoretical and treatment perspectives.
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Roméo, Bruno. "Impact de la symptomatologie et du sevrage en cannabis sur les marqueurs immunitaires chez des patients atteints de troubles psychiatriques". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR006.
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Introduction : Depuis plusieurs années, de nombreuses études portant sur la dysrégulation du système immunitaire chez les patients atteints de troubles psychiatriques ont été réalisées, aboutissant à des modèles physiopathologiques comme le modèle vulnérabilité-stress-inflammation. Cependant, de nombreux facteurs semblent moduler ce système, ce qui pourrait expliquer une hétérogénéité des résultats obtenus. L’objectif de cette thèse est donc d’évaluer l’impact de la clinique ainsi que du sevrage en cannabis sur les marqueurs immunitaires utilisés en pratique clinique courante chez des patients atteints de troubles psychiatriques. Méthodes : Afin d’évaluer l’impact de la clinique sur les marqueurs immunitaires, nous avons réalisé une méta- analyse évaluant les niveaux de C-reactive protein (CRP) chez les patients atteints de schizophrénie à différents stades de la maladie (aiguë vs stable) par rapport à des témoins sains. Afin de compléter cette évaluation, nous avons également réalisé une cohorte rétrospective étudiant les marqueurs immunitaires utilisés en pratique courante dans une population spécifique de patients ayant nécessité un isolement thérapeutique durant leur hospitalisation. Afin d’évaluer l’impact du sevrage en cannabis sur les marqueurs immunitaires, nous avons réalisé deux cohortes rétrospectives, la première chez des patients atteints de schizophrénie, et la deuxième incluant des patients atteints de psychose plus généralement, puis nous avons terminé en réalisant une étude évaluant l’impact d’une infection à Toxoplasma Gondii (T. gondii) sur ces mêmes paramètres lors du sevrage en cannabis. Résultats principaux: Dans notre première partie de thèse, nous montrons des niveaux de CRP plus importants durant les décompensations aiguës que durant les périodes de stabilité, à la fois dans notre méta-analyse mais aussi dans notre étude rétrospective, avec un impact de l’agressivité/agitation psychomotrice sur les niveaux des ratios neutrophile/lymphocyte (NLR) et monocyte/lymphocyte (MLR) chez des patients ayant nécessité un isolement thérapeutique. Dans les deux cas, les niveaux de ces marqueurs immunitaires reviennent à la normale après l’épisode d’exacerbation symptomatique. La deuxième partie de cette thèse met en évidence qu’un sevrage en cannabis est associé à ,des niveaux des paramètres immunitaires plus élevés que cela soit de la CRP mais également des niveaux de leucocytes, d’éosinophiles, de lymphocytes, de monocytes ou encore des ratios éosinophiles sur lymphocytes ; ou éosinophiles neutrophiles sur lymphocytes. Pour finir, nous avons mis en évidence une possible modulation de cette augmentation des paramètres immunitaires par la séropositivité au T. gondii. Conclusion : Cette thèse permet de faire un état des lieux des facteurs pouvant moduler les paramètres immunitaires chez les patients atteints de troubles psychiatriques. En effet, nous mettons en évidence que l’état clinique a un impact sur ces marqueurs, principalement ceux de l’immunité innée, avec notamment des différences entre les états aigus de décompensation et les patients stables. De plus, nous mettons en évidence un potentiel impact de la consommation de cannabis et de son sevrage sur ces marqueurs avec des modulations de l’imminuté principalement innée à l’arrêt des consommations. Pour finir, nous avons trouvé que la cinétique des marqueurs de l’immunité innée telle que l’augmentation des niveaux d’éosinophiles lors de l’arrêt de la consommation de cannabis est également modulée par le statut T. gondii. L’ensemble de ces résultats doit être complété par d’autres études prospectives permettant d’investiguer les mécanismes par lesquels ces modulations ont lieu comme la modulation des perméabilités intestinale et hémato-encéphaliqueIntroduction: Various studies have examined the dysregulation of the immune system in psychiatric disorders, leading to pathophysiological models such as the vulnerability-stress-inflammation model. However, some factors could modulate this system, and may partly explain the heterogeneity of results. The aim of this thesis is to evaluate the impact of the clinical status and of cannabis cessation on immune markers in routine care among patients with psychiatric disorders. Methods: To assess the impact of the clinical status on immune markers, we carried out a meta-analysis of C- reactive protein (CRP) levels in stable and patients in an acute phase, compared with healthy controls. In addition, we also carried out a retrospective cohort studying immune markers in patients requiring seclusion during hospitalization. To assess the impact of cannabis cessation on immune markers, we carried out two retrospective cohorts (the first including patients with schizophrenia and the second including patients with psychosis). Finally, we conducted a last study on the impact of Toxoplasma Gondii (T. gondii) seropositivity on immune markers during cannabis cessation. Main results: In the first part of our thesis, we found highest levels of CRP during acute as compared to stable phase of the disease in our meta-analysis. Additionally, in our retrospective study, we observe the impact of aggressive behavior/agitation on the neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) in patients requiring therapeutic seclusion. In both cases, the levels of these immune markers return to normality after the acute episode. The second part of this thesis reveals that cannabis cessation is associated with highest levels of immune parameters, including CRP, as well as levels of leukocytes, eosinophils, lymphocytes, monocytes, and ratios such as eosinophil-to-lymphocyte ratio or eosinophil-to-neutrophil ratio over lymphocytes. Finally, we identified a potential modulation of this increase in immune parameters by latent T. gondii infection. Conclusion: This thesis provides an overview of factors that can modulate immune parameters in patients with psychiatric disorders. We highlight that the clinical status impacts these markers, particularly those involved in innate immunity, with differences between acute decompensation states and stable patients. Furthermore, we reveal a potential impact of cannabis consumption and its cessation on these markers, with modulations of primarily innate immunity after cessation of consumption. Finally, we found that the kinetics of innate immune markers such as the increase of eosinophil levels during cannabis cessation are also influenced by T. gondii status. All these findings should be reinforced by further prospective studies investigating the mechanisms behind these modulations, such as the modulation of intestinal and blood-brain barrier permeabilities
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O'Keefe, Edward. "A counseling internship at Addictions, Health and Community Services, Western with an internship project on how to integrate cocaine intervention strategies into Western's existing addictions services program". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ42418.pdf.
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Sierra-Scroccaro, Nathalie. "Adolescence et addictions : quelles interventions envisager pour les parents de jeunes consommateurs ?" Thesis, Rennes 2, 2015. http://www.theses.fr/2015REN20005.
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Les addictions constituent un problème majeur de santé publique et soulèvent de nombreuses questions sur le plan clinique et psycho-pathologique ainsi que sur leur prise en charge. Toutefois, si elles sont d’un intérêt certain dans le domaine de la recherche scientifique, ce n’est que récemment que la souffrance des proches, et plus encore celle des parents de jeunes adolescents, sont l’objet de travaux pour les chercheurs comme pour les professionnels.L’objectif de cette recherche qualitative et exploratoire est d’étudier les vécus des parents d’adolescents ayant des pratiques addictives. Elle est réalisée au sein d’un dispositif de prévention en addictologie.Ce sont en majorité des mères qui consultent pour leurs fils. Généralement, ces adolescents ou jeunes adultes sont âgés entre 15 et 23 ans, aux prises avec un problème de consommation de cannabis, d’alcool, de jeux vidéo et vivent chez leurs parents.Six formes de vécus parentaux et certaines configurations familiales en lien avec les conduites addictives des adolescents ont pu être identifiées à l’aide de quinze vignettes cliniques.Les addictions des jeunes interpellent la fonction maternelle, en tant que médiatrice de la fonction paternelle. De même, le sujet adolescent convoquerait chez la mère, un objet répondant à la question du réel d’une autre jouissance, en tant qu’une suppléance à l’absence de signifiant.Ces résultats permettent d’interroger les possibilités d’interventions en clinique auprès de ces familles d’une part, et de réfléchir à un nouveau dispositif d’accompagnement médico-psycho-social d’autre partAddiction constitutes a major public health problem and raises numerous questions from a clinical and psychopathological perspective as well as on young users’ care. Even though certain interest has been shown in the field of scientific research on the subject, only recently has the suffering of the parents of young teenagers been the object of researchers’ and professionals’ studies.The objective of this qualitative and exploratory study is to examine the personal experiences of the parents of teenagers suffering from addiction. It was carried out at a prevention and treatment center for addiction.Mothers who consult for their sons make up the majority of those who consult. Generally, these teenagers or grown-up young adults are between the ages of 15 and 23, live at home with their parents, and battle against excessive use of cannabis, alcohol, and video games.Six forms of parental personal experiences and certain family configurations in connection with the addictive behaviors of the teenagers were identified by means of fifteen clinical cases.The addictions of the young people in question call out to the maternal function as a mediator of the paternal function.Additionally, the adolescent subject summons within his/her mother an object in response to the question of the real of the Other jouissance, as a substitution in the absence of the signifier.These results allow us to question the possibilities of clinical interventions with these families, and to think about new tools of medical-psychosocial support
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Gunner, Michelle, of Western Sydney Nepean University e School of Health and Nursing. "Going for broke: a Heideggerian phenomenological study of problem gamblers". THESIS_XXXX_SHN_Gunner_M.xml, 2000. http://handle.uws.edu.au:8081/1959.7/261.
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This study represents the first phenomenological investigation of problem gambling. The subjective experiences of six problem gamblers are explored. Heideggerian, hermeneutic phenomenology provides the constructs and framework that underpin this research. Four themes, each reflecting the participants' experiences, emerged from conversations conducted. These themes were: being alone, buying time, magical thinking and critical voices - themes are independent and have no ranking. The study articulates the needs of problem gamblers, as well as providing an opportunity for them to be heard. It allows health professionals to gain insight into underlying problems. The implications of the findings for the participants, health professionals and government are discussedDoctor of Philosophy (PhD)
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Benedetti, Elisa. "Three essays on the evaluation of public policies in the field of addictions". Doctoral thesis, Università di Siena, 2020. http://hdl.handle.net/11365/1111312.
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This dissertation, composed of three essays, aims at providing an evaluation of selected public policies in the field of addictions, focusing on drugs and gambling. Evaluation is increasingly recognised as essential for effective policymaking, helping to empirically verify that policies and programmes have the desired effect, provide value for money and do not have negative unintended consequences. In the case of socially undesirable behaviours, policy evaluation is frequently challenged by the limited data available.
To tackle this challenge, the analyses proposed in the present work make use of novel datasets which combine epidemiological, financial, political and administrative data.
On the one hand, addictive behaviours constitute an enormous source of revenue for organized crime and for national governments, in the case of legal substances or behaviours such as gambling. On the other hand, they represent a cost for public authorities, e.g., for public health and law enforcement reasons. For these reasons, over the years several policy approaches have been implemented to contrast the externalities produced by the spread of addictive behaviours, however very limited work has been performed to evaluate their effects.
The present dissertation aims at contributing to the literature seeking to provide evidence on the possible intended and unintended effects of public policies on addictions, focusing on selected policies aimed at regulating cannabis consumption and gambling.
The first chapter is aimed at analysing the effects that the drug policy reforms implemented in Europe in the last 15 years had on youth cannabis consumption behaviours. In fact, cannabis is the most used illicit drug and accounts for the largest share of the European illicit drug market. To tackle this longstanding problem, a broad set of reforms to national cannabis control policies have been implemented, but their effectiveness in achieving the desired results is still unclear. This essay analyses the association between selected categories of cannabis policy reforms and changes in cannabis availability and useamong adolescents. Data from 20 European countries across 15 years were drawn from a novel database of the European school Survey Project on Alcohol and other Drugs. The influence of policy changes on reported access to cannabis and different frequencies of use was estimated through an identification strategy based on a Differences-in-Differences model, which application is allowed by the fact that only thirteen out of the twenty countries included in the analysis implemented relevant reforms. The findings suggest that selected categories of reforms influence the availability and prevalence of cannabis among adolescents. In particular, some forms of restrictive interventions reduce the general prevalence of use and more liberal reforms seem to cause an increase in the share of students approaching cannabis. However, none of the analysed reforms seems to have been able to influence the consumption habits of frequent users.
The second chapter deepens the analysis of the effects of drug policy changes by focusing of the reform that in the period 2006-2014 criminalised the possession of cannabis for personal use in Italy. The chapter addresses a key question in the ongoing policy debate over cannabis’ legal status as to whether removing or increasing penalties attached to cannabis use and possession leads not only to changes in the proportion of cannabis users, but also to changes in the dynamics of cannabis use. Empirically investigating this aspect is a growing field of study. This paper aims at extending previous research by studying the effect of increasing penalties on initiation into cannabis use. This is done in the Italian context where, despite the relevant drug policy reforms implemented over the last 30 years, very little econometric studies have been performed to evaluate their effects. In order to identify the effect of criminalisation on the transition into cannabis use, the paper exploits the policy change that in the period from 2006 to 2014 increased the penalties attached to cannabis possession in Italy. For this, a unique dataset pooling seven waves (2001-2017) of the Italian Population Survey on Alcohol and other Drugs (IPSAD) is used. The empirical investigation is based on a Complementary Log-Log regression model to analyse the starting rate, that is, the transition rate from non-use to use. The results suggest that the introduction of higher punishments for cannabis possession has a significant, although limited, effect in reducing the uptake of cannabis. However the research highlights that this relative achievement need to be evaluated against the backdrop of the social consequences of criminalisation.
The third chapter is aimed at assessing the market effects of limiting the supply of gambling products. This is done by exploiting the effects of the local policies that imposed restrictions on the supply of offline entertainment machines implemented in the years 2017-2018 by some municipalities in one of the Northern regions of Italy. The market effects of reducing the allowed functioning time of offline entertainment machines are assessed both on the level of the gross gambling turnover and on its composition in terms of possible shifts towards online gambling products. Although the policy should have applied to the entire regional territory, some municipalities did not approve the necessary implementing acts, whilst others imposed functioning time restrictions with varying level of intensity. This variation is exploited using a regression-based Differences-in-Differences (DiD) design with continuous treatment with a unique dataset recording yearly gambling turnover by type of game in the years 2016, 2017, and 2018 matched with data on municipal acts collected for the study and socio-demographic variables. The results suggest that the implemented policies actually reduced the gambling consumption through offline entertainment machines. However, no significant reduction of the total gambling consumption was observed. In fact, focusing on the composition of gambling turnover there is evidence of a shift toward online gambling products. These results support the argument that limiting the physical availability of entertainment machines is an effective policy for reducing the amount of resources invested by consumers in this type of game. At the same time attention should be paid to the possible unintended effects on the shift towards other gambling products, which by definition cannot be subject to similar restrictions.
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Cayn, Delphine. "Fonction des addictions avec et sans drogues dans le trouble de la personnalité borderline". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB143.
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Addictions, passages à l'acte et troubles alimentaires sont connus pour leur fréquence dans trouble de la personnalité borderline, ce qui laisse supposer qu'ils jouent un rôle dans le fonctionnement de la personnalité borderline et limite. Le sujet borderline est poussé à l'agir dans une notion d'urgence par les fluctuations d'humeur, la dépression, l'instabilité émotionnelle et l'incapacité à se réguler. Dans le fonctionnement limite de la personnalité, les défenses sont variées entre névrose et psychose, le dysfonctionnement majeur semble se situer dans un défaut de contenance du soi, une porosité des limites, bien caractéristique des états limite. Le trouble identitaire et la défaillance narcissique sont au cœur de la problématique et semblent s'actualiser dans les relations pathologiques à l'objet primaire, et à celles qui suivront. La dépendance à autrui et la peur de l'abandon animent les sujets limite et leur symptomatologie, ponctuée d'addictions et passages à l'acte. Ce travail de recherche se propose d'étudier différentes dimensions : la dépendance interpersonnelle, l'attachement, l'alexithymie, la dépression, le sentiment de désespoir et l'anaclitisme, les troubles de la personnalité dépendant et évitant au regard des addictions avec et sans drogues dont les passages à l'acte addictif : tentatives de suicide et automutilationsAddictions, acting-out and eating disorders are known to be comorbid with borderline personality disorder. Their high frequencies mean that they support involvements and functions in the way that borderline personality operates. Borderline subjects are led to acting-out urgently by mood disorder, depression, emotional instability and incapacity to regulate them. In borderline personality, defense mechanisms are diversified between nevrosis and psychosis. The major dysfunction seems to set on fail of self-containing and porosity of the borders of the self. Identity disorder and narcissistic failures are the main issues in borderline personality disorder which lead to recreate pathological relationship to the primary object with later relationship. Dependent relationship and fear of abandonment manage borderline subjects and their symptomatology with addictions and acting-out. This research aim to examine different dimensions: interpersonal dependency, attachment, alexithymia, depression, hopelessness feeling, anaclitism, dependent and avoidant personality disorders according to addictions with and without drugs, and suicide attempts and non suicidal self-injury
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Odier, Nicolas. "Apports des sciences sociales à la compréhension des addictions : un enjeu de santé publique ?" Thesis, Aix-Marseille, 2014. http://www.theses.fr/2014AIXM5009/document.
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Freud parlait au siècle dernier de Malaise dans la civilisation (Freud, 1929), notre siècle ne cache-t-il pas un malaise tout aussi profond ? En effet, nous pouvons penser que la somme des contraintes aujourd'hui dépasse la capacité d'adaptation des individus et de leurs réseaux familiaux et sociaux ; le recours aux addictions devient alors pour beaucoup une stratégie de survie ou un mécanisme de contrôle pour garder un équilibre psychosocial. Tout se passe dans la réalité de la prise en charge des addictions en lien ou pas avec un trouble psychiatrique ou inversement, comme si l'individu agissait dans un ensemble social vide. Or, le contexte social - et Freud a été un des premiers à le démontrer - interagit selon la tradition interactionniste sur tous les comportements déviants. Notre travail a pour objectif de mettre en lumière les apports des sciences sociales et plus particulièrement de la sociologie dans la compréhension des addictions. En effet, il est admit aujourd'hui que les approches purement médicales qu'elles soient somatiques ou cognitives, n'ont su répondre aux attentes des patients et des professionnels de santé. Nous proposons donc au travers de cette étude de démontrer que l'approche sociologique des addictions peut nous aider à la fois à comprendre pourquoi un individu à un moment de sa vie se laisse prendre dans un comportement à risque et comment nous pouvons essayer de l'accompagner à retrouver un état de plaisir.L'enjeu est de comprendre l'addiction au travers de l'histoire sociale de l'individu. nous savons que nous pouvons modifier nos comportements pour préserver notre état de santéIn the last century, Freud spoke of "Discontents in Civilisation" (Freud, 1929), our century not hide a deeper malaise ?Indeed, we can think that the sum of the constraints, now exceed the adaptive capacity of individuals and their family and social networks, that the use of addictions become so much a survival strategy or a control mechanism to keep a psychosocial balance. Everything happens in the reality of the management of addictions related or not with a psychiatric disorder or vice versa, as if the individual was in an empty social world. However, the social context - and Freud was one of the first to demonstrate - interacts according to interactionist tradition on all deviant behavior. One of our aims is to highlight the contributions of the social sciences and especially sociology in understanding addictions. Indeed, he is admitted today that purely medical approaches, somatic or cognitive, haven't met the expectations of patients and health professionals. We therefore propose to demonstrate through this study that the sociological approach to addictions can help us both to understand why an individual at a time of his life gets caught in a risky behavior and how we can try to help him regain a state of pleasure. The challenge is to understand the addiction through the social history of the individual. The various models proposed so far are failures for normative reasons. However, we know that we can change our behavior to preserve our health. We propose a model of care that takes into account both an individualized management over the long term and the social history of each
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Johansson, Daniel, e Bing He. "Sustainable Gambling Business : -The responsibility of companies to protect gamblers from becoming addictive". Thesis, Uppsala universitet, Företagsekonomiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-226606.
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Gambling availability has increased as well as the number of people gambling. Within gambling, addiction has become a growing problem, affecting both the gambling business as well as the individuals. This situation forces companies to balance their profit with responsible action in order to prevent gambling addiction. This thesis examines why and how gambling companies differ in their methods to help players avoid addiction in order to establish a sustainable society. A multiple case-study has been carried out, where three gambling companies have been examined and analyzed. The companies are Svenska Spel, Norsk Tipping and Unibet. The survey is based on interviews with representatives from the companies working in the departments of Responsible gambling or CSR. The conclusions of this study show that gambling companies can profit both economically and establish good will, if they show responsibility. Gambling companies differ in how they handle addiction, mainly because of diffuse concepts as CSR and Responsible Gambling. If gambling companies cooperate actively between themselves as well as with research of addiction, a balanced, sustainable society may be reached. Discussions of solving the problem of gambling addiction can preferably continue in order to reach a sustainable society.
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Ginzer, Linda M. "Diagnostic Criteria for Alcohol Use Disorders in Older People: Are They Valid?" The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1265921452.
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Ryan, Shannon Amber. "The many directions of four stories, Aboriginal women's experiences living with addictions and HIV/AIDS". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0008/MQ61492.pdf.
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Harris, Barbara. ""Urban Native Women in recovery from addictions: Towards holistic integration of Treatment and Aftercare Services"". School of Native Human Services, 2003. http://142.51.24.159/dspace/handle/10219/411.
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The purpose of this exploratory study was to determine the adequacy of current addiction services for Vancouver's urban Native women in recovery from addiction. It is evident that urban Native women continue to be at risk of recidivism, due to a multitude of issues that directly affect their ability to maintain a health addiction-free lifestyle. If recidivism is to be reduced, there needs to be a dramatic reconstruction of current addiction services. In fact, there is a need to integrate treatment and aftercare services, in conjunction with systemic changes that provide a holistic approach to addressing the issues faced by this population. Certainly, First Nations women are recovering from addiction, in spite of the failure to meet their needs. Regardless, as this study indicates, urban Native women experience unique difficulties in their efforts to find a new way to live, difficulties that could be mitigated by providing holistic and integrated services.
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BERENDONK, EDUARDO HENRIQUE COUTINHO. "I ENJOY THEREFORE I EXIST, SEEKING FOR THE THOUGHT: A PSYCHOANALYTICAL STUDY ON DRUG ADDICTIONS". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2005. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=6615@1.
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COORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOREste estudo investiga o tema das drogadicções a partir de um referencial psicanalítico. A droga é vista como um meio de intensa satisfação pulsional, que pode levar, pela drogadicção, a um certo isolamento e alheamento das determinações subjetivas. O autor parte de algumas proposições freudianas sobre a droga e as drogadicções para investigar as operações de constituição do sujeito em Lacan. Verifica, a partir daí, a importância da relação com a alteridade no processo contínuo de sustentação da atividade representativa inconsciente. Para o tratamento, propõe que o analista forneça uma atenção especial aos atos - passagem ao ato e acting-out - que surgem desde as entrevistas preliminares. Indica a presença, nestes casos, de uma operação de exclusão da atividade representativa, que poderá ser inicialmente retomada pela via dos atos que, por sua vez, podem servir para resgatar a função do sujeito do inconsciente. Inclui um caso clínico, onde se fez uso das concepções teóricas desenvolvidas.
This study investigates the theme of drug addiction from a psychoanalytic referential. The drug is seen as a way of intense drive satisfaction, which may lead, through drug addiction, to a certain alienation and isolation from subjective determinations. Starting with some Freudian principles about the drug and the drug addictions, the author sets out to investigate the operations of subject constitution in Lacan. It is therefore ascertained the importance of the relation with the Other in the continuous process of sustaining the representative activity of the unconscious. For the treatment, it is proposed that the analyst pays particular attention to the acts - passage à l acte and acting-out - which become evident from the preliminary interviews. It is indicated the existence of an operation of exclusion of the representative activity. This representative activity may be initially resumed via the acts, which, in turn, may serve to recapture the function of the unconscious subject. A clinical case is included, in which the use of theoretical concepts developed is made.
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Durastante, Richard. "Les addictions à l’adolescence : de la transmission psychique transgénérationnelle à la figuration du traumatisme cumulatif". Lyon 2, 2008. http://theses.univ-lyon2.fr/documents/lyon2/2008/durastante_r.
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L’adolescence réactive les traumatismes parentaux et bouscule les pactes et contrats narcissiques familiaux. Les parents se retrouvent ainsi confrontés en direct aux deuils non faits des générations précédentes. Le transgénérationnel brouille et embrouille les places en famille et l’ordre des générations. Il devient alors urgent de préserver le lien familial coûte que coûte, ce qui donne lieu à des configurations familiales où il est impossible de se séparer et de s’individuer. Le mécanisme de rétorsion qui se met en place à l’encontre de l’adolescent accentue chez lui le bouleversement pulsionnel déjà inhérent au pubertaire. Les parents désigneraient l’adolescent comme figure de l’intrus, dont le corps-soma deviendrait pour la famille un mode de figuration de leur trop plein d’excitations inhérent à la transmission traumatique d’une souffrance impensable. Le traumatisme passerait d’une génération à l’autre par un ensemble de relations inadéquates qui se tisse, dès l’origine, entre les objets parentaux et l’enfant, donnant ainsi lieu à un traumatisme cumulatif. L’addiction, avec ou sans produit, serait ainsi pour l’adolescent un mode de figuration cumulatif de la croissance progressive des excès d’excitations, qui s’originent dans cet ensemble de relations inadéquates s’étendant sur une longue période, de l’enfance à l’adolescence, qui caractérisent le traumatisme cumulatif, ce dernier pouvant être considéré comme un vecteur de répétitions transgénérationnelles. La répétition des agirs addictifs pourrait augmenter la potentialité figurative qui se construit et s’amplifie peu à peu, à partir du cumul traumatique engendré par une telle répétition, et de ses après-coupsAdolescence reactivates parental trauma and disrupts narcissistic pacts and contracts existing in the family. Parents find themselves directly confronted with previous generations’ unresolved mourning. These transgenerational phenomena blur and mix up the place of each family member within the family and the order of the different generations. At that time it becomes urgent to protect by any means family ties, thus creating family configurations in which separation or the acquisition of one’s own identity become impossible. The retaliation mechanism which develops against the adolescent increases the turmoil of the drives that are already inherent to puberty. The parents designate so to speak the adolescent as an embodiment of the intruder, his body-soma becoming for the family a means of representing their excessive arousal, excessive arousal inherent to the traumatic transmission of an inconceivable suffering. The trauma is passed on, one might say, from one generation to another by a set of inadequate relationships interwoven from the beginning between the parental objects and the child. This would give rise to a cumulative trauma. Addiction, whether it be to a substance or not, would thus be for the adolescent a cumulative means of embodying the gradual development of the excessive arousal, springing from this set of inadequate relationships which have been in place from childhood to adolescence and are characteristic of the cumulative trauma, vector of transgenerational repetition. Repetitive addictive acting out could increase the figurative potentiality which has gradually been building up and developing from the traumatic accumulation induced by such repetition and its after effects
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Amadéo, Stéphane. "Addictions : études des facteurs génétiques et culturels en Polynésie : maniaco-dépressions et suicides, facteurs génétiques". Pacifique, 1998. http://www.theses.fr/1998PACI0025.
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Les conduites addictives (ca : alcoolisme et toxicomanies), les maniaco-depressions (md) et les conduites suicidaires (cs) restent, malgre les moyens importants mis en oeuvres par les autorites sanitaires ainsi que les efforts des professionnels, un probleme majeur de sante publique. Ces pathologies ont une origine multifactorielle et, a cote des facteurs psychologiques, sociaux et culturels, les etudes familiales, d'adoption et de jumeaux suggerent l'existence de facteurs genetiques. Ces facteurs genetiques interviennent en interaction avec les autres facteurs (il s'agit ici d'une heredite complexe). Du fait des progres recents en biologie moleculaire et en neurosciences, la recherche medicale s'est orientee ces dernieres annees vers l'identification de ces facteurs genetiques afin d'apporter de nouvelles therapies. Dans nos premieres etudes realisees en france metropolitaine, nous avons pu confirmer l'existence d'une association (etude de population cas/temoins) et d'une liaison (etude familiale) entre le gene tyrosine hydroxylase (th) et la md. Nous n'avons pas retrouve d'implication du gene tryptophane hydroxylase (tph), et du gene recepteur dopaminergique d2 (drd2) dans les md ainsi que dans les cs. Concernant les ca, les aspects genetiques puis ethnoculturels ont ete ici pris en compte. Notre etude realisee en france metropolitaine est en faveur de l'association entre le gene drd2 et les ca en accord avec les resultats globaux des etudes portant sur les populations caucasiennes. Notre etude realisee dans une population de polynesiens n'est pas significative pour le gene drd2 mais montre que le gene alcohol dehydrogenase (adh) est un facteur protecteur dans la susceptibilite a l'alcoolisme dans certains sous-groupes. Les aspects historiques et culturels des ca en polynesie sont analyses a travers une revue de la litterature et sur la base de notre enquete par questionnaire. Des precautions ethiques sont necessaires a la realisation de ces etudes genetiques.
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Durastante, Richard Duez Bernard. "Les addictions à l'adolescence :de la transmission psychique transgénérationnelle à la figuration du traumatisme cumulatif". Lyon : Université Lumière Lyon 2, 2008. http://demeter.univ-lyon2.fr/sdx/theses/lyon2/2008/durastante_r.
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DiMarco, Sandra. "Solution-Focused Family Weekends in an Addictions Treatment Facility: An Action Treatment-and-Research Study". Diss., NSUWorks, 2019. https://nsuworks.nova.edu/shss_dft_etd/53.
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For the past 69 years, since the start of the addiction treatment system in the United States, treatment providers have been utilizing the same interventions in rehab centers, the majority of which are based on outdated ideas about substance misusers. Though the premise of such interventions has been questioned by researchers, treatment providers continue to utilize them. Family therapy, in particular, shows promising results for substance misusers and their families; it has been cited as the most powerful form of intervention in addiction treatment. Nevertheless, family therapy is underrepresented in the addiction literature and rehab centers. Furthermore, postmodern models of family therapy are even more scarce within these contexts.
The purpose of this study was twofold: to explore the viability of an underrepresented, alternative approach to treatment, and to explore the personal, organizational, and clinical processes occurring throughout the development of a systemic family program implemented in an adult inpatient rehab center with an individualistic approach. The researcher modified action research methodology to analyze archival data acquired from a completed clinical project, which was implemented over the course of three weekends. The researcher adapted categorizing and coding procedures from action research in order to analyze 34 personal journal entries and 11 supervision meetings, all of which illuminated the changes in the personal, organizational, and clinical processes that occurred throughout the clinical project. To illustrate the viability of a solution-focused, multiple family group (SFBT-MFG) approach for substance misusers and their families, the researcher collected and analyzed a total of 79 client and family evaluation surveys, 19 pretreatment change questionnaires, and six staff evaluation surveys.
The results of this study support an SFBT-MFG approach for adult substance misusers and their families. The researcher identified enhanced communication, understanding, honesty, and support as key themes, along with nine other themes, in the evaluation surveys completed by the participants in the family weekends. The study can help other marriage and family therapists undergo their own processes of integration when practicing systemically in a culture guided by individualistic notions of mental health.
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Omgba-Noah, André Christian. "L’économie morale de l’accompagnement médico-social : étude de deux dispositifs de lutte contre les addictions". Electronic Thesis or Diss., Bourgogne Franche-Comté, 2023. http://www.theses.fr/2023UBFCC038.
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Cette thèse analyse l’orientation de l’agir productif des professionnels du médico-social à partir de la probabilité d’une économie morale de l’accompagnement spécifique à ce champ d’intervention. Après avoir exposé et circonscrit le cadre définitionnel dans lequel s’inscrit cette communauté de valeurs, nous nous appuyons sur un travail empirique effectué dans deux dispositifs de lutte contre les addictions (TAPAJ et l’équipe mobile Aller-vers). L’objectif de cette contribution est d’essayer de montrer que, ces professionnels ne sont pas mûs que par une volonté rationnelle qui les dispose à appliquer sans médiation, les lois qui régissent leur environnement. Ils sont aussi parfois pris et saisis dans un univers baigné par les émotions et les affects, portant leur agir dans des dimensions quasi-vocationnelles. Cette économie morale, dès lors, façonne l’éthique du care qui est une philosophie théorico-pratique considérant principalement le soin comme étant au cœur des préoccupationsThis thesis analyzes the orientation of the productive action of medico-social professionals based on the probability of a moral economy of support specific to this field of intervention. After having exposed and circumscribed the definitional framework in which this community of values fits, we rely on empirical work carried out in two systems for combating addictions (TAPAJ and the Aller-vers mobile team). The objective of this contribution is to try to show that these professionals are not moved only by a rational will which disposes them to apply, without mediation, the laws which govern their environment. They are also sometimes caught and seized in a universe bathed in emotions and affects, carrying their action into quasi-vocational dimensions. This moral economy, therefore, shapes the ethics of care which is a theoretical-practical philosophy mainly considering care as being at the heart of concerns
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Lavie, Estelle. "Addictions, comorbidités psychiatriques et qualité de vie : associations et évolution en traitement : l'exemple des opiacés". Bordeaux 2, 2008. http://www.theses.fr/2008BOR21573.
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Les données de la littérature montrent qu'addiction, psychopathologie et qualité de vie sont fortement intercorrélées. Cependant, peu d'études ont décrit les associations entre ces facteurs et leur évolution au cours de la prise en charge en conditions naturalistes. Le premier objectif de ce travail était d'étudier la relation entre sévérité de l'addiction et psychopathologie chez des sujets dépendants aux substances non traités. Cela a fait l'objet d'une étude transversale parmi des sujets dépendants à au moins une substance en demande de prise en charge en centre de soins spécialisé en addictologie. Le deuxième objectif était de décrire l'évolution clinique et la qualité de vie des sujets dépendants aux opiacés après 1 an de prise en charge et de déterminer des facteurs associés à l'évolution. Cela a fait l'objet d'une étude prospective parmi des sujets traités par méthadone ou buprénorphine en centre spécialisé et toujours présents dans le programme après 1 an de prise en charge. La prévalence des troubles psychiatriques à l'inclusion était importante. Les comorbidités psychiatriques étaient associées à une addiction plus sévère et une qualité de vie plus mauvaise. Après 1 an de prise en charge, les sujets étaient significativement améliorés pour la consommation de substances, la situation légale, les relations familiales et sociales, l'état psychologique et la qualité de vie. L'état psychologique de base influençait peu l'évolution clinique à 1 an. À 1 an, l'amélioration de la qualité de vie était associée à une symptomatologie dépressive moindre et un état médical moins sévère, mais pas aux consommations de substancesLiterature has reported a high correlation betwenn addiction, psychopathology and quality of life. However, few studies have assessed the assocition between these factors and in-treatment evolution in naturalistic conditions. Our first aim was to explore the relationship between severity of addiction and psychopathology among substance-dependent subjects not in treatment. This was a cross sectional study among subjects seeking treatment in an addiction treatment center for a least one substance dependence. The second aim was to explore clinical and quality of life outcomes at a 1-year follow-up among opiate-dependent subjects undegoing treatment and to assess predictors of improvement. This was a prospective study among subjects undergoing buprenorphine or methadone treatment in an addiction clinic who were still in treatment at 1-year. At intake, the prevalence of psychiatric disorders was high. Psychiatric comorbidity was associated with severity of addiction and quality of life impairment. At 1-year follow-up, study subjects showed improvement in substance use, legal issues, familial relations, social relations, psychological conditions and overall quality of life. Subjects' initial psychological status did not heavily affect clinical outcome with respect to the above characteristics at 1-year. At 1-year, improvement in quality of life was related to fewer symptoms of depression and better medical status, but was not related to substance use outcome
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Manning, Jill Christine. "A Qualitative Study of the Supports Women Find Most Beneficial When Dealing With A Spouse's Sexually Addictive or Compulsive Behaviors". BYU ScholarsArchive, 2006. https://scholarsarchive.byu.edu/etd/354.
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While not included in the diagnostic classifications of sexual disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM), sexual addictions and compulsivities are increasingly being encountered by mental health professionals, and the field of sexual addictions is gaining wider acceptance (Delmonico & Carnes, 1999; Garos, 1997). Research shows the majority of people struggling with sexual addictions and compulsivities involving the Internet are married, heterosexual males (Cooper, Delmonico, & Burg, 2000), and that women who are married to these men are directly impacted by this problem (Schneider, 2000b). Although there is research on many issues relating to wives of sex addicts, there is currently a void in the research literature regarding the kinds of support women find most beneficial when dealing with a spouse's sexually addictive or compulsive behaviors. The primary purpose of this qualitative study was to identify the kinds of support women find most beneficial when dealing with a spouse's sexually addictive and compulsive behaviors. Using grounded theory methodology (Strauss & Corbin, 1990), twenty-two women from Canada and the United States were interviewed to find out what they found most helpful as they sought support to cope with a spouse's sexually addictive and compulsive behaviors. A theory of support for this population emerged from the data. It was found that women in affected marriages utilize two main categories of support, namely, coping supports, and change-oriented supports such as Recreational, Relational, Professional, Spiritual and Conceptual. Responding to problematic sexual behavior is moderated by numerous internal and external factors. Five common factors of positive support experiences were identified across the sample. These five common factors were: (a) Connection, (b) Advocacy, (c) Validation, (d) Education, and (e) Direction (CAVED). This study did not succeed in identifying distinct pathways of support for women who discover this problem versus those who have it disclosed to them, nor did this study identify specific treatment modalities that are effective. The results of this study provide a useful template for clinicians, support networks and researchers to begin understanding what is helpful and unhelpful when working with this population.
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Grégoire, Solène. "Adolescents et jeunes adultes atteints de cancer : entre adaptation et conduites à risque". Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB249/document.
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La population des adolescents et des jeunes adultes (AJAs 15-25 ans) atteints de cancer représentent environ 1700 nouveaux cas, par an, en France. L'apparition d'une maladie cancéreuse, potentiellement létale, au cours de l'adolescence, vient impacter à différents niveaux les jeunes patients. La vie est rythmée selon les examens médicaux, traitements et/ou hospitalisations. La scolarité ou l'activité professionnelle sont bien souvent suspendues, reportées voire même remaniées. Alors qu'à cette période de développement les adolescents tentent de se séparer de leurs parents, tant affectivement, que financièrement et socialement, on observe bien souvent un mouvement de retour vers les figures parentales. De plus, la maladie vient directement impacter le corps qui est, entre autre, au centre des préoccupations des adolescents. Ainsi, les problématiques adolescentes sont à la croisée de la maladie et du développement dit « normal » de l'adolescent. Par ailleurs, nous savons que l'adolescence est la période des premières expériences en termes de relations amoureuses, sexuelles et de consommations de substances (alcool, tabac, cannabis). C'est également une période propice aux addictions comportements, telles que les jeux vidéo et internet et les troubles des conduites alimentaires. Cette recherche a pour objectif de décrire les consommations d'alcool, de tabac et de cannabis chez une population d'adolescents et de jeunes adultes atteints de cancer, ainsi que les conduites alimentaires et en ligne. Cette étude vise également à décrire et comprendre le vécu de ces jeunes et les stratégies adaptatives auxquelles ils ont recours pour faire face à la fois à l'annonce de la maladie et aux traitements. Une méthodologie mixte a été utilisée. Le volet quantitatif, utilise un ensemble de questionnaires évaluant les stratégies de coping, la symptomatologie anxio-dépressive, les consommations de tabac, d'alcool et de cannabis, ainsi que les conduites alimentaires et le comportement en ligne. Cette étude propose un suivi de cohorte durant la phase de traitement curatif (N=66) ; 6 mois après le début des traitements (N=20) où l'on met en relation les stratégies adaptatives initiales ainsi que les consommations et conduites alimentaires et en ligne. Le volet qualitatif, propose une exploration du vécu personnel de six jeunes patients confrontés à la maladie et aux traitements à l'aide de l'Interpretative Phenomenological Analysis. Les analyses quantitatives ont montré que la grande majorité des participants ne présentaient pas de symptomatologie anxio-dépressive durant les traitements anti-cancéreux et qu'ils se tournaient globalement vers des stratégies centrées sur le problème (acceptation et réinterprétation positive). Une minorité de participants déclarent consommer de l'alcool (3%), du tabac (1,5%) et du cannabis (4,5%). Les participants déclarant avoir des préoccupations concernant l'alimentation représentent 9% de l'échantillon et enfin, environ 19% des participants déclarent un usage problématique d'internet avec de possibles conséquences. Six mois après le début des traitements, l'intensité de la symptomatologie anxio-dépressive a tendance à diminuer. Il n'existe pas de différences significatives entre les scores de conduites à risque au T1 et T2 et les stratégies d'ajustement restent inchangées entre la première et la deuxième passation. Dans les premiers mois de prise en charge, les adolescents et jeunes adultes ne présentent pas de symptomatologie anxio-dépressive structurée. Leur modalité de consommation ne présente pas de risque concernant l'observance aux traitements anti-cancéreux. Enfin, les éléments recueillis à travers ce travail et notamment les analyses qualitatives, permettent de mieux comprendre et d'appréhender le vécu des jeunes patients traités pour une maladie cancéreuseThe population of adolescents and young adults (AJAs - 15-25 years) with cancer represent approximately 1,700 new cases per year in France. Over The appearance of a potentially lethal cancerous disease during adolescence is affecting young patients at different levels. According to medical examinations, treatments and / or hospitalizations life is punctuated. School or professional activity are often suspended, postponed or even reworked. While in this period of development, adolescents try to separate themselves from their parents, emotionally, financially and socially, there is often a movement back to the parent figures. Moreover, the disease directly impacts the body which is, among other things, at the center of adolescents' concerns. Thus, adolescent problems are at the crossroads of the disease and the so-called "normal" development of the adolescent.Nevertheless, we know that adolescence is the first experience period in terms of romantic relationships, sexual relations and consumption of substances (alcohol, tobacco, cannabis). It is also a period conducive to addictions behaviors, such as video games and internet and eating disorders. The objective of this research is to describe alcohol, tobacco and cannabis consumption in a population of adolescents and young adults with cancer, as well as eating and online behaviors. This study also aims to describe and understand the experiences of these young people and the adaptive strategies they use to deal with both the announcement of the disease and treatments. A mixed methodology was used. The quantitative component uses a set of questionnaires evaluating coping strategies, depressive-anxiety symptoms, tobacco, alcohol and cannabis use, as well as eating behaviors and online behavior. This study proposes a cohort follow-up during the curative treatment phase (N 66); 6 months after the beginning of treatments (N20) where the initial adaptive strategies as well as the consumption and behavior of food and online are related. The qualitative component provides an exploration of the personal experiences of six young patients with disease and treatment using the Interpretative Phenomenological Analysis. Quantitative analyzes showed that the vast majority of participants did not exhibit symptomatology anxio-depressive during anti-cancer treatments and that they generally turn to oriented strategies problems (acceptance and positive reinterpretation). A minority of participants reported using alcohol (3%), tobacco (1.5%) and cannabis (4.5%). Participants claiming to have food disorder count for 9% of the sample, and finally, about 19% of participants report problematic use of the Internet with possible consequences. Six months after the onset of treatment, the intensity of anxiety-depressive symptoms tends to decrease. There are no significant differences between scores of lines at risk at T1 and T2 and the adjustment strategies remain unchanged between the first and the second passes. In the first few months of treatment, adolescents and young adults have no structured anxio-depressive symptoms. Their mode of consumption does not present any risks regarding adherence to anti-cancer treatments. Finally, the information gathered through this work, and in particular the qualitative analyzes, make it possible to understand better and apprehend the experience of young patients treated for a cancerous disease
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Wilkie, Heather E. "A meta-analysis examining the relationship of pathological gambling to impulsivity, addictions and obsessive-compulsive traits". online access from Digital Dissertation Consortium access full-text, 2004. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?MR00164.
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