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A systematic review of the effectiveness of the community reinforcement approach in alcohol, cocaine and opoid addiction
- Authors:
- ROOZEN Hendrik G., et al
- Journal article citation:
- Drug and Alcohol Dependence, 74(1), April 2004, pp.1-13.
- Publisher:
- Elsevier
The community reinforcement approach (CRA) to alcohol, cocaine and opoid addiction aims to develop social activities that allow the initiation and maintenance of abstinence. This review covers eleven randomised controlled trials, most of which were carried out by only three research groups. There is strong evidence that CRA is more effective than usual treatment with regard to number of drinking days, but conflicting evidence with regard to continuous abstinence in alcohol treatment. There is moderate evidence that CRA with disulfiram is more effective in terms of number of drinking days, limited evidence that CRA with ‘incentives’ is more effective than an opoid detoxification programme, and limited evidence that is more effective than a methadone maintenance programme. There is strong evidence that CRA with ‘incentives’ is more effective than CRA treatment alone aimed at cocaine abstinence. While these studies indicate limited to moderate evidence for the efficacy of CRA in substance abuse disorders, more research conducted by other research groups is needed, in particular to establish the most effective aspects of the interventio
Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies
- Authors:
- MACLEOD John, et al
- Journal article citation:
- Lancet, 363(9421), May 2004, pp.1579-1588.
- Publisher:
- Elsevier
A review of 16 longitudinal studies identified as the result of extensive searching shows fairly consistent associations between cannabis use and both lower educational attainment and increased reported use of other illicit drugs. Less consistent associations were evidence between cannabis use and both psychological problems and problematic behaviour. However, causal relationships were not clear and all associations seemed to be explicable in terms of non-causal mechanisms. Better evidence from more appropriately designed studies is needed to clarify causal relationships in this area.
A validation study of the Adolescent dissociative experiences scale
- Authors:
- SEELEY Susan M. Keck, PEROSA Sandra L., PEROSA Linda M.
- Journal article citation:
- Child Abuse and Neglect, 28(7), July 2004, pp.755-769.
- Publisher:
- Elsevier
This study aimed to further the validation process of the Adolescent Dissociative Experiences Scale (A-DES). A 6-item Likert response format with descriptors was used when responding to the A-DES rather than the 11-item response format used in the original A-DES. The internal reliability and construct validity of the A-DES were examined by analyzing the relationships between A-DES scores, sexual abuse, and behavior. The sample consisted of 65 females ranging in age from 11 to 18 who were categorized into two groups. Thirty-four adolescents who were not in therapy and who denied a history of traumatic experiences formed the nonclinical group. Thirty-one sexually abused adolescents who were currently receiving therapy formed the clinical group. The adolescent participants completed the A-DES, their parent or guardian completed a measure of behavior (the Child Behavior Checklist-CBCL), and the therapists of the clinical adolescents completed a Trauma History Form. Results found the A-DES discriminated between the nonclinical and clinical sexually abused adolescents. However, in post hoc analyses, the A-DES did not discriminate between PTSD adolescents and those with other psychiatric diagnoses. Significant moderate correlations were found between the A-DES and the CBCL Total behavior problem scale and Internalizing and Externalizing scales. The authors conclude the A-DES items are internally consistent, and the A-DES shows promise for screening adolescents for pathological dissociation.
The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction
- Authors:
- DONG Maxia, et al
- Journal article citation:
- Child Abuse and Neglect, 28(7), July 2004, pp.771-784.
- Publisher:
- Elsevier
Childhood abuse and other adverse childhood experiences (ACEs) have historically been studied individually, and relatively little is known about the co-occurrence of these events. The purpose of this study is to examine the degree to which ACEs co-occur as well as the nature of their co-occurrence. The study used data from 8,629 adult members of a health plan who completed a survey about 10 ACEs which included: childhood abuse (emotional, physical, and sexual), neglect (emotional and physical), witnessing domestic violence, parental marital discord, and living with substance abusing, mentally ill, or criminal household members. The bivariate relationship between each of these 10 ACEs was assessed, and multivariate linear regression models were used to describe the interrelatedness of ACEs after adjusting for demographic factors. Two-thirds of participants reported at least one ACE; 81%–98% of respondents who had experienced one ACE reported at least one additional ACE. The presence of one ACE significantly increased the prevalence of having additional ACEs. The observed number of respondents with high ACE scores was notably higher than the expected number under the assumption of independence of ACEs, confirming the statistical interrelatedness of ACEs. The study provides strong evidence that ACEs are interrelated rather than occurring independently. Therefore, collecting information about exposure to other ACEs is advisable for studies that focus on the consequences of a specific ACE. Assessment of multiple ACEs allows for the potential assessment of a graded relationship between these childhood exposures and health and social outcomes.
The use of Ecological Momentary Assessment approaches in the study of sexually abused children
- Authors:
- SIMONICH Heather, et al
- Journal article citation:
- Child Abuse and Neglect, 28(7), July 2004, pp.803-809.
- Publisher:
- Elsevier
The authors describe their experiences using EMA-plam top methodology with Child Sexual Abuse victims. In the study measures were programmed into the palm top computers, which allowed traditional paper and pencil measures to be completed by the child on the computer. The authors argue that it is a promising method in teh assesesment of child victims, and particularly for those aspects of behaviour which are thought to vary over relatively short periods of time.
Psychological sequelae of childhood sexual abuse: abuse-related characteristics, coping strategies, and attributional style
- Author:
- STEEL Jennifer
- Journal article citation:
- Child Abuse and Neglect, 28(7), July 2004, pp.785-801.
- Publisher:
- Elsevier
The aim of this American study was to test a model predicting the contribution of abuse-related characteristics and mediating variables such as coping and attributional style in the development of psychological sequelae in adults reporting a history of child sexual abuse (CSA). Two hundred and eighty-five males and females from three settings (a nonpatient, psychiatric outpatient, and psychiatric inpatient) completed a battery of questionnaires that included a (1) Sexual History Questionnaire, (2) Ways of Coping Questionnaire, (3) Attributional Style Questionnaire, and (4) the SCL-90-R. Of the 285 participants, 33% reported unwanted or forced sexual contact before the age of 18 years. Participants who reported a history of CSA also reported higher levels of psychological distress when compared to those who did not report a history of abuse. In testing the model concerning the relationship between victim-offender characteristics, mediating variables and psychological distress in adulthood; two abuse-related characteristics (number of offenders and duration of abuse) were found to be directly associated with psychological distress in adulthood. Other abuse-related variables (i.e., relation with offender, force, resistance, age of onset, participation, and frequency of abuse) were found to be related to psychological distress in adulthood through the mediation of various coping strategies (i.e., Accepting Responsibility, Confrontive Coping) and attributions (i.e., internalization of the abuse). The results of the present study further our understanding regarding the relationship between abuse-related characteristics, mediating factors such as coping and attributional style and psychological distress in adults with a history of CSA. Future research should focus on the development of interventions that focus on variables amenable to psychotherapy to ameliorate the psychological sequelae of CSA.
Factor structure and reliability of the childhood trauma questionnaire in a Canadian undergraduate student sample
- Authors:
- PAIVIO C Sandra, CRAMER M Kenneth
- Journal article citation:
- Child Abuse and Neglect, 28(8), August 2004, pp.889-904.
- Publisher:
- Elsevier
The aims of this study were to examine (1) the psychometric properties of the Childhood Trauma Questionnaire(CTQ); initial reliability and validity of a new retrospective measure of child abuse and neglect in an undergraduate sample and (2) the prevalence of abuse and neglect in this sample. Principal components analyses (PCA), coefficient alpha, and correlations were used to analyse data for 470 undergraduate students from a mid-western Canadian university. The authors conclude that the CTQ appears to be a valid measure of abuse and neglect in student samples, although experiences are somewhat differentially identified as different types of abuse and neglect depending on age and patient versus nonpatient status.
Child abuse in South Africa: an examination of how child abuse and neglect are defined
- Authors:
- PIERCE Lois, BOZALEK Vivienne
- Journal article citation:
- Child Abuse and Neglect, 28(8), August 2004, pp.817-832.
- Publisher:
- Elsevier
This study aimed to explore which of 17 categories of child maltreatment South Africans evaluated as most serious and to determine if those working with abuse and neglect evaluated abuse and neglect differently from those who did not. A revised version of Giovannoni and Becerra’s questionnaire exploring the definition of abuse and neglect was completed by 181 residents of Cape Town, South Africa. The new form had 17 categories of child maltreatment, including 4 categories of societal abuse. Respondents were 57 social workers, 42 human service workers, 65 laypersons, and 18 members of the child protection unit of the South African Police. ANOVA was used to compare the groups’ responses. When significant differences among groups were found, a Bonferroni post hoc test was run to determine differences between groups. The respondents ranked sexual abuse and child prostitution as most serious and housing and child labour as least serious of the 17 categories. There was a significant difference between groups on nine categories. When post hoc tests were run, differences were found for eight categories with laypersons generally evaluating categories as significantly more serious than social workers. Reasons for the order of the rankings are discussed, but concern remains that differences in the evaluation of child maltreatment will lead to difficulty in implementing a protocol for identifying and responding to incidents of abuse and neglect.
Child sexual abuse in Tanzania and Kenya
- Author:
- LALOR Kevin
- Journal article citation:
- Child Abuse and Neglect, 28(8), August 2004, pp.834-844.
- Publisher:
- Elsevier
This article aims to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. Little empirical data exist on child sexual abuse in Tanzania. It is widely perceived that it may be increasing as a result of AIDS sufferers’ attempts to “cleanse” themselves. The breakdown of traditional childcare systems, foreign influences, poverty, and the lowly position of girls in society are also implicated. Studies by UN agencies such as United Nations Children’s Fund (UNICEF) and the International Labour Organisation (ILO) have focused on the commercial sexual exploitation of children, to the neglect of more pervasive abuse in children’s own communities by family, relatives, and neighbors. The authors conclude that given the high incidence of AIDS/HIV in both countries, it is important to know if the epidemic is increasing the risk of rape or incest for children.
Reactive attachment disorder in maltreated toddlers
- Authors:
- ZEANAH H. Charles, et al
- Journal article citation:
- Child Abuse and Neglect, 28(8), August 2004, pp.878-888.
- Publisher:
- Elsevier
To determine if Reactive Attachment Disorder (RAD) can be reliably identified in maltreated toddlers in foster care, if the two types of RAD are independent, and to estimate the prevalence of RAD in these maltreated toddlers. Clinicians treating 94 maltreated toddlers in foster care were interviewed regarding signs of attachment disorder at intake in an intervention program. Using categorical and continuous measures, both types of RAD can be reliably identified in maltreated toddlers. Both continuous scores and categorical diagnoses indicated that a substantial minority of maltreated young children do exhibit signs of attachment disorders sufficient to meet criteria in DSM-IV and ICD-10. The two types were moderately convergent and at times co-occurred in the same child. Prevalence of RAD in this high-risk sample was 38-40%. Indiscriminate/disinhibited RAD was identified in children with and without an attachment figure. Within this maltreated group, toddlers whose mothers had a history of psychiatric disturbance were more likely to be diagnosed with attachment disorders. RAD may be reliably identified in maltreated toddlers. Emotionally withdrawn/inhibited and indiscriminate/disinhibited types of RAD are not entirely independent.