ZoekresultatenZoekresultaten
Volg ons op
Volg ons op
Types
0Instelling
26Bestandstype
9Taal
5Publicatiejaar
12Thema's
14Producttype
14Publicaties met bestand / URL
2Projectstatus
3Purpose To explore the impact of having relatives with addiction problems on students’ health, substance use, social life, and cognitive functioning, and to establish possible contributions of the participants’ gender, type of relationship, and type of addiction of the relative(s). Methods A qualitative, cross-sectional study of semi-structured interviews with thirty students from a University of Applied Sciences in the Netherlands who had relatives with addiction problems. Results Nine major themes were identified: (1) violence; (2) death, illness, and accidents of relatives; (3) informal care; (4) perception of addiction; (5) ill health, use of alcohol and illegal drugs; (6) financial problems; (7) pressured social life; (8) affected cognitive functioning, and(9) disclosure. Conclusions Having relatives with addiction problems severely affected the life and health of participants. Women were more likely to be informal carers, to experience physical violence, and to choose a partner with addiction problems than men. Conversely, men more often struggled with their own substance use. Participants who did not share their experiences reported more severe health complaints. It was impossible to make comparisons based on the type of relationship or type of addiction because participants had more than one relative or addiction in the family.
DOCUMENT
Background: Family members of relatives with addiction (often referred to as Affected Family Members [AFMs]) experience potentially traumatic events, including psychological violence, physical violence, sexual violence, death, or accidents of relatives due to addiction. Objective: This study explores the development of stress in young adult AFMs over several years and why their stress increases or decreases. Method: A three-year longitudinal qualitative study. Four rounds of in-depth, semi-structured individual interviews were conducted. Twenty-four students drew a stress graph. They scored their stress levels from the first interview in 2019/2020 to the last two years later on a 10-point scale and explained why their stress increased or decreased. Interpretative Phenomenological Analysis was applied. Results: We distinguished four patterns of stress: stress remained stable (high or low; n = 3), stress increased over time (n = 5), stress decreased over time (n = 10), and stress had erratic highs and lows (n = 6). For most participants, stress related to their relatives’ addiction problems was high and highly dynamic. We found factors associated with the direct stress of life with relatives with addiction problems, such as recovery, relapse, aggression, incidents, and accidents. We also found indirect effects, such as trust, intimacy issues, stressors related to education, work, coping strategies, and support. AFMs’ stress persisted often over the long term, even after a relative died or contact was broken. Conclusions: Identifying reasons for stress increase or decrease might help AFMs, healthcare professionals, and educational professionals who want to support AFMs in managing their stress.
DOCUMENT
Addiction is a major social problem that affects not only the person with these problems but also causes harm to family members, for example, by domestic violence, abuse, and neglect. They are often called Affected Family Members (AFMs). While the adverse effects of parental substance use on children have been well-researched, effects on young adults have been studied less extensively. Therefore, in this dissertation, we analyze these effects among a sample of students who were followed for three years using quantitative and longitudinal qualitative methods.
LINK
Addiction problems impact not only the persons with these problems but also family members. This study aims to examine the impact of the COVID-19 pandemic on stress, strain on health, study experiences, coping strategies, and access to support of students with relatives with addiction problems. Thirty students, aged 18–30 years, from a University of Applied Sciences in the Netherlands participated in a three-year qualitative longitudinal interview study. One round of individual semi-structured interviews was conducted before the COVID-19 pandemic, and three during the COVID-19 pandemic. Directed Content Analysis was applied, using the Stress-Strain-Information-Coping-Support-model. Four major themes were identified: (1) Increase in stress and strain; (2) Decrease in stress and strain; (3) Coping strategies, and (4) Access to social, professional, and educational support. Before the pandemic, most participants had health problems, especially mental health problems, including problems with their own substance use. Some had study delay. Analysis revealed that during the pandemic, most participants experienced an increase in these problems. This appeared to be related to their living situation: An increase in violence and relapse of relatives increased stress, especially for those living with their relatives. The coping strategies ‘standing up’ or ‘putting up’, and a decrease in support—social, professional, and educational—also contributed to stress. A few participants experienced less health problems and study problems. This was related to diminishing addiction problems of relatives, less social pressure, available help, and the coping strategy ‘withdrawing’. Withdrawing was much easier for participants who did not live with their relatives with addiction problems. It is recommended to keep schools and universities open during pandemics, offering a safe haven for students at risk in the home situation.
DOCUMENT
Background
Substance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.
Methods/design
In a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome – persistence of or desistance from SUD.
Discussion
There are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood.
Trial registration
The Netherlands National Trial Register Trial NL7928. Date of registration January 17, 2019.
DOCUMENT
Non-attendance in mental healthcare is a substantial problem. Research has
shown that sending a short message service (SMS) reminder could reduce non-attendance by 50 percent in general health services and by 25 percent in mental health institutions. However, no studies exist on the effect of sending SMS reminders in mental healthcare for addiction. Objectives: To examine the influence of SMS reminders on non-attendance in mental health care for addiction and to examine whether different effects occur between appointments for intake or for treatment. Methods. In a specialized institution for addiction
care in the north of the Netherlands 193.474 appointments of outpatient patients, representing 12.797 unique patients, were analyzed for non-attendance and related to registered SMS reminders. Results: Non-attendance was statistically significantly lower for appointments of patients who had received an SMS reminder (20.5%) than for appointments of patients who had not received a reminder (21.9%). Effects were found to be greater for intake
appointments in several analyses. Conclusions: Sending an SMS reminder is associated with a statistically significant lower non-attendance at appointments by patients with a substance use disorder, but the differences have hardly any clinical significance. Special characteristics of the population of patients with substance use disorders may explain this small clinical effect.
DOCUMENT
Introduction: Over the past decade, frequent use of large quantities of nitrous oxide (N2O) has become more common in the Netherlands. Although N2O poses several negative health consequences for a subgroup of problematic N2O users, there is a lack of knowledge on what characterizes these intensive users. This study therefore aims to provide the demographic and substance use characteristics and experiences during treatment of treatment seeking problematic N2O users and to compare this with a matched group of treatment-seeking problematic cocaine users. Methods: A retrospective chart review was performed of patients who were referred for treatment of problematic N2O use at a large Dutch addiction care facility from January 2020 to September 2022, extracting demographics, pattern of use and follow-up data. Additionally, a subgroup of N2O users was propensity-score matched (1:1) with a subgroup of treatment seeking problematic cocaine users, both groups excluding users with substance use disorders or frequent use of substances other than N2O and cocaine, respectively. Results: 128 patients with a N2O use disorder were included in the total sample and a subgroup of 77 N2O-only users was propensity-score matched on age and sex to 77 cocaine-only users. N2O users were typically young (mean age 26.2 years), male (66.4%), unmarried (82.9%), with a low education level (59.0%) and born in the Netherlands (88.2%), with parents born in Morocco (45.3%). N2O was used intermittently (median 10 days/month, IQR 4.0–17.5 days) and often in very large quantities (median 5 kg [ca. 750 balloons] per average using day, IQR 2–10 kg). Compared to the patients with a cocaine use disorder, matched N2O users were lower educated, more often from Moroccan descent, and less likely to be alcohol or polysubstance users. Despite receiving similar treatments, N2O users were twice as likely to discontinue treatment before completion compared to cocaine users (63 vs. 35%, p = 0.004). Conclusion: Treatment-seeking problematic N2O users are demographically different from treatment-seeking problematic cocaine users and are much more likely to dropout from psychological treatment. Further research is needed into the needs and other factors of problematic N2O users that relate to poor treatment adherence in problematic N2O users.
DOCUMENT
Background and aim Addiction problems also affect the lives of family members. This study aims to examine: (1) young adult family members’ experiences with informal and professional support in coping with the impact of relatives’ addiction problems and (2) how these experiences evolve over time. Method A three-year longitudinal qualitative study. Four rounds of in-depth, semi-structured individual interviews were conducted. Thirty students aged 18–30 years, participated in the study at baseline. 93% participated in at least two interviews, and 80% participated three or four times. The Stress-Strain-Information-Coping-Support model was used, and Directed Content Analysis was applied. Findings Five major themes were extracted from the data: (1) Informal support; (2) Educational support; (3) Healthcare support; (4) Resilience factors; and (5) Developments over time. Informal and educational support were more often described as effective than healthcare support, although the number of participants who sought healthcare support increased over time. Effective elements of support included being able to discuss their experiences with people listening without judgment or unsolicited advice and having long-term relationships of trust with people from the social environment and professionals. Participants were mainly treated with Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Learning how to distinguish between accurate and inaccurate thoughts, especially about themselves, was considered effective. Body-oriented therapy was remarkably absent. Finding effective healthcare support was often a long and winding road through various therapies and therapists. Participants were not attracted to peer group interventions but needed advice on how to deal with their relatives. They also needed recognition by their relatives for harm done. This recognition was seldom given. Conclusions It is recommended to train educational and healthcare professionals to recognize the support needs of young people with relatives with addiction problems, to help them cope, or to refer them adequately. We also suggest broadening the scope of professional support offered to AFMs, including body-oriented and cultural interventions.
DOCUMENT
Background: Addiction medicine still largely neglects the topic of mild and borderline intellectual disabilities (MBID), although patients with MBID are considered a risk group for substance-related problems and offending behaviour. This study aimed to explore the cognitive and adaptive impairments of inpatients in forensic addiction mental health care. Method: Participants included a total of 50 consecutive referrals who had a substance use disorder. Results: 74% of the patients had a total IQ-score lower than 85, and 78% had an adaptive impairment in one or more domains of functioning. Only 10% had no cognitive or adaptive impairments. The total IQ-score significantly predicted the total number of impaired domains of adaptive functioning and the severity of substance use disorder did not predict adaptive functioning at all. Conclusions: It can be concluded that in forensic addiction care the prevalence of cognitive and adaptive impairments is high, with 62% having cognitive as well as adaptive impairments.
DOCUMENT
Internet-related addictive behaviors are a public health concern, especially in Asian jurisdictions. Guided by theory, the present study employed moderated mediation modeling using cross-sectional data from Taiwan, Malaysia, Hong Kong, and China to explore relationships between psychological distress, internet-related addictive behaviors, and quality of life (QoL). Jurisdictional differences were also explored. Using snowball sampling to recruit online data, 6,074 participants aged 18 years or older were recruited. Moderated mediation models suggested that psychological distress was related to all internet-related addictive behaviors, and specific behaviors were related to poor QoL in specific domains: gaming addiction to physical and social QoL, shopping addiction to physical, social, and environmental QoL, social networking addiction to all QoL domains, and pornography addiction and gambling addiction to psychological and social QoL (albeit more weakly). Jurisdictional variations were observed, with stronger associations in Taiwan and China compared to Malaysia and Hong Kong. The findings suggest important relationships between psychological distress, internet-related addictive behaviors, and QoL. They also suggest a need for culturally tailored interventions that address psychological distress and specific internet-related addictive behaviors to improve QoL.
LINK
