Anxiety sensitivity is a cognitive, individual difference variable that is differentiated by an individual's fear of anxiety sensations and centred on the belief that such sensations result in harmful consequences. In order to test anxiety sensitivity, Reiss, Peterson, Gursky, and McNally (1986) developed the Anxiety Sensitivity Index (ASI). However, one contentious issue in the area concerns the factor analytic structure of anxiety sensitivity and this has important consequences for the construct. Numerous investigations have been conducted using the ASI, and the results have varied appreciably with some researchers arguing for a unidimensional construct. However the general consensus now is that anxiety sensitivity is multidimensional. It has been argued that the repeated attempts to clarify the dimensionality of anxiety sensitivity, using the 16-item ASI, is problematic because the scale was never designed to measure a multidimensional construct in the first instance. Thus, the objective of the dissertation was to critically examine the anxiety sensitivity construct by using an expanded, multidimensional measure of anxiety sensitivity referred to as the Anxiety Sensitivity Index - Revised ([ASI-R] Taylor & Cox, 1998) and establish the psychometric properties of the measure by conducting a series of empirical investigations to assess the clinical utility of the measure. A series of three empirical investigations are presented in the current dissertation. The first investigation aimed to critically examine the factor structure and psychometric properties of the ASI-R. Confirmatory factor analysis using a clinical sample of adults revealed that the ASI-R could be improved substantially through the removal of 15 problematic items in order to account for the most robust dimensions of anxiety sensitivity. The modified measure was re-named the 21-item Anxiety Sensitivity Index (21-item ASI) and re-analysed with a large sample of nonclinical adults, revealing configural and metric invariance across groups. Further, comparisons with other alternative models that also include comparisons with previous published ASI models indicated the 21-item ASI to be the best fitting model for both groups. There was also evidence of internal consistency, test-retest reliability, and construct validity for both samples. The aim of the second investigation was to critically examine differences between and within various anxiety classifications, a mood disorder classification, and a nonclinical control sample, with respect to both general and specific dimensions of anxiety sensitivity as identified by the 21-item ASI. In most instances, the results revealed that the differences between and within the diagnostic groups were consistent with theoretical expectations. Finally, the third investigation aimed to examine differences within each diagnostic category before and after cognitive behavioural therapy in order to provide a further test of validity for the revised 21-item ASI. The results revealed significant differences within all but one diagnostic group on the pre and post-treatment scores, using the global and specific dimensions of the 21-item ASI. The strengths, theoretical contribution, limitations, and directions for future research are discussed. It is concluded that the overall findings relating to the series of empirical investigations presented in the current dissertation make a significant and valid theoretical contribution to the field of anxiety sensitivity in particular, and anxiety research in general, by enhancing our understanding of anxiety sensitivity and how the 21-item ASI can be used to improve therapeutic interventions in clinical practice.

Esse estudo teve como objetivo avaliar a evolução dos pacientes com síndrome de dependência de álcool nas dimensões sociais e de saúde. Metodologia: O desenho metodológico do estudo é do tipo longitudinal e a mensuração da evolução do tratamento ocorreu por meio da abordagem quantitativa. A amostra foi composta por 35 pacientes de ambos os sexos com diagnóstico de síndrome de dependência alcoólica em tratamento no CAPS - AD II de Ribeirão Preto-SP. A evolução do tratamento foi realizada por meio de duas avaliações, sendo a primeira consulta no primeiro mês e a segunda agendada para três meses posteriormente ao início do tratamento. Para a coleta de dados utilizouse o The Addiction Severity Index ASI, um questionário que possibilita mensurar a evolução do tratamento considerando seis áreas de maior importância da vida da pessoa. Resultados: identificou-se que os usuários em tratamento no CAPS - AD II são adultos, a maioria do sexo masculino, de cor branca, solteiros/separados, católicos, possui baixo nível de escolaridade, quase a metade está desempregado e os que trabalham recebem uma renda mensal entre R$380 a R$1000. Para a análise estatística das áreas do ASI, dos dados sociodemográficos e do padrão de uso utilizaram-se o modelo estatístico da análise linear de efeitos mistos. Desse modo, a idade, a escolaridade, o estado civil, a religião, o emprego, a renda, os anos de consumo de álcool, a freqüência de uso e o valor em dinheiro gasto com o uso foram as variáveis que influenciaram na evolução do tratamento em cada área. Os resultados indicaram que a evolução do tratamento foi positiva ao longo dos três meses nas Áreas Uso de Álcool, Legal, Relação Família/Social e nas Condições Psiquiátricas. Conclusão: A relação entre o consumo do álcool e as conseqüências sociais e de saúde são complexas e multidimensionais. Avaliar a evolução do tratamento de pacientes alcoolistas de um CAPS - AD possibilitou identificar as características sociais e de saúde que podem contribuir de maneira mais apropriada no norteamento e planejamento da assistência a essa população. / This study aimed to evaluate the evolution of patients with alcohol dependency syndrome in terms of social and health dimensions. Methodology: The methodological design is longitudinal and the measurement of the treatment evolution occurred through qualitative approach. The sample was composed of 35 patients, both genders, with diagnosis of alcohol dependency syndrome in treatment at CAPS-ad II in Ribeirão Preto - SP, Brazil. The treatment evolution was measured through two evaluations, the first consultation in the first month and the second one scheduled for three months after the beginning of the treatment. The Addiction Severity Index ASI, a questionnaire that measures the treatment evolution considering six areas of high importance in a persons life, was used for data collection. Results: It was identified that users at CAPS-ad II, in treatment for alcoholism, are adults, male in their majority, white, single, catholic, with low schooling, almost half of them are unemployed, and those who work have a monthly income ranging from R$ 380 to R$ 1000. For the statistical analysis of the socio-demographic data, pattern of use, and ASI areas, the linear mixed-effects statistical model was used. This way, age, schooling, marital status, religion, work, income, years of alcohol consumption, frequency of use, and amount of money spent in each area were the variables that influenced the treatment evolution in each area. Results indicate that the treatment evolution was positive over the three months in the areas of Alcohol Use, Legal, Family/Social Relation and Psychiatric conditions. Conclusion: The relation between the consumption of alcohol and social and health consequences are complex and multidimensional. Evaluating the treatment evolution of alcoholic patients in one of the CAPS-ad allowed the identification of social and health characteristics that can contribute in a more effective way in the planning and guiding the care delivered to the services users.

This thesis includes the complete process of my visual interpretation of John Webster?s Jacobean play named The Duchess of Malfi for DAMU?s International Master Degree final task. It includes a political and social account of the 16th century, the development of my idea, which consist of inspirations storyboard and the psychological meaning of my use of a minimalist stage and ending with a conclusion of the progression of my idea and my personal development at DAMU.

Esse estudo teve como objetivo avaliar a evolução dos pacientes com síndrome de dependência de álcool nas dimensões sociais e de saúde. Metodologia: O desenho metodológico do estudo é do tipo longitudinal e a mensuração da evolução do tratamento ocorreu por meio da abordagem quantitativa. A amostra foi composta por 35 pacientes de ambos os sexos com diagnóstico de síndrome de dependência alcoólica em tratamento no CAPS - AD II de Ribeirão Preto-SP. A evolução do tratamento foi realizada por meio de duas avaliações, sendo a primeira consulta no primeiro mês e a segunda agendada para três meses posteriormente ao início do tratamento. Para a coleta de dados utilizouse o The Addiction Severity Index ASI, um questionário que possibilita mensurar a evolução do tratamento considerando seis áreas de maior importância da vida da pessoa. Resultados: identificou-se que os usuários em tratamento no CAPS - AD II são adultos, a maioria do sexo masculino, de cor branca, solteiros/separados, católicos, possui baixo nível de escolaridade, quase a metade está desempregado e os que trabalham recebem uma renda mensal entre R$380 a R$1000. Para a análise estatística das áreas do ASI, dos dados sociodemográficos e do padrão de uso utilizaram-se o modelo estatístico da análise linear de efeitos mistos. Desse modo, a idade, a escolaridade, o estado civil, a religião, o emprego, a renda, os anos de consumo de álcool, a freqüência de uso e o valor em dinheiro gasto com o uso foram as variáveis que influenciaram na evolução do tratamento em cada área. Os resultados indicaram que a evolução do tratamento foi positiva ao longo dos três meses nas Áreas Uso de Álcool, Legal, Relação Família/Social e nas Condições Psiquiátricas. Conclusão: A relação entre o consumo do álcool e as conseqüências sociais e de saúde são complexas e multidimensionais. Avaliar a evolução do tratamento de pacientes alcoolistas de um CAPS - AD possibilitou identificar as características sociais e de saúde que podem contribuir de maneira mais apropriada no norteamento e planejamento da assistência a essa população. / This study aimed to evaluate the evolution of patients with alcohol dependency syndrome in terms of social and health dimensions. Methodology: The methodological design is longitudinal and the measurement of the treatment evolution occurred through qualitative approach. The sample was composed of 35 patients, both genders, with diagnosis of alcohol dependency syndrome in treatment at CAPS-ad II in Ribeirão Preto - SP, Brazil. The treatment evolution was measured through two evaluations, the first consultation in the first month and the second one scheduled for three months after the beginning of the treatment. The Addiction Severity Index ASI, a questionnaire that measures the treatment evolution considering six areas of high importance in a persons life, was used for data collection. Results: It was identified that users at CAPS-ad II, in treatment for alcoholism, are adults, male in their majority, white, single, catholic, with low schooling, almost half of them are unemployed, and those who work have a monthly income ranging from R$ 380 to R$ 1000. For the statistical analysis of the socio-demographic data, pattern of use, and ASI areas, the linear mixed-effects statistical model was used. This way, age, schooling, marital status, religion, work, income, years of alcohol consumption, frequency of use, and amount of money spent in each area were the variables that influenced the treatment evolution in each area. Results indicate that the treatment evolution was positive over the three months in the areas of Alcohol Use, Legal, Family/Social Relation and Psychiatric conditions. Conclusion: The relation between the consumption of alcohol and social and health consequences are complex and multidimensional. Evaluating the treatment evolution of alcoholic patients in one of the CAPS-ad allowed the identification of social and health characteristics that can contribute in a more effective way in the planning and guiding the care delivered to the services users.

Appetite control and satiety mechanisms help animals maintain energy homeostasis; however, these mechanisms can be misregulated, leading to overweight and obesity. Caenorhabditis elegans is an excellent model system to study appetite and satiety because of its conserved behavioral aspects of satiety and conserved molecular mechanisms. ASI senses nutrition and its activity is required for the behavioral state of satiety quiescence. The purpose of this thesis project was to elucidate the function of cGMP signaling in ASI by looking at behavioral effects from the pharmacological use of sildenafil (Viagra), a PDE inhibitor, and the effects on ASI activation from mutating guanylyl cyclase DAF-11. Sildenafil treatment increases satiety quiescence and decreases fat storage in a PDE-dependent manner. The daf-11 mutation decreased overall fluorescence intensity of ASI activation and the frequency at which ASI activated by about 50% compared to wild-type worms, suggesting that DAF-11 plays an important role in ASI to promote satiety.

<p>Ett problem som många människor lever med i dagens samhälle är missbruk av alkohol eller droger. Inom socialtjänsten i Sverige används olika bedömningsmetoder för att fastställa klienters problem och hjälpbehov. En av dessa metoder är Addiction Severity Index (ASI) som rekommenderas av Socialstyrelsen i Nationella riktlinjer för missbruks- och beroendevården och som är en del i en överenskommelse i RIM-projektet i Uppsala län. Tidigare studier har visat att socialarbetare har en positiv attityd till ASI men trots det används metoden inte fullt ut eller i så stor utsträckning som kan förväntas.Syftet i föreliggande uppsats var att undersöka hur personal inom socialtjänsten implementerade ASI, det vill säga hur de använde och värderade metoden i verksamheten. Studiedesign var fallstudie i vilken intervjuer utfördes med 10 socialsekreterare i Enköping och Uppsala. Analysen utgick ifrån analysmodellen kan, förstår, vill och de huvudkategorier som lyftes fram med hjälp av denna var Hur – socialsekreterarnas användning av ASI, Kan – åtgärder för användning av ASI, Förstår – socialsekreterarnas förståelse för ASI, Vill – socialsekreterarnas vilja att använda ASI.Studien visade att socialsekreterarna använde ASI i utredningsarbetet. I verksamheten vidtogs det åtgärder för att socialsekreterarna skulle kunna använda ASI. De hade kunskaper både om varför och hur de skulle använda metoden, de hade tillgång till olika resurser och tycktes vilja använda metoden. Trots den positiva inställning som socialsekreterarna tycktes ha till ASI implementerade de inte metoden enligt uppsatta mål.</p>

Ett problem som många människor lever med i dagens samhälle är missbruk av alkohol eller droger. Inom socialtjänsten i Sverige används olika bedömningsmetoder för att fastställa klienters problem och hjälpbehov. En av dessa metoder är Addiction Severity Index (ASI) som rekommenderas av Socialstyrelsen i Nationella riktlinjer för missbruks- och beroendevården och som är en del i en överenskommelse i RIM-projektet i Uppsala län. Tidigare studier har visat att socialarbetare har en positiv attityd till ASI men trots det används metoden inte fullt ut eller i så stor utsträckning som kan förväntas.Syftet i föreliggande uppsats var att undersöka hur personal inom socialtjänsten implementerade ASI, det vill säga hur de använde och värderade metoden i verksamheten. Studiedesign var fallstudie i vilken intervjuer utfördes med 10 socialsekreterare i Enköping och Uppsala. Analysen utgick ifrån analysmodellen kan, förstår, vill och de huvudkategorier som lyftes fram med hjälp av denna var Hur – socialsekreterarnas användning av ASI, Kan – åtgärder för användning av ASI, Förstår – socialsekreterarnas förståelse för ASI, Vill – socialsekreterarnas vilja att använda ASI.Studien visade att socialsekreterarna använde ASI i utredningsarbetet. I verksamheten vidtogs det åtgärder för att socialsekreterarna skulle kunna använda ASI. De hade kunskaper både om varför och hur de skulle använda metoden, de hade tillgång till olika resurser och tycktes vilja använda metoden. Trots den positiva inställning som socialsekreterarna tycktes ha till ASI implementerade de inte metoden enligt uppsatta mål.

Zugl.: Bochum, University, Diss., 2006.

Addiction Severity Index (ASI) är tänkt att användas både för klientarbete på individnivå och för forskning på gruppnivå. Denna studie undersöker i vilken omfattning ASI-Uppföljning genomförs samt vilka individ- och organisationsfaktorer som påverkar användningen. Studien är kvantitativ dvs presenterar statistiska analyser. Data samlades in på två sätt. Tillgång till ASI-data gjordes möjlig genom en avidentifierad fil från databasen ASI-Net och omfattade data från elva kommuner i Jönköpings län. ASI-data bestod av 1964 intervjuer från ASI-Grund och ASI-Uppföljning och behövdes för undersökningen av individfaktorerna. Data angående organisationsfaktorerna samlades in genom webbenkäter till cheferna inom Individ- och Familjeomsorg (IFO) i samma elva kommuner. Resultatet visar att andelen uppföljningsintervjuer ökar för varje år och att det föreligger stora skillnader mellan kommuner i genomförande av andelen uppföljningsintervjuer. Analysen av individfaktorerna tyder på att de äldre, med högre utbildning och ett yrke återintervjuas i högre utsträckning. Klienterna med stora problem och hjälpbehov med alkohol genomgår i högre grad en uppföljningsintervju, medan mer problem med narkotika och rättsliga problem tenderar att följas upp i mindre grad. Analysen av organisationsfaktorerna kunde ej på meningsfullt sätt signifikansprövas då populationen för webbenkäten var liten. Dock upptäcktes korrelation mellan andelen uppföljningsintervjuer för varje kommun och två organisationsfaktorer, befolkningsmängd i kommunerna samt personalomsättning. Organisationsfaktorerna visar tvärtemot förväntat att små kommuner följer upp en högre andel, och att faktorer som personalomsättning, utbildning och ärendemängd inte förklarar de skillnader som finns.  Studiens slutsats visar att andelen genomförda ASI-Uppföljning ökar kontinuerligt. Även om ASI-Uppföljning ökar så är det långt kvar till dess att ens hälften av alla ärenden med ASI-Grund återintervjuas. För att öka motivationen att genomföra uppföljningsintervjuer kan det vara viktigt att socialsekreterarna får mer tillbaka i form av sammanställningar och analyser på gruppnivå. / Addiction Severity Index (ASI) is thought to be used both for client work at the individual level and for research at a group level. This study examines the extent to which the ASI Follow-up is carried out, and the individual and organizational factors influencing the usage. The study is quantitative, i.e. presents statistical analyzes. Data were collected in two ways. Access to ASI data was made possible by an anonymous file from the database ASI-Net and included data from eleven municipalities in Jönköping County. ASI data consisted of 1,964 interviews from ASI Basic and ASI Follow-up and was needed for the investigation of individual factors. Data regarding organizational factors was collected through web surveys to managers in Individual and Family Care (IFO) in the same eleven municipalities. The result shows that the percentage of follow-up interviews is increasing every year and that there are large differences between municipalities in the usage of the percentage of follow-up interviews. The analysis of individual factors suggest that the elderly, with higher education and a profession are interviewed to a greater extent. Clients with serious problems and in need of help with alcohol also undergo follow-up interviews more frequently, while more problems with drugs and legal problems tend to be followed-up to a lesser degree. The analysis of organizational factors could not in a meaningful way be tested for significance since the population for the web survey was small, however, correlation was discovered between the percentage of follow-up interviews for each municipality and organizational factors of population in municipalities and employee turnover. Organizational factors show the contrary as expected that small municipalities follow up to higher degree, and that factors such as staff turnover, training and case quantity does not explain the existing differences. The study's conclusions are that the percentage of ASI Follow-up is continuously increasing. Although the ASI follow-up is increasing, it is a long way until the even half of all cases with ASI Basic are re-interviewed. To increase the motivation to carry out follow-up interviews, it may be important for the social workers to get back more in the form of summaries and analyzes at the group level.

INTRODUÇÃO: O abuso no consumo de drogas constitui um problema social e de saúde pública na maioria dos países, pelas consequências negativas que esse consumo provoca sobre o desenvolvimento emocional e físico das pessoas. O início do uso de substâncias tem-se apresentado na população de adolescentes cada vez mais cedo e, como consequência, uma avaliação para identificar comportamentos de risco é imprescindível para triagem e encaminhamentos adequados. Assim, o objetivo deste estudo foi revisar estudos e descrever três importantes instrumentos validados para o Brasil e utilizados para avaliação do abuso de álcool e outras drogas em adolescentes. MÉTODO: Estudo de revisão de literatura, realizado no período de janeiro de 1998 a agosto de 2010, em publicações nas bases de dados: Adolec, MedLine, Lilacs, PubMed e SciELO. Na seleção dos estudos, foram avaliados: artigos com aplicação dos instrumentos DUSI-R, Teen ASI e CBCL; o detalhamento do instrumento utilizado para diagnóstico; utilização de algum indicador de desempenho do instrumento; qualidade do estudo que permita avaliação do desempenho do instrumento, assim como a sua coerência com a literatura. RESULTADOS: Foram encontrados 767 artigos e, de acordo com os critérios de inclusão, foram avaliados 54, após as exclusões daqueles que não atenderam aos critérios. Os artigos com aplicação do instrumento DUSI-R foram 30, sendo 25 referentes a intervenções, prevalência e outros. Os estudos sobre validação do instrumento foram 5, com taxas de sensibilidade variando de 80 a 85% e especificidade variando de 70 a 90%. Outra medida foi a consistência interna com Alfa de Cronbach de 0,91 a 0,9451, apresentada em dois estudos. Já os artigos com aplicação do Teen ASI foram 12, sendo 8 estudos sobre intervenção, prevalência e outros. Para a validação do instrumento, foram encontrados 4 estudos, com taxa de confiabilidade em 2 estudos com r variando entre 0,69 e 0,90, um estudo com consistência interna com Alfa de Cronbach de 0,54 a 0,88 e outro estudo que avaliou a área sobre a curva de ROC = 0,88. Finalmente, os artigos com aplicação do CBCL foram 12, dos quais 8 foram sobre prevalência e fatores de risco. As medidas de desempenho do instrumento foram apresentadas em 4 estudos, sendo que dois mediram a taxa de sensibilidade do instrumento, variando de 80,4 a 87%. Ainda, um estudo apresentou consistência interna com Alfa de Cronbach entre 0,85 e 0,94 e outro estudou as propriedades psicométricas conforme dados da versão alemã do CBCL. CONCLUSÃO: Os resultados dos estudos apontam que os instrumentos pesquisados avaliam o abuso de álcool e outras drogas em adolescentes, possuindo boas propriedades psicométricas, porém de formas diferentes. O Teen ASI e o DUSI-R identificam e avaliam o uso de substâncias e outras áreas da vida. Por sua vez, o CBCL é voltado para avaliar a saúde mental do adolescente, não sendo específico para avaliar o abuso de álcool e outras drogas. Portanto, na escolha de instrumentos de avaliação, é importante considerar: organização do tempo, investimento na formação de profissionais e consolidação dos resultados que contribua efetivamente na melhora do tratamento / INTRODUCTION: The substance abuse is a major social problem in public health in most countries, due to the negative consequences of this behavior on the physical and emotional development of the people involved. The initiation phase of the substance abuse is beginning at earlier ages, and, as a consequence of that, an assessment to identify risk behaviors is very important for an acurate triage and subsequent steps. The objective of this study was to review studies and to describe 3 important instruments validated for Brazil and applied for the assessment of substance abuse in adolescents. METHOD: A literature review study, in the period from January of 1998 to August of 2010, in the databases of: Adolec, MedLine, Lilacs, PubMed and SciELO. In the selection of the studies the following criteria were evaluated: articles with application of the instruments DUSI-R, Teen ASI, and CBCL; the detailing of the instrument utilized for diagnostics; utilization of a performance indicator; quality of the study that enables the performance assessment of the instrument, and its coherence with the literature. RESULTS: 767 articles were found according to the inclusion criteria, and 54 of them were analysed, after the exclusions of the ones that did not meet the detailed criteria. 30 articles for the DUSI-R instrument were found, 25 of them related to interventions, prevalence and others. 5 studies were related to the validation of the instrument, with sensitivity rates varying from 80 to 85% and specificity variying from 70 to 90%. Another measure was the internal consistency with Cronbachs Alpha varying from 0.91 to 0.9451, presented in two studies. For the Teen ASI, 12 articles were found, and 8 of them were related to intervention, prevalence and others. For the validation of the instrument, 4 studies were found, with the reliability in 2 studies varying from r = 0.69 to 0.90, one study with internal consistency with Cronbachs Alpha varying from 0.54 to 0.88 and another study with the area under the ROC curve = 0.88. For the CBCL, 12 studies were found, and 8 of them were related to the prevalence and risk factors. The performance measures were presented in 4 studies, where 2 instruments measured the sensitivity rate varying from 80.4 to 87%. One study report the Cronbachs Alpha between 0.85 and 0.94, and another study studied the psicometric properties for the German version. CONCLUSION: The results of the studies suggest that the instruments included on the research evaluate the substance abuse in adolescents, with good psychometric properties, although in different ways. The Teen ASI and DUSI-R evaluate the substance abuse and other areas of life. The CBCL is useful to evaluate the mental health, and its not specific to conduct an assessment for substance abuse. So, when choosing assessment instruments, its important to consider: time management, investment in the education of the professionals; and consolidation of the results that contribute effectively to the improvement of the treatment