published_or_final_version / abstract / Sociology / Master / Master of Philosophy

This ethnography of intravenous (IV) drug users challenges popular representations of a "junkie" subculture and stereotypes of users as rejecting the dominant cultural values of mainstream society. Users attempts to construct and maintain a moral identity are examined. Beyond "war stories" ennobling street life and survival, life narratives were constructed through a juxtaposition of voices and images establishing moral worth in opposition to others. Moral identity is a central concern for IV drug users, one influencing their response to risk. Social relations, responsibility, and an ethic of care were found to underlay the moral codes developed by users, codes socially-embedded and to some degree gender specific. Men tended to adopt a "tough guy," "independence" voice in which responsibility was largely framed around status and image as a role model. Women tended to see responsibility and morality within a web of interdependence and care. Social responsibility was a measure of moral goodness. The desire to be defined by mainstream values was strongly evident among women users who were mothers. Motherhood was a core symbol representing inherent goodness, a marker of moral identity, and a means toward achieving a socially acceptable identity. The identities of "junkie" and "mother" placed women in a state of perpetual tension and conflict as manifested in issues of child custody and welfare. Maintaining relationship with their children was central to the women's moral identity, be it based in daily interaction or visitations inspiring hopes for a future. This ethnography suggests that IV drug users, while chemically dependent, maintain a sense of agency. Contrary to stereotypes of irresponsibility, users are reflexive about their habit's control and their use of drugs to block suffering, social responsibility, and the pain they cause others. Displays of agency and exercises of control proved critical in identity construction, particularly for women users diagnosed HIV positive. Documented was the process whereby they redefined their "health" and moral identity in the company of others who assisted in constructing identities in contrast to the negative stereotypes of AIDS. Through discourse within these "life narrative groups" a positive diagnosis was transposed into a positive identity.

Ho Man Choi. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 178-215). / Abstracts and appendices in English and Chinese. / ACKNOWLEDGEMENT --- p.ii / ABSTRACT --- p.iii / 研究摘要 --- p.vi / Chapter CHAPTER 1 --- INTRODUCTION / Chapter 1.1. --- Heroin --- p.1 / Chapter 1.1.1. --- Manufacture --- p.1 / Chapter 1.1.2. --- Administration --- p.2 / Chapter 1.1.3. --- Physical and Psychological Effects --- p.4 / Chapter 1.1.4. --- Heroin Metabolism --- p.5 / Chapter 1.1.5. --- Treatments for Heroin Dependence --- p.6 / Chapter 1.2. --- Opioids and Analgesia --- p.8 / Chapter 1.2.1. --- Pain Transmission --- p.8 / Chapter 1.2.2. --- Pain Modulation and Endogenous Opioid System --- p.9 / Chapter 1.2.3. --- Clinical Application of Opiates in Pain Management --- p.11 / Chapter 1.2.4. --- Narcotics and Pain --- p.11 / Chapter 1.3. --- Biological Basis of Drug Addiction --- p.12 / Chapter 1.3.1. --- Mesocorticolimbic Reward System --- p.13 / Chapter 1.3.2. --- Molecular Neurobiology of Drug Addiction --- p.16 / Chapter 1.3.2.1. --- "Cyclic Adenosine-3',5'-Monophosphate and Protein Kinase A" --- p.16 / Chapter 1.3.2.2. --- Transcription Factors: cAMP-Response Element Binding Protein and Delta-Fos B --- p.18 / Chapter 1.3.2.3. --- Neurotrophic Factors --- p.23 / Chapter 1.4. --- Biological Basis of Relapse --- p.25 / Chapter 1.4.1. --- Environmental Stimuli --- p.26 / Chapter 1.4.2. --- Drug Re-exposure/Priming --- p.26 / Chapter 1.4.3. --- Acute Stress Exposure --- p.27 / Chapter 1.5. --- Gene Polymorphisms and Opioid Dependence --- p.30 / Chapter 1.5.1. --- Opioidergic System --- p.31 / Chapter 1.5.2. --- Dopaminergic System --- p.36 / Chapter 1.5.3. --- Serotoninergic System --- p.41 / Chapter 1.5.4. --- Noradrenergic System --- p.43 / Chapter 1.5.5. --- GABAergic System --- p.44 / Chapter 1.6. --- Aim of Research --- p.45 / Chapter CHAPTER 2 --- METHODS OF STUDY / Chapter 2.1. --- Subject Recruitment and Demographic Data Collection --- p.49 / Chapter 2.1.1. --- Heroin-dependent Subjects --- p.49 / Chapter 2.1.1.1. --- Phenotype Assessment --- p.49 / Chapter 2.1.1.2. --- Socio-demographics Data and Substance Use History --- p.50 / Chapter 2.1.1.3. --- Addiction Severity Index (ASI) --- p.51 / Chapter 2.1.1.4. --- History of Detoxifications and Relapse --- p.51 / Chapter 2.1.2. --- Control Subjects --- p.51 / Chapter 2.2. --- Pain Response Assessment using Cold-Pressor Test (CPT) --- p.52 / Chapter 2.3. --- Personality Trait Assessment --- p.53 / Chapter 2.4. --- Genotype Analysis --- p.55 / Chapter 2.4.1. --- DNA Extraction --- p.55 / Chapter 2.4.2. --- Genotyping --- p.56 / Chapter 2.4.2.1. --- MORA118G --- p.56 / Chapter 2.4.2.2. --- DOR T921C --- p.56 / Chapter 2.4.2.3. --- COMTVal108/158Met --- p.57 / Chapter 2.4.2.4. --- Prodynorphin 68bp-VNTR --- p.58 / Chapter 2.4.2.5. --- DRD2 TaqI A --- p.59 / Chapter 2.4.2.6. --- DRD4 -521C/T --- p.59 / Chapter 2.4.2.7. --- 5HT1B G861C --- p.60 / Chapter 2.5. --- Saliva Collection and Salivary Cortisol Measurement --- p.61 / Chapter 2.6. --- Statistical Analysis --- p.62 / Chapter CHAPTER 3 --- RESULTS / Chapter 3.1. --- Demographics --- p.64 / Chapter 3.1.1. --- Age --- p.64 / Chapter 3.1.2. --- Ethnicity --- p.64 / Chapter 3.1.3. --- District of Residence and Type of Housing --- p.64 / Chapter 3.1.4. --- "Education, Employment and Income" --- p.68 / Chapter 3.1.5. --- ASI Scores --- p.71 / Chapter 3.1.5.1. --- Family/Social Relationship --- p.71 / Chapter 3.1.5.2. --- Employment and Support Status --- p.73 / Chapter 3.1.5.3. --- Medical Status --- p.73 / Chapter 3.1.5.4. --- Legal Status --- p.75 / Chapter 3.1.5.5. --- Psychiatric Status --- p.75 / Chapter 3.1.5.6. --- Drug Use Status --- p.76 / Chapter 3.1.5.7. --- Alcohol Use Status --- p.79 / Chapter 3.1.6. --- Tranquillizer Use Status --- p.79 / Chapter 3.1.7. --- Smoking Status --- p.81 / Chapter 3.1.8. --- Detoxification and Relapse --- p.83 / Chapter 3.2. --- Cold-Pressor Test (CPT) --- p.88 / Chapter 3.3. --- Personality Traits --- p.90 / Chapter 3.3.1. --- NEO PI-R --- p.90 / Chapter 3.3.2. --- BIS/BAS --- p.93 / Chapter 3.3.3. --- SSS-V --- p.93 / Chapter 3.4. --- Salivary Cortisol Levels --- p.93 / Chapter 3.5. --- Genotype and Allele Frequencies of Gene Polymorphisms --- p.96 / Chapter 3.5.1. --- MOR A118G Polymorphism --- p.96 / Chapter 3.5.2. --- DOR T921C Polymorphism --- p.96 / Chapter 3.5.3. --- COMT Val108/158Met Polymorphism --- p.99 / Chapter 3.5.4. --- Prodynorphin 68bp-VNTR --- p.99 / Chapter 3.5.5. --- DRD2 TαqI A Polymorphism --- p.102 / Chapter 3.5.6. --- DRD4 -521C/T Polymorphism --- p.102 / Chapter 3.5.7. --- 5HT1B G861C Polymorphism --- p.105 / Chapter 3.6. --- "Association of Gene Polymorphisms, Personality Traits and CPT" --- p.105 / Chapter 3.7. --- Association of Gene Polymorphisms and CPT --- p.108 / Chapter 3.7.1. --- COMT Val108/158Met Polymorphism --- p.108 / Chapter 3.7.2. --- DRD4 -521C/T Polymorphism --- p.108 / Chapter CHAPTER 4 --- DISCUSSIONS AND CONCLUSIONS / Chapter 4.1. --- Demographics and Potential Environmental Factors of Relapse --- p.111 / Chapter 4.1.1. --- Medical and Psychological Status --- p.114 / Chapter 4.1.2. --- Substance Use Status --- p.116 / Chapter 4.1.3. --- Detoxification and Relapse --- p.118 / Chapter 4.2. --- Cold-Pressor Test (CPT) --- p.121 / Chapter 4.3. --- Personality Traits --- p.123 / Chapter 4.4. --- Salivary Cortisol --- p.125 / Chapter 4.5. --- "Association of Gene Polymorphisms, Personality Traits and Cold-Pressor Test" --- p.127 / Chapter 4.5.1. --- MORA118G Polymorphism --- p.127 / Chapter 4.5.2. --- DOR T921C Polymorphism --- p.129 / Chapter 4.5.3. --- COMT Val108/158Met --- p.130 / Chapter 4.5.4. --- Prodynorphin (ProDYN) 68bp-VNTR --- p.133 / Chapter 4.5.5. --- DRD2 A Polymorphism --- p.134 / Chapter 4.5.6. --- DRD4 -521C/T Polymorphism --- p.138 / Chapter 4.5.7. --- 5HTlB G861C Polymorphism --- p.141 / Chapter 4.5.8. --- Personality Traits --- p.142 / Chapter 4.6. --- Limitations --- p.144 / Chapter 4.7. --- Potential Clinical Application --- p.145 / Chapter 4.8. --- Conclusion --- p.146 / APPENDIXES --- p.148 / APPENDIX 1 Addiction Severity Index (ASI) with Additional Questions for Heroin Users / APPENDIX 2 Detoxification and Relapse History Questionnaire / APPENDIX 3A Questionnaire for Control Subjects (Chinese version) / APPENDIX 3B Questionnaire for Control Subjects (English version) / APPENDIX 4A NEO PI-R (Chinese version) / APPENDIX 4B NEO PI-R (English version) / APPENDIX 5A BIS/BAS (Chinese version) / APPENDIX 5B BIS/BAS (English version) / APPENDIX 6A SSS- V (Chinese version) / APPENDIX 6B SSS- V (English version) / REFERENCES --- p.178

M.A. (Clinical Social Work) / Chemical dependence has a negative impact on a family’s ability to maintain a healthy level of functioning and stability. The ecological system’s framework emphasises the significance of a system’s ability to manage and cope with the negative impacts of chemical dependence. Family systems in the face of chemical dependency, engage in various coping strategies in order to manage the impact of stress caused. One way in which the system is able to manage this stress is through the phenomenon of denial. Denial from an ecological system’s perspective is considered a defense mechanism, which is utilised in order to defend from the painful and disturbing realities. The use of denial on a continuous level however, is considered maladaptive and as a result, the family system is no longer able to maintain an optimal level of functioning. Denial within chemical dependence treatment is a common obstacle that professionals are faced with. The motivation for this research was based on the inconsistency of the understanding of denial within chemical dependence treatment. Therefore, the research aimed to create a descriptive framework of the phenomenon of denial with chemical dependence to better understand the phenomenon, so as to better manage the obstacles such phenomenon presents within treatment settings. The assumption was that denial is the result of a transactional dynamic across system levels, specifically within the micro system between the individual and family members. The researcher engaged in an in-depth literature review encompassing the topics of denial, the ecological system’s perspective, and chemical dependence, in order to acquire all the relevant knowledge for the study. The method of research was qualitative in nature in order to explore the phenomenon of denial as understood from the stories of individuals recovering from chemical dependence and a respective family member. The researcher conducted interviews with six pairs of participants, one recovering participant and one respective family member. The analysis of the research findings was guided by a thorough step-by step analytical process. The interviews were transcribed, common themes were identified, coded and then further categorised. The researcher then identified the categories of denial behaviours, underlying needs and the break in denial. As a result of the findings, the researcher developed a model called the Progression of denial. This model depicted the four levels of denial in which the various denial behaviours and underlying needs are presented within each system level. First order denial developed on an individual level. This level of denial and the behaviours presented were applicable to the individual engaging in chemical dependency. The second order denial was assigned within the micro system, the immediate family of the chemically-dependent individual. This order of denial was characterised by transactional dynamics between the individual and family members, both exhibiting denial behaviours in order to satisfy their individual needs as well as the system’s attempt to maintain functioning and not confront the realities of the extent of the impact of the chemical dependence. The third order denial was assigned to the meso-system and was understood as the immediate community of the family system. The family system, in response to the chemical dependency, engaged in denial behaviours in fear of the chemical dependence being exposed and no longer kept a secret. Fourth order denial was then the break in denial, in which the individuals no longer denied that they had a problem and as a result the need for denial behaviours was no longer needed. The chemical dependence was confronted and participants reported a period of six months in which their lives were chaotic before they went for treatment. The value of this research is to assist professionals in managing the evident denial that is so commonly associated with chemical dependency; for professionals to gain the criteria required to assess the level of denial at which an individual is struggling with chemical dependence; and whether intervention is needed in more than one system level. In addition the research aims to assist professionals in being able to identify the various denial behaviours that are most prevalent within each system level. Intervention can then possibly be directed at the most appropriate system level in which the professionals are able to assist with identifying the systems maladaptive methods of coping and subsequently direct the systems development towards more constructive adaptive methods. . The research was conducted within a small sample population and was therefore a specific representation of the six pairs of participants who took part in the research. Ongoing research needs to be conducted to further establish the findings.

EEG biofeedback (neurotherapy) has been demonstrated as effective in the treatment of alcoholism, as evidenced by Peniston and Kulkosky's research efforts. These neurotherapy pioneers evaluated the efficacy of alpha-theta brain wave biofeedback as a treatment for chronic alcohol abuse, citing 80% abstinence rates as measured by improvements in psychopathology, serum beta endorphin levels, and long-term alcohol abstinence. Most research with alpha-theta EEG biofeedback has addressed alcohol addiction. Cocaine is now considered to be the most common drug problem of patients entering treatment for drug abuse. To date, only one controlled study has been published that researched alpha-theta neurofeedback in the treatment of "crack" cocaine addiction. The present study was an extension of a 4-year EEG-biofeedback treatment outcome project underway at a faith-based homeless mission in Houston, Texas, with male "crack" cocaine addicts. Changes in personality, attention, and impulsivity were measured following 30 sessions of a non-individualized EEG -biofeedback protocol. Experimental subjects received a variant of the Peniston-Kulkosky alpha-theta protocol for 30 sessions while controls received all elements of the experimental protocol except the EEG biofeedback. Assessment measures included the MMPI-2 and the IVA. Although experimental subjects showed greater mean improvement on most MMPI basic scales and all IVA Attention related measures, results indicated no significant differences between control and experimental groups. The present study did not result in significant differences between control and experimental groups on attentional or personality variables in crack cocaine addicts. Implications and limitations of the study are discussed.

Choi Fai-ming, Jonathan. / "July 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 132-151). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

by Chan, Hak-man, Christian. / Includes questionaire in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 64-76). / Chapter I. --- INTRODUCTION --- p.1 / Chapter II. --- METHOD --- p.16 / Chapter III. --- RESULTS --- p.26 / Chapter IV. --- DISCUSSION --- p.50 / REFERENCES --- p.64 / APPENDIX --- p.77

by Tse Kam Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 216-228). / Abstract / Acknowledgements / Chapter Chapter 1: --- Introduction / Chapter 1.1 --- Contexts and Objectives of the Study --- p.1 / Chapter 1.2 --- Related Studies in Hong Kong --- p.9 / Chapter 1.3 --- "Identity, Role, and Social Behavior" --- p.13 / Chapter 1.4 --- Data and Methodology --- p.16 / Chapter 1.5 --- Outline of Chapters --- p.20 / Chapter Chapter 2: --- Literature Review / Chapter 2.1 --- Medical-Disease Model: Exposition and Critique --- p.22 / Chapter 2.2 --- Social Deviance Model --- p.24 / Chapter 2.2.1 --- On Etiology and Process of Drug Use / Chapter 2.2.2 --- On Cessation of Drug Use / Chapter 2.2.3 --- "Social Learning, Resocialization and Therapeutic Community" / Chapter 2.2.4 --- Resocialization as Social Learning: The Oversocialization Critique / Chapter 2.3 --- Identity Model --- p.32 / Chapter 2.3.1 --- Resocialization as Identity Transformation / Chapter 2.3.2 --- Types of Identity Transformation / Chapter 2.3.3 --- Resocialization as Conversion / Chapter Chapter 3: --- A Comparison Between SARD A and Operation Dawn / Chapter 3.1 --- "History, Services, and Social Position" --- p.43 / Chapter 3.2 --- Treatment Philosophy and Practice --- p.47 / Chapter 3.3 --- Treatment and Rehabilitation Programme --- p.48 / Chapter 3.3.1 --- Pre-admission Procedure / Chapter 3.3.2 --- In-patient Service / Chapter 3.3.3 --- Halfway House and Aftercare / Chapter 3.4 --- A Statistical Profile of Admission Cases: SKC vs Dawn Island Centre --- p.60 / Chapter Chapter 4: --- Pre-admission Stage / Chapter 4.1 --- "Addict Role-taking, Role-engulfment and Deviant Identity Formation" --- p.63 / Chapter 4.1.1 --- First Use and the Honeymoon; Taking the addict role / Chapter 4.1.2 --- "Addiction and Life as ""Junkie"": Developing the deviant self-identity" / Chapter 4.2 --- Addict Role-strain and Identity Crisis --- p.83 / Chapter 4.2.1 --- """Hitting the Bottom"" and Motivation to Change" / Chapter 4.2.2 --- Preliminary Attempts: Using Self-administered Methods / Chapter Chapter 5: --- Treatment and Rehabilitation Stage / Chapter 5.1 --- Role-conflict and Identity Negotiation --- p.92 / Chapter 5.1.1 --- "Accepting the ""patient"" or ""sinner"" role" / Chapter 5.1.2 --- The Intensity and Nature of Role Conflict / Chapter 5.1.3 --- Altercasting of Normal Identity / Chapter 5.1.4 --- "Strategies of Identity Negotiation: ""how actors react""" / Chapter 5.2 --- "Identity Transformation: ""how actors are transformed""" --- p.115 / Chapter 5.2.1 --- "Strategies, Materials, and Agents" / Chapter 5.2.2 --- Cognitive Base of Transformation / Chapter 5.2.3 --- Affective Base of Transformation / Chapter 5.2.4 --- Normative Base of Transformation / Chapter Chapter 6: --- Continued Rehabilitation and Social-Reintegration Stage / Chapter 6.1 --- Types of Identity Transformation --- p.140 / Chapter 6.1.1 --- Dawn Island Centre: Religious Conversion / Chapter 6.1.2 --- SKC: Alternation / Chapter 6.2 --- Identity Validation and Types of Role-Support --- p.144 / Chapter 6.2.1 --- Identity Validation and Legitimation / Chapter 6.2.2 --- Types of Role-Support / Chapter Chapter 7: --- Conclusion and Discussion / Chapter 7.1 --- "Identity Transformation, Role-Support and Abstinence" --- p.156 / Chapter 7.2 --- Drug Addicts' Recovery: An Interactive and Joint Accomplishment --- p.159 / Chapter 7.3 --- The Contingent Nature of Recovery Career --- p.161 / Chapter 7.4 --- SARD A and Operation Dawn: Two Different Pathways of Recovery --- p.163 / Chapter 7.4.1 --- Religious Conversion: Pathway to Christianity / Chapter 7.4.2 --- Alternation: Pathway to Normality / Chapter 7.5 --- Significance and Limitations of Study --- p.166 / Appendix I: A Socio-Demographic Profile of Informants --- p.169 / Appendix II: Tables --- p.173 / Appendix III: A Glossary of Hongkong Addicts' Argots --- p.190 / Appendix IV: Document and Questionnaire Samples --- p.192 / Appendix V: Photos of the Dawn Island Gospel Treatment Centre --- p.203 / Appendix VI: Interview Schedules --- p.209 / Bibliography --- p.216

by Cheung Wai-ting. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 131-142). / Abstracts in English and Chinese. / Chapter Chapter 1 --- The Research Problem --- p.1 / Chapter Chapter 2 --- Literature Review / Chapter 2.1 --- Prohibitionist Approach --- p.7 / Chapter 2.2 --- Medical-Treatment Approach --- p.8 / Chapter 2.3 --- How Should We Understand Post-Treatment Drug Use Behavior ？ --- p.14 / Chapter Chapter 3 --- Analytical Framework / Chapter 3.1 --- Social Capital Theory --- p.24 / Chapter 3.2 --- Differential Association Theory and Social Capital --- p.26 / Chapter 3.3 --- Control Theory and Social Capital --- p.31 / Chapter 3.4 --- Labeling Theory --- p.39 / Chapter 3.5 --- Self-Efficacy Theory --- p.44 / Chapter 3.6 --- The Hypotheses --- p.48 / Chapter Chapter 4 --- Methodology / Chapter 4.1 --- Data and Sample --- p.52 / Chapter 4.2 --- General Profile of Respondents --- p.54 / Chapter 4.3 --- Conceptualization and Operationalization of Variables --- p.57 / Chapter 4.4 --- Method of Data Analysis --- p.66 / Chapter Chapter 5 --- Results / Chapter 5.1 --- Quantitative Analysis --- p.68 / Chapter 5.1.1 --- Bivariate Analysis / Chapter 5.1.2 --- Path Analysis / Chapter 5.1.3 --- Verification of Hypotheses / Chapter 5.2 --- Qualitative Analysis --- p.86 / Chapter Chapter 6 --- Summary and Discussion / Chapter 6.1 --- The Study --- p.112 / Chapter 6.2 --- Summary of Findings --- p.113 / Chapter 6.3 --- Theoretical Implications --- p.117 / Chapter 6.4 --- Practical Implications --- p.120 / Chapter 6.5 --- Limitations and Suggestions for Future Research --- p.122 / Appendix I Interview Schedule --- p.125 / Appendix II Socio-demographic Profile of the Ten Informants --- p.127 / Bibliography --- p.130

by Eliza Lau Mei Ting. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 67-71). / Abstract and questionnaire also in Chinese. / ACKNOWLEDGEMENTS --- p.ii / TABLE OF CONTENTS --- p.iii / LIST OF TABLES --- p.vi / LIST OF FIGURES --- p.v / CHAPTERS / abstract --- p.2 / Chapter 1 --- INTRODUCTION AND LITERATURE REVIEW --- p.3-13 / Purpose of the Study --- p.11 / Hypotheses --- p.12 / Chapter 2 --- METHOD --- p.14-24 / Participants --- p.15-18 / Measures --- p.18-24 / Procedure --- p.24 / Chapter 3 --- RESULTS --- p.25-56 / Chapter 4 --- DISCUSSION --- p.57-64 / REFERENCES --- p.65-69 / APPENDIX A / questionnaire for the study