Background: Changes in neuropsychological and emotional systems are associated with substance dependence and reduce the chance of successfully maintaining abstinence after treatment. Impulsivity is strongly associated with substance dependence and is a risk factor for development, a consequence of excessive use and a marker for poor treatment outcomes. The focus of this thesis is impulsivity, as well as emotional and motivational factors, in the context of harmful substance use and dependence. The thesis is formed of two parts; the first (Studies 1 and 2) focusses on the multi-faceted role of impulsivity in substance dependence. The second part (Studies 3 and 4) investigates negative reinforcement and automatic approach and avoidance behaviour in heavy alcohol use. Study 1: A multi-dimensional investigation of impulsivity in abstinent substance dependent individuals using three complementary techniques: self-report, behavioural and neural measures. Results suggest that self-report measures of impulsivity are more sensitive in abstinent individuals than behavioural or fMRI measures. Study 2: An alternative approach to the classification of substance dependent individuals; using Latent Profile Analysis, abstinent substance dependent participants from Study 1 were regrouped based on personality risk factors rather than primary dependence. Important differences were detected within a previously undifferentiated group of abstinent substance dependent individuals; notably the greater incidence of childhood adversity and stimulant dependence history in one group, while the other did not differ from controls. Study 3: A behavioural investigation of the effect of stress induction on automatic approach and avoidance in heavy drinking individuals compared to light drinkers. Results indicated no differential effect of stress. These findings may suggest that the behaviour of older, more established heavy drinkers is comparable to that of alcohol dependent participants and reflects an advanced stage along the spectrum of alcohol use and dependence. Study 4: An fMRI investigation conducted on a subset of participants from Study 3 using neuroimaging paradigms to assess automatic approach and avoidance behaviour in heavy drinking individuals compared to light drinkers. Results can be interpreted to suggest that heavy drinkers approach alcohol in a less controlled manner than light drinkers, and that trait anxiety may be involved in the extent of avoidance behaviour. Conclusions: Although there are more questions raised by this research than are answered, some general conclusions can be drawn. Specifically, impulsivity measures need to be made more appropriate to all stages of substance use and dependence. Furthermore I propose a longitudinal theory of substance use and dependence with different neurocognitive profiles at each stage, as well as individual differences throughout the trajectory. This has implications for future addiction research that should enable better understanding for the benefit of clinical practice and treatment of substance related disorders.

Magister Artium (Social Work) - MA(SW) / Addiction has seen to be an illness that not only affects the individual but the holistic well-being of the family. Primary caregivers form an integral part of the family system. The caregivers take on roles that might stagnate their own development and coping methods, which if used, could affect the entire family system. There are in-conclusive research on the effect of the coping method of the primary caregiver on the well-being of himself/herself and the family system as a whole. The aim of the research was to quantitatively, through making use of Orford’s Coping questionnaire, explore the different coping methods employed by the primary caregiver of an adult substance dependent and thereafter to qualitatively, through utilizing a narrative approach, explore the experience of the different means of coping. The study design was a mixed method study. Quantitative research was the dominant approach followed by qualitative research. The population was the primary caregivers of adult substance dependents who have sought treatment and who resided in the Mitchell’s Plain area. Eighty participants completed the coping questionnaire and four narratives were done. Quantitative research results was analyzed using SPSS and the qualitative research was analyzed by making use of narrative analysis whereby the interview was analyzed Labov and Waletzky’s structural model of narrative. The theoretical framework from which the researcher addressed this study was collaboration between the family systems theory and the disease model of addiction. Quantitative findings indicated that there more caregivers make use of tolerant coping than engaged and withdrawal coping. There is a distinction between the coping methods that males and females make use of. Qualitative findings indicated that there is no ‘correct’ way of coping with being the caregiver of a substance dependant. Caregivers take on coping methods that they are comfortable with.

Magister Psychologiae - MPsych / Recent increases in intellectual, social, infrastructural and economic resources available for the treatment of substance related mental disorders in the Western Cape reflects the national surge towards health promotion and eradication of the burden created by substance abuse. This large number of people who relapse and return to active substance abuse after receiving treatment obstruct this aim. This study aimed to determine the differences in self efficacy and assess for the risk for relapse during the first twelve months of recovery. Albert Bandura’s social cognitive theory provided a suitable framework for the objectives of this study. A cross-sectional survey research design was implemented. Research participants were recruited from different aftercare groups across Western Cape using cluster sampling. The sample consisted of 105 English literate, consenting adult residents of Western Cape who completed an inpatient substance abuse rehabilitation program within twelve months spanning April 2014- April 2015. Data was collected from respondents using two instruments; a demographic information sheet, and an adapted alcohol abstinence self-efficacy scale (AASE). This instrument showed high validity and reliability during a pilot study conducted to ascertain its reliability in a South African sample. Ethics clearance and project registration was given by the Senate Research Committee of the University of the Western Cape. All ethics principles were adhered to and attention was paid particularly to ensuring confidentiality, informed consent, voluntary participation and the right to withdraw without risk of loss or negative consequence. The data was analysed using descriptive statistics, correlation matrices and regression analysis. The results indicated that self-efficacy was highest during the first days and weeks following discharge from a treatment facility. Respondents who remained gainfully employed during recovery reported higher overall self-efficacy and coped better with negative emotions, withdrawal, physical discomfort and urges to use. Respondents’ perceived ability to cope with negative emotions, and resist withdrawal and urges to use again decreased as post-discharge time increased, with females reporting lower self-efficacy than males and respondents’ age showing no significant effect on recovery outcomes. In conclusion, high abstinence self-efficacy has proven to be a predictor of sobriety. After care, interventions can focus on activities to strengthen abstinence self-efficacy levels. Employment stands out as a vital factor to consider in helping people maintain sobriety.

People with substance dependence show maladaptive approach responses toward stimuli related to their drug of addiction. Reducing the motivational salience of these appealing but maladaptive stimuli could decrease these inappropriate approach responses. Tasks that involve response inhibition influence the affective valence of stimuli, such that previously inhibited items are disliked compared to never-inhibited items. It is not clear, however, whether this effect can be harnessed to develop interventions to decrease the maladaptive motivational salience of addiction-related stimuli. To lay the groundwork for such an intervention, I first determined that people in treatment for substance dependence showed affective devaluation of previously-inhibited stimuli (Experiment 1). Because adolescence is associated with high risk of illegal substance use, I then examined the magnitude of the inhibitory devaluation effect in a group of adolescents from an adverse background (Experiment 2). Devaluation of inhibited stimuli increased significantly with age, suggesting that the effect occurs more strongly as the brain matures. Drug-related stimuli are extremely motivationally salient to people with substance dependence. Experiments 3-6 examined the affective consequences of inhibition for different types of motivationally salient stimuli: geometric images associated with monetary gains or losses, or sexually-appealing images. Finally, I determined that inhibition affects not only a stimulus’ affective valence, but also its motivational value. Heterosexual male participants who inhibited images of attractive females were later less likely to press a key in order to see more images of that type than participants who did not inhibit these images (Experiment 7). Taken together, this evidence suggests that computer-based tasks involving inhibition may be useful for decreasing the affective and motivational salience of drug-related stimuli in substance-dependent individuals.

Throughout history, the human race has been characterized by the use of physical and emotional aggression by individuals, particularly males, in their intimate relationships. Intimate abusiveness is particularly common among substance dependent males. As a result of male intimate abusiveness, victims suffer a variety of problems ranging from emotional trauma to death due to physical injury. Despite increased attention to this problem, our understanding of the process leading to intimate abusiveness is far from comprehensive. The primary purpose of the present study was to expand our understanding of intimate abusiveness through the application of a social-cognitive model of intimate abusiveness among substance dependent males. Fifty-seven males from an inpatient substance abuse treatment program participated. Subjects completed questionnaires indicating their level of intimate abusiveness. In addition, they completed partner-related attribution measures as well as coping response measures indicating how they would interpret and handle five ambiguous vignettes involving their partner. It was hypothesized that violent men would attribute greater negative intent and responsibility to their partner and that they would choose to handle the ambiguous vignettes in less competent ways compared with non-violent men. Further, it was predicted that the association between intimate abusiveness and competency of coping responses would be mediated by attributions made about the partner. Results of the study generally supported predictions. The implications of the results are discussed as well as suggestions for future research. / Ph. D.

Research suggests that substance use is a risk factor for increased suicidal ideation. This study explored the relationship between substance use, suicidal ideation, and impulsivity in a sample of college students and individuals seeking outpatient treatment. Participants were interviewed for information on severity of suicidal ideation and substance use. Participants completed the Psychiatric Diagnostic Screening Questionnaire, the substance use section of the Structured Clinical Interview for the DSM-IV, the Alcohol Use Disorders Identification Test, the Scale for Suicide Ideation, and the UPPS-P Impulsivity Behavior Scale. These measures were used to determine the amount of variance in suicidal ideation accounted for by substance use. Variables reflecting substance use classification, frequency, and severity were used to predict severity of suicidal ideation.

This research study examined the effects of high levels of sugar intake on mental health in marijuana smokers. Because the literature demonstrates a similarity between refined sugar and other commonly addictive drugs, those who ingest a higher percentage of dietary sugar will score more poorly on the DASS21, meaning that with higher levels of sugar ingestion, a greater deficit in mental health functioning will be measurable. Of 16 participants, nine were female and seven were male, and the participants ranged from a normal weight to obese. The results did support the hypothesis of sugar dependence. This has implications for future studies on the impact of sugar on mental health. The results to this study may provide insight into potential for greater understanding of eating disorders associated with sugar dependence, thereby potentially leading to the development of more effective treatment options.

Bakgrund: Substansberoende är ett växande folkhälsoproblem som kräver allt större resurser i dagens hälso- och sjukvård. Detta leder till att dagens sjuksköterskor möter personer med substansberoende i större utsträckning än tidigare. Sjuksköterskeutbildningen omfattar oftast inte kunskap om substansberoende och studier visar att bristande kunskap kan påverka personalens attityder till olika patientgrupper vilket i sin tur kan påverka både den givna vården och vårdmötet. Syfte: Syftet med studien var att belysa vilka attityder sjuksköterskor kan ha till att vårda personer med substansberoende inom somatiska vårdmiljöer. Metod: Studien är en litteraturöversikt, som utifrån tidigare forskning, belyser sjuksköterskors attityder till att vårda personer med substansberoende. Översikten är baserad på sju vetenskapliga kvalitativa och kvantitativa artiklar, som både kvalitetsgranskats och analyserats. Resultat: De artiklar vi fann pekade på en negativ attityd hos sjuksköterskor till att vårda personer med substansberoende i somatiska vårdmiljöer. De mest framträdande attityderna är att det är en krävande patientgrupp, och att det inte känns meningsfullt att vårda dem. Diskussion: För att kunna uppnå bättre vårdkvalitet och förbättra vårdmötet till patienter med substansberoende behövs det enligt resultatet en attitydförändring hos sjuksköterskor. Kunskap, erfarenhet och en känsla av mening i vårdandet av patientgruppen verkar vara viktigt och diskuteras enligt Antonovsky´s KASAM teori. / Background: Substance dependence is a growing health problem. As a result, nurses encounter people with substance dependence to a greater extent than before, while the nursing education has only limited focus on substance dependence. Studies show that a lack of knowledge can have an impact on nurses’ attitudes towards different patient groups, which also seems to affect the care provision and the nurse-patient encounter. Purpose: The aim of this study was to illuminate nurses’ attitudes in caring for people with substance dependence in somatic healthcare settings. Method: The study is a literature review, based on, in all, seven qualitative and quantitative empirical studies. The studies were quality assessed and analyzed. Results: The results indicate that nurses in somatic healthcare settings generally have a negative attitude towards caring for people with substance dependence. The most prominent attitudes were that it is a difficult group to care for, and that caring for them does not feel meaningful. Conclusion: In order to provide a high quality care for this group, a change of attitudes is required. Knowledge, experience and a sense of meaning in caring for this group, seems essential, and is discussed in the light of Antonovsky’s theory, Sense of Coherence.

Substance abuse and dependence are globally contested issues. In a volatile space, the field is undergoing major changes in terms of decriminalisation and reduction of harm efforts in numerous countries. Despite continued efforts to minimise or even eradicate substance use and abuse, recovery programmes still lack sustainability. Relapse is still common, and there is little in the way of literature explaining how some individuals manage successful sustained recovery. Although the field is undergoing many changes, it appears obvious that society still lacks adequate research and information to guide and motivate sustainable recovery. Family systems are generally experienced as a person’s primary system, and it may be assumed that many people become dependent on their family or family members for varying degrees of support. Systems theory underpinned this qualitative case study, comprising multiple cases, in order to explore the experience of individuals who expressed an interest in their own recovery and, more specifically, to discover whether they viewed family support as an assistive factor in this decision. The study found that although family support did not motivate recovery, it was nevertheless an important factor in continued efforts toward recovery once the individual had made their own decision to commence a recovery programme. / Dissertation (MA)--University of Pretoria, 2019. / Psychology / MA Psychology / Unrestricted

SLAVÍČKOVÁ, T. Tématicko apercepční test u uživatelů drog. Pedagogická fakulta Univerzity Karlovy v Praze, 2012. 140 s. Diplomová práce. Diplomová práce měla za cíl odhalit specifika použití TAT u problémových a závislých uživatelů drog a na základě srovnání s výsledky, kterých v testu dosáhla kontrolní skupina, přinést evidenci pro zhodnocení diagnostického potenciálu TAT u uživatelů drog. Výzkumné šetření bylo provedeno v Kolíně na klientech nízkoprahového kontaktního centra, které poskytuje služby harm reduction skryté populaci uživatelů nealkoholových drog. Těžiště výzkumu bezprostředně souvisí s metodou analýzy příběhů, jejichž vyprávění bylo u probandů vyvoláno předložením tabulí TAT. K analýze příběhů byl použit psychometricky zakotvený skórovací systém SCORS (Social Cognition - Object Relation Scale) současného amerického autora D. Westena. Použití TAT u uživatelů drog tak bylo zaměřeno na zhodnocení úrovně jejich fungování v sociálních vztazích. Metodologický princip diplomové práce tkví v induktivním usuzování a statistickém zpracování dat. Způsob zpracování dat, který je až na několik oblastí výhradně v režii kvantitativních metod, spolu s dostatečně velkým souborem zkoumaných osob umožňuje zobecnění důležitých rozdílů ve výsledcích TAT u výzkumné a kontrolní skupiny. V rámci analýzy...