Heroin abuse is devastating to both the individual abusers and society. Owing to its ability to elicit rapid feelings of euphoria and transcendent relaxation, coupled with adverse withdrawal effects, it is one of the most addictive illicit drugs of abuse. The severe and persistent socio-economic detriment caused by heroin abuse signifies an urgent need for understanding how this substance affects abusers. Currently, scientific research into the biopsychosocial functioning of heroin abusers is limited. This thesis presents a series of three studies that sought to contribute to our understanding of how biopsychosocial functioning may be influenced by the abuse of heroin. This thesis contains three studies that drew on a large-scale data collection process, involving the collection of neurobiological, psychosocial, molecular, and neurocognitive measures in both abstinent heroin abusers and matched healthy controls. Study One aimed to identify the neurobiological deficits in relation to heroin abuse. It was revealed that heroin abuse was associated with widespread brain structural atrophy, and such atrophy was more profound with a more severe heroin abuse profile. Study Two aimed to identify the neurobiological substrates of the heroin abusers’ personality traits. It was revealed that the heroin abusers’ pathological sensation seeking trait was underpinned by structural integrity of the midbrain and the functional connectivity between the midbrain and the prefrontal cortex. Furthermore, the dorsolateral and ventromedial prefrontal cortices were connected in differential ways with the midbrain in relation to heroin abusers’ sensation seeking tendency. Finally, Study Three aimed to examine an untested hypothesis that the abuse of heroin accelerates the aging process. It was revealed that heroin abusers had a significantly low telomerase activity level, which reflected acceleration of cellular aging. Moreover, heroin use and telomerase activity interacted to impact on brain structures and functional networks that are closely linked with aging. These brain functional networks were found to correlate with behavioural performance in the respective cognitive domains, further supporting the behavioural relevance of these abnormal brain networks. Altogether, these findings have yielded a convergence of understanding of the detrimental effects of heroin use on its abusers. Theoretically, the current findings support the neurobiological models that assign the prefrontal cortex as the core neuropathology of drug addiction, and also recognize the importance of investigating into brain regions that have incidentally but frequently been found to be influenced by the abuse of heroin. Clinically, the current findings suggest new directions for the assessment, conceptualization and interventions for people affected by drug addiction. These implications pave the way for studies that seek to further understand and remediate the biopsychosocial sabotage caused by substance abuse. / published_or_final_version / Psychology / Doctoral / Doctor of Philosophy

University of Macau / Faculty of Social Sciences / Department of Sociology

The focus of this report is on exploring and clarifying research in the areas of spirituality and substance abuse. In terms of their definitions, these constructs, spirituality and religiosity, have been the subject of debate among researchers. The measurement of spirituality/religiosity and substance abuse has been inconsistent from study to study. Conflicting results are reported in the research evaluating the relationship between spirituality/religiosity and substance abuse, and in intervention studies that have employed treatment methods such as meditation and prayer. However, studies comparing spiritual interventions have yet to be conducted. In this report I review and critique the literature and provide guidelines for future research. / text

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There is ample evidence to suggest that, in the context of dating relationships, female-perpetrated intimate abuse is as common as male-perpetrated intimate abuse (e.g., Archer, 2000). Despite awareness of this fact, female-perpetrated intimate abuse remains an understudied area. The current study adds to the available literature on female-perpetrated intimate abuse by examining Dutton’s (2007) theory of the Abusive Personality in a sample of 914 women who had been involved in dating relationships. This is the first study to examine all elements of the Abusive Personality in women simultaneously. Consistent with the Abusive Personality, recalled parental rejection, borderline personality organization (BPO), anger, and trauma symptoms all demonstrated moderate to strong relationships with women’s self-reported intimate psychological abuse perpetration. Fearful attachment style demonstrated a weak to moderate relationship with psychological abuse perpetration. With the exception of fearful attachment, all elements of the Abusive Personality demonstrated a relationship with women’s self-reported intimate violence perpetration. However, these relationships were comparatively weak. A potential model for explaining the interrelationships between the elements of the Abusive Personality was tested using structural equation modeling. This is the first study with either sex to examine all elements of the Abusive Personality simultaneously using structural equation modeling. Consistent with the proposed model, recalled parental rejection demonstrated a relationship with BPO, trauma symptoms, and fearful attachment. Also consistent with the model, trauma symptoms demonstrated a relationship with anger, and BPO demonstrated strong relationships with trauma symptoms, fearful attachment, and anger. Additionally, anger itself had a strong relationship with women’s self-reported perpetration of intimate psychological and physical abuse. Contrary to the proposed model, fearful attachment had a non-significant relationship with anger – when this relationship was examined using structural equation modeling. Based on findings from the current study, fearful attachment has a weaker relationship with college women’s perpetration of intimate abuse than it does with clinical samples’ perpetration of intimate abuse. Following a discussion of the results, limitations of the study are discussed in conjunction with possible future directions for this line of research.

Since the 1970s, wife abuse has been recognized and studied as a major problem in the Western World. Until this decade, little attention has been directed to the effects of these battering relationships on the children who witnessed them. This exploratory study described a group of children whose mothers had been previously physically abused by their intimate partners. Specifically, the school behavior and achievement, social behavior, and health concerns of the children were described. Twenty school-aged children between the ages of seven and thirteen years formed the sample. A combination of quantitative and qualitative research modes were used in the study. The children and their mothers were interviewed using semi-structured interviews designed for the study. A standardized behavior checklist, the Achenbach Child Behavior Checklist, was also completed by each mother, which further described her child and allowed for comparisons between the children in this study and children in a normalized sample. Comparisons were made between gender groups within the sample. The data were also reviewed for indications of the modeling behavior described in Social Learning Theory. Children in the sample were reported to have witnessed the abuse of their mothers for an average of 4.7 years. Child abuse as well as wife abuse had occurred in a high percentage of the homes. There was a high incidence of intergenerational violence in the families of the children studied. Mother and child reports were highly consistent and comparisons based on gender showed no significant differences between boys and girls. Many school problems including a high percentage of school grade repeats were described. Aggressive behavior was reported for over half of the children. Few serious health problems were reported although many of the children complained of headaches and stomachaches. A large number of improvements occurred in the children after the abuse of the mother ended. In spite of the many problems described, most of the children in the study seemed to be functioning well and the mothers were optimistic about their futures. It was concluded that with the help of such measures as supportive parenting and short-term counselling, these children should continue to function well. However, approximately one quarter of the children had more severe problems and will probably require long-term help. / xiv, 125 leaves ; 28 cm

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Alcohol is frequently co-administered with other psychotropic substances, yet little is known about patterns of alcohol use in a simultaneous polysubstance context. In the present dissertation concomitant alcohol-drug administration is examined with an emphasis on delineating patterns of alcohol use when it is co-administered with psychostimulant drugs known to interact with neural mechanisms believed to be involved in mediating alcohol's ascending limb reinforcing effects: midbrain dopamine transmission. / In two retrospective self-report studies polysubstance users reported on their simultaneous use of drugs and alcohol. Results revealed that alcohol was commonly co-administered with various abused substances, particularly with psychostimulant drugs that are known to increase dopamine neurotransmission, and there was an identifiable pattern of administration that was characterized by initial alcohol consumption preceding repeated intermingled alcohol-psychostimulant administrations which resulted in alcohol dose escalation. / In a third study, the effects of administering the psychostimulant drug nicotine on alcohol intake was directly examined using a double-blind placebo controlled self-administration procedure. Nicotine was found to significantly increase alcohol ingestion. / In a final study we examined the effect of decreasing dopamine neurotransmission on alcohol self-administration by using a dietary manipulation that depletes the nutritional precursors to dopamine. This procedure was found to decrease alcohol consumption, an effect that was especially evident in a subset of drinkers thought to be hypersensitive alcohol's ascending limb dopamine effects. Overall findings suggest that alcohol co-administration with psychostimulant drugs affects patterns of alcohol intake and that this may be the result of an interaction involving dopamine neurotransmission.

Comorbid substance use disorders are quite common among patients with schizophrenia. Such individuals' substance use has been associated with psychiatric instability, psychosocial problems and an increased use of health care services. / An existing data set encompassing a range of health care services was analysed, along with patient demographics such as age, living arrangements and education. The subjects were 444 patients with a lifetime diagnosis of schizophrenia, with and without a secondary substance use disorder. / It was found that 32.4% of the male patients and 14.7% of the female patients in this study had a concurrent disorder. The substance abusers tended to be younger than the non-abusers. Male patients who lived in group homes were less likely to have a substance use disorder than male patients in other living situations. Patients with a substance use disorder were more intensive users of hospital services. / The need for the development of integrated services and role of the social worker was discussed.