Call number: LD2668 .T4 1985 B46 / Master of Science

Thesis (Phd)-- Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: Adolescents are recognised as a nutritionally at-risk group, as they have high nutritional demand for growth and development, poor eating behaviour as well as a propensity for unhealthy behaviours. Heavy alcohol use, particularly in the form of binge drinking, is typical for an alarming proportion of school-going adolescents and is a plausible contributor to the nutritional challenges in adolescents, but this has not yet been fully investigated. Aim: This study investigated the potential influences of alcohol use on the nutritional status of adolescents with alcohol use disorders (AUDs), specifically with regards to their eating behaviour and dietary intake, growth and weight status, iron status, as well as vitamin D and calcium status. Methods: Substance use, physical activity, eating behaviour, dietary intake, growth and weight status, iron status and vitamin D and calcium status were assessed and compared in heavy drinking adolescents (meeting DSM-IV criteria for AUDs) (n=81) and in light/non-drinking adolescents without AUDs (non-AUDs)(n=81), matched for age, gender, language, socio-economic status and education. Observed dietary intake distributions were adjusted statistically to obtain usual nutrient intake distributions. Regression-adjusted differences between the groups were assessed using multi-level mixed effects linear regression, adjusting for potential confounders. Results: Lifetime alcohol dose in standard drinks of alcohol was orders of magnitude higher in the AUDs group compared to the non-AUDs group. AUDs adolescents had a binge alcohol use pattern and a “weekends-only” style of alcohol consumption. Poor eating patterns (breakfast skipping and frequent snacking), poor food choices (energy-dense and nutrient-poor foods) and low fruit and vegetable intake (non-AUDs 90 [42.4-153.3]; AUDs 88.3 [30.0-153.0] grams per day) in both groups were reflected in the poor nutritional quality of the diet. More than half of adolescents in both groups were at risk of inadequate intakes of folate (non-AUDs 97.5%; AUDs 98.8%), vitamin C (non-AUDs 65%; AUDs 67.5%), vitamin A (non-AUDs 80%; AUDs 82.5%), vitamin E (non-AUDs 78.8%; AUDs 51.3%), magnesium (non-AUDs 98.8%; AUDs 97.5%), and phosphorus (non-AUDs 76.3%; AUDs 73.8%) and all participants were at risk of inadequate calcium and vitamin D intakes. AUDs adolescents had a greater intake of unhealthy foods (energy-dense nutrient-poor) and a significantly greater energy intake than non-AUDs adolescents (p<0.001) that exceeded energy requirements. AUDs adolescents consumed foods high in unhealthy fats significantly more frequently (p=0.037) than the non-AUDs adolescents and had ensuing greater total fat (p<0.001), saturated fat (p<0.001) and cholesterol (p=0.009) intakes. Frequency of intake of sodium-rich foods was significantly higher in AUDs adolescents (p=0.001) and prevalence of risk of excessive sodium intake was significantly greater in the AUDs adolescents (45%) compared to non-AUDs adolescents (18.8%) (p<0.001). Anthropometric indices of growth and weight status were comparable between the groups and in line with that of the South African adolescent population. Female AUDs adolescents had increased odds (OR 2.42) of being overweight/obese compared to non-AUDs females. Physical activity in both groups was well below the WHO global recommendation. Iron store depletion (serum ferritin < 20 μg/L) was evident in a quarter of adolescents in both groups (non-AUDs 23.5%; AUDs 24.7%), with biochemical iron status measures (serum iron and total iron binding capacity) indicating a greater risk of iron store depletion in the AUDs group. Biochemical vitamin D insufficiency/deficiency (serum 25-hydroxyvitamin D < 30 ng/mL) was prevalent in both groups (non-AUDs 70.4%; AUDs 88.8%), although this was significantly greater in the AUDs group (p=0.013), with significantly lower serum 25-hydroxyvitamin D levels in the AUDs group compared to the non-AUDs group (p=0.038). Conclusions: Heavy alcohol use in the form of binge drinking in adolescents may have the following nutrition-related influences: increased intake of energy; unhealthy fats and sodium, increased risk of overweight/obesity in females; increased risk of iron store depletion; and increased risk of vitamin D insufficiency/deficiency. Persistence of heavy alcohol use, poor food choices and dietary intake may increase the risk for adverse nutrition-related health outcomes in the AUDs adolescents. / AFRIKAANSE OPSOMMING: Inleiding: Adolessente het 'n verhoogde risko vir wanvoeding as gevolg van hul hoë voedingbehoeftes vir groei en ontwikkeling, swak eetgedrag, asook 'n geneigdheid tot verdere ongesonde gedrag. Swaar alkohol gebruik in die vorm van “binge” drinkery kom toenemend onder skoolgaande adolessente voor. Hierdie gedrag kan moontlik bydra tot die verhoogde voeding risiko in dié ouderdomsgroep. Hierdie moontlikheid is egter nog nie ten volle ondersoek nie. Doel: Hierdie studie het die potensiële invloed van alkohol gebruik op die voedingstatus van adolessente met alkohol gebruik versteurings (AGVs) ondersoek, spesifiek met betrekking tot hul eetgedrag en dieetinname, groei en gewigstatus asook yster-, vitamien D- en kalsiumstatus. Metodes: Swaar drinkende adolessente wat voldoen aan DSM-IV kriteria vir AGVs (n=81) en lig/nie-drinkende adolessente sonder AGVs (nie-AGVs) (n=81), wat afgepaar is vir ouderdom, geslag, taal, sosio-ekonomiese status en opvoedingsvlak is gewerf vir deelname aan die studie. Middel gebruik, fisiese aktiwiteit, eetgedrag, dieetinname, groei en gewigstatus, ysterstatus en vitamien D- en kalsiumstatus is tussen die twee groepe vergelyk. Waargenome dieetinname verspreidings is statisties aangepas om gewoontelike nutriëntinname te verkry. Regressie-aangepaste verskille tussen die groepe is met behulp van ’n meervoudige gemengde effekte liniêre regressie model getoets, waartydens daar vir moontlike gestrengelde faktore aangepas is. Resultate: Leeftyd alkohol dosis, gemeet in standaard alkohol drankies, was beduidend hoër in die AGVs groep in vergelyking met die nie-AGVs groep. Alkohol gebruik in die AGVs adolessente het ‘n “binge” patroon en ‘n “slegs naweke” styl getoon. Swak eetgewoontes (oorslaan van ontbyt en gereelde peuselgewoontes), swak voedsel keuses (energie-dig en laag in nutriënte) en lae groente en vrugte inname (nie-AGVs 90.0 [42.4-153.3]; AGVs 88.3 [30.0-153.0] gram per dag), in beide groepe, is gereflekteer in die swak voeding kwaliteit van die dieet. ‘n Risiko vir onvoldoende inname van folaat (nie-AGVs 97.5%; AGVs 98.8%), vitamien C (nie-AGVs 65%; AGVs 67.5%), vitamien A (nie-AGVs 80%; AGVs 82.5%), vitamien E (nie-AGVs 78.8%; AGVs 51.3%), magnesium (nie-AGVs 98.8%; AGVs 97.5%), en fosfor (nie-AGVs 76.3%; AGVs 73.8%) was teenwoordig in meer as helfte van adolessente in beide groepe, asook Inleiding: Adolessente het 'n verhoogde risko vir wanvoeding as gevolg van hul hoë voedingbehoeftes vir groei en ontwikkeling, swak eetgedrag, asook 'n geneigdheid tot verdere ongesonde gedrag. Swaar alkohol gebruik in die vorm van “binge” drinkery kom toenemend onder skoolgaande adolessente voor. Hierdie gedrag kan moontlik bydra tot die verhoogde voeding risiko in dié ouderdomsgroep. Hierdie moontlikheid is egter nog nie ten volle ondersoek nie. Doel: Hierdie studie het die potensiële invloed van alkohol gebruik op die voedingstatus van adolessente met alkohol gebruik versteurings (AGVs) ondersoek, spesifiek met betrekking tot hul eetgedrag en dieetinname, groei en gewigstatus asook yster-, vitamien D- en kalsiumstatus. Metodes: Swaar drinkende adolessente wat voldoen aan DSM-IV kriteria vir AGVs (n=81) en lig/nie-drinkende adolessente sonder AGVs (nie-AGVs) (n=81), wat afgepaar is vir ouderdom, geslag, taal, sosio-ekonomiese status en opvoedingsvlak is gewerf vir deelname aan die studie. Middel gebruik, fisiese aktiwiteit, eetgedrag, dieetinname, groei en gewigstatus, ysterstatus en vitamien D- en kalsiumstatus is tussen die twee groepe vergelyk. Waargenome dieetinname verspreidings is statisties aangepas om gewoontelike nutriëntinname te verkry. Regressie-aangepaste verskille tussen die groepe is met behulp van ’n meervoudige gemengde effekte liniêre regressie model getoets, waartydens daar vir moontlike gestrengelde faktore aangepas is. Resultate: Leeftyd alkohol dosis, gemeet in standaard alkohol drankies, was beduidend hoër in die AGVs groep in vergelyking met die nie-AGVs groep. Alkohol gebruik in die AGVs adolessente het ‘n “binge” patroon en ‘n “slegs naweke” styl getoon. Swak eetgewoontes (oorslaan van ontbyt en gereelde peuselgewoontes), swak voedsel keuses (energie-dig en laag in nutriënte) en lae groente en vrugte inname (nie-AGVs 90.0 [42.4-153.3]; AGVs 88.3 [30.0-153.0] gram per dag), in beide groepe, is gereflekteer in die swak voeding kwaliteit van die dieet. ‘n Risiko vir onvoldoende inname van folaat (nie-AGVs 97.5%; AGVs 98.8%), vitamien C (nie-AGVs 65%; AGVs 67.5%), vitamien A (nie-AGVs 80%; AGVs 82.5%), vitamien E (nie-AGVs 78.8%; AGVs 51.3%), magnesium (nie-AGVs 98.8%; AGVs 97.5%), en fosfor (nie-AGVs 76.3%; AGVs 73.8%) was teenwoordig in meer as helfte van adolessente in beide groepe, asook

Alcohol use in young adults requires continued attention due to the significant number of problems related to alcohol consumption. The alcohol use literature has explored a variety of constructs related to alcohol use in young adults including religiousness. The aims of the current study were to demonstrate the relationships between religiousness and alcohol use, explore the associations between religiousness and descriptive drinking norms, replicate the relationships between drinking norms and alcohol outcomes, and explore the mediating role of descriptive drinking norms on the relationships between religiousness and alcohol outcomes. Three hundred and thirtythree undergraduate students (M=19.72 years old; SD=1.1) completed questionnaires assessing religiousness, descriptive drinking norms, alcohol consumption, and alcoholrelated consequences. Religious commitment and comfort were inversely associated with alcohol consumption and alcohol-related consequences; religious strain was positively associated with alcohol-related consequences but not significantly related to alcohol consumption. Religious commitment and comfort were inversely associated with drinking norms for ones close friends; religious commitment was also inversely related to drinking norms for the average person his/her age. The significance of the relationships between drinking norms and alcohol outcomes depended on the specific drinking norm target; however the majority of drinking norms were positively associated with personal drinking behavior. Finally, perceptions of close friends drinking behavior at least partially mediated the relationships between religious commitment and comfort and alcohol outcomes. This study contributed to the current literature by examining multiple aspects of religiousness and alcohol use, exploring the role of descriptive drinking norms, and empirically testing a theoretical model explaining the role of religiousness in alcohol use.

The text and accompanying video tape describe the "talking circle" ritual as it is being used spiritually by a Native American group in Southern Arizona. The text analyzes the evolution of the ritual and applies widely accepted models of group therapy to its uses in the following capacities: Spiritually, (and in) Substance Abuse, Education and the Psychological Treatment of Troubled Teen-agers. The video tape features interviews with local practitioners and is narrated by a traditional Chippewa Indian.

This study investigated the impact of gender on alcohol use among African-American college students. The two study hypotheses were: (1) there is no difference between the rates of alcohol use for African-American males and African-American females; and (2) there is no difference in alcohol use among African-American college students according to social variables, i.e., personal and situational variables. The Clark Atlanta University survey of Alcohol Use (1992) was used to assess the drinking patterns of a select group of African-American college students. The participants in this study consisted of 128 African-American college students (males and females) who attended schools in the Atlanta University Center. Results indicated that, contrary to the expected predictions, the rate of alcohol use tended to be higher for African-American females than for African-American males, however, this difference was not significant. Furthermore, influences of social variables i.e., place, type of consumption, reasons for drinking and group composition, appeared to be significant when looking at the gender differences. It was concluded that type of consumption tended to be significant, e.g., African-American college females, who reported that they used alcohol, indicated that they prefer to drink wine coolers when they consume alcohol. The African-American college males indicated that they prefer to drink beer when they consume alcohol. The second most significant difference, between African-American college males and females, was their responses to alcohol consumption based upon group composition. It was revealed that African- American females, who reported consuming alcohol, preferred to drink with friends and same sex. However, when African -American college males responded to this question, they reported that they prefer to drink in the presence of large mixed groups more often.

Distress tolerance (DT) is considered to be a trait-like factor encompassing an individual’s behavioral and/or perceived ability to withstand negative affective states. Behavioral measures of DT are being increasingly utilized, however, these tasks have been implemented in studies prior to thoroughly establishing the psychometric properties. The present study aimed to evaluate the reliability of two DT behavioral tasks (Breath-Holding Task [BHT], computer-based Paced Auditory Serial Addition Task [PASAT-C]) in different settings (laboratory, online) among a sample of college students. Participants completed the tasks during two sessions, approximately one week apart. 52 participants were in the laboratory condition, and 65 were in the online condition. There were three main findings: a) test-retest reliability estimates were within acceptable ranges for both the BHT and PASAT-C, b) BHT performance differed significantly by modality while PASAT-C performance did not, c) number of distractors endorsed was not significantly associated with quit latency on either task.

O uso problemático de álcool tem sido apontado como problema de saúde pública. A prevalência de dependência de álcool é maior em pessoas com transtornos psiquiátricos. Esta comorbidade pode trazer sérias implicações para a identificação, tratamento e reabilitação do indivíduo doente. O presente estudo teve como objetivo identificar o uso problemático de álcool em pacientes com transtornos psiquiátricos, a partir da realidade clínica assistencial terciária de um serviço universitário. Foi realizado um estudo transversal, com uma amostra clínica ambulatorial composta por 127 indivíduos em tratamento por um dos seguintes diagnósticos: esquizofrenia, transtorno afetivo bipolar, depressão e transtornos de ansiedade. Os dados foram colhidos através de entrevista com o paciente e também através do prontuário. As informações coletadas foram: dados sócio-demográficos, história psiquiátrica, problemas de saúde, características familiares e registros do prontuário relacionados ao diagnóstico do paciente e ao consumo de álcool. Foi aplicado o instrumento de rastreamento CAGE e realizada a entrevista estruturada em conformidade com os diagnósticos da CID-10 para uso nocivo e dependência de álcool. A fim de aumentar a sensibilidade do CAGE,trabalhou-se com o ponto de corte ¡Ý1. Da amostra total, 6,3% fazem uso nocivo de álcool e 3,9% são dependentes, de acordo com os critérios da CID-10. Quarenta e três pessoas (33,9%) pontuaram positivo no CAGE, o que indica a possibilidade de uso problemático de álcool em algum momento de suas vidas. Os fatores sócio-demográficos que mostraram relação com o uso problemático de álcool foram: ser homem, ter menos de 40 anos de idade, não ter companheiro(a) e não ser praticante de religião. Ao se comparar médias de escore no CAGE, entre os quatro grupos diagnósticos estudados, encontrou-se que a maior média foi a do grupo de esquizofrenia, seguida pelo de transtornos ansiosos, transtorno afetivo bipolar e, por último, depressão. Foi encontrada uma relação entre pontuação no CAGE e idade de início da enfermidade. Entre os pacientes que pontuaram positivo no CAGE, 60,5% não tinham registros, em seus prontuários, de uso de álcool. Sugere-se a disseminação de informações a respeito da comorbidade entre transtornos psiquiátricos e uso problemático de álcool na formação de profissionais de saúde, assim como treinamento para uso de instrumentos de rastreamento do uso problemático de álcool. / The problematic use of alcohol is becoming recognised as a serious public health problem. The prevalence of alcohol dependence is higher in persons with a psychiatric disorder. This comorbidity has serious implications for the identification, treatment and rehabilitation of the person. The aim of this research is to identify the problematic use of alcohol among individuals with psychiatric disorders by evaluating patients attending a psychiatric outpatient clinic at a university hospital. A transversal study was carried out, with a clinical sample composed of 127 individuals in treatment for one of the following disorders: schizophrenia, bipolar disorder, depression and anxiety disorders. The data was gathered from the patient’s records and through interview. The information collected was: sociodemographic data, psychiatric history, health problems, family characteristics and information from the records concerning the patient’s diagnosis and their previous alcohol use. The screening instrument CAGE was applied along with a structured interview based on the ICD-10 criteria for harmful use and alcohol dependence. In order to increase the sensitivity of CAGE the cut off point ¡Ý1 was used. It was found that 6.3% of patients met the criteria for harmful alcohol use and 3.9% for dependence (ICD-10). Forty-three persons (33,9%) scored positive with CAGE, indicating the possibility of problematic use of alcohol at a point in their lives. The sociodemographic factors that showed an association with problematic use of alcohol were: to be male, to be less than 40 years of age, to be without a partner and not to be practicing a religion. When the mean averages of CAGE scores for the four studied diagnostic groups were compared, the schizophrenia group scored higher, followed by the anxiety disorder group, bipolar disorder group and the depression group. A relationship was found between CAGE scores and patient age at the onset of the disorder. Among patients that scored positive with CAGE, 60,5% did not have any history, in their records, of alcohol use. It is suggested that information regarding comorbidity between psychiatric disorders and problematic use of alcohol be disseminated among health professionals, in conjunction with training in the use of screening instruments for problematic use of alcohol.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Master of Science / School of Family Studies and Human Services / Joyce Baptist / There is a need for culturally sensitive clinical interventions for substance use disorders. Parental modeling, peer alcohol use, and depression are related to alcohol use, but have not been specifically examined among Latin American adolescents and young adults in the U.S. The purpose of this study is to examine contributing factors to alcohol use in Latin American adolescents and young adults in the U.S. Participants included 400 Hispanic and Latino adolescents from the National Longitudinal Study of Adolescent Health (Add Health). Results from a path analysis suggested that parent and peer alcohol use are associated with adolescent alcohol use and that adolescent alcohol use mediates the relationship between peer alcohol use and young adult alcohol use. Clinical and research implications are described.

O uso problemático de álcool tem sido apontado como problema de saúde pública. A prevalência de dependência de álcool é maior em pessoas com transtornos psiquiátricos. Esta comorbidade pode trazer sérias implicações para a identificação, tratamento e reabilitação do indivíduo doente. O presente estudo teve como objetivo identificar o uso problemático de álcool em pacientes com transtornos psiquiátricos, a partir da realidade clínica assistencial terciária de um serviço universitário. Foi realizado um estudo transversal, com uma amostra clínica ambulatorial composta por 127 indivíduos em tratamento por um dos seguintes diagnósticos: esquizofrenia, transtorno afetivo bipolar, depressão e transtornos de ansiedade. Os dados foram colhidos através de entrevista com o paciente e também através do prontuário. As informações coletadas foram: dados sócio-demográficos, história psiquiátrica, problemas de saúde, características familiares e registros do prontuário relacionados ao diagnóstico do paciente e ao consumo de álcool. Foi aplicado o instrumento de rastreamento CAGE e realizada a entrevista estruturada em conformidade com os diagnósticos da CID-10 para uso nocivo e dependência de álcool. A fim de aumentar a sensibilidade do CAGE,trabalhou-se com o ponto de corte ¡Ý1. Da amostra total, 6,3% fazem uso nocivo de álcool e 3,9% são dependentes, de acordo com os critérios da CID-10. Quarenta e três pessoas (33,9%) pontuaram positivo no CAGE, o que indica a possibilidade de uso problemático de álcool em algum momento de suas vidas. Os fatores sócio-demográficos que mostraram relação com o uso problemático de álcool foram: ser homem, ter menos de 40 anos de idade, não ter companheiro(a) e não ser praticante de religião. Ao se comparar médias de escore no CAGE, entre os quatro grupos diagnósticos estudados, encontrou-se que a maior média foi a do grupo de esquizofrenia, seguida pelo de transtornos ansiosos, transtorno afetivo bipolar e, por último, depressão. Foi encontrada uma relação entre pontuação no CAGE e idade de início da enfermidade. Entre os pacientes que pontuaram positivo no CAGE, 60,5% não tinham registros, em seus prontuários, de uso de álcool. Sugere-se a disseminação de informações a respeito da comorbidade entre transtornos psiquiátricos e uso problemático de álcool na formação de profissionais de saúde, assim como treinamento para uso de instrumentos de rastreamento do uso problemático de álcool. / The problematic use of alcohol is becoming recognised as a serious public health problem. The prevalence of alcohol dependence is higher in persons with a psychiatric disorder. This comorbidity has serious implications for the identification, treatment and rehabilitation of the person. The aim of this research is to identify the problematic use of alcohol among individuals with psychiatric disorders by evaluating patients attending a psychiatric outpatient clinic at a university hospital. A transversal study was carried out, with a clinical sample composed of 127 individuals in treatment for one of the following disorders: schizophrenia, bipolar disorder, depression and anxiety disorders. The data was gathered from the patient’s records and through interview. The information collected was: sociodemographic data, psychiatric history, health problems, family characteristics and information from the records concerning the patient’s diagnosis and their previous alcohol use. The screening instrument CAGE was applied along with a structured interview based on the ICD-10 criteria for harmful use and alcohol dependence. In order to increase the sensitivity of CAGE the cut off point ¡Ý1 was used. It was found that 6.3% of patients met the criteria for harmful alcohol use and 3.9% for dependence (ICD-10). Forty-three persons (33,9%) scored positive with CAGE, indicating the possibility of problematic use of alcohol at a point in their lives. The sociodemographic factors that showed an association with problematic use of alcohol were: to be male, to be less than 40 years of age, to be without a partner and not to be practicing a religion. When the mean averages of CAGE scores for the four studied diagnostic groups were compared, the schizophrenia group scored higher, followed by the anxiety disorder group, bipolar disorder group and the depression group. A relationship was found between CAGE scores and patient age at the onset of the disorder. Among patients that scored positive with CAGE, 60,5% did not have any history, in their records, of alcohol use. It is suggested that information regarding comorbidity between psychiatric disorders and problematic use of alcohol be disseminated among health professionals, in conjunction with training in the use of screening instruments for problematic use of alcohol.