The purpose of this study was to examine the comorbidity of substance use disorders and mental illness: Addressing access to dual diagnosis treatment centers and the correlation of perceived effectiveness. The research project was conducted in collaboration with California State University, San Bernardino, (CSUSB) and the Master in Social Work Program. The study used a survey designed with items that measured the participant’s perception of availability and effectiveness of dual diagnosis treatment centers. A quantitative study was conducted using a fixed choice response and data was analyzed on an interval measurement scale. Frequencies and cross tabulations were used to present participant’s answers. 86.7% of respondents perceived that they benefited from a dual diagnosis treatment center. All respondents perceived they were better equipped to manage their alcoholism after treatment, were better equipped to manage their mental illness after treatment, and better equipped to be a contributing member of society after treatment. The findings of this research may contribute to social work's knowledge of treating comorbidity by providing insight into the factors that contribute to individual's effectiveness in regards to post dual diagnosis treatment.

Attention-deficit hyperactivity disorder (ADHD), the most commonly diagnosed childhood neurobehavioral disorder, is increasing annually at about 5% per year. ADHD has been diagnosed in approximately 6.4 billion children in the U.S., and it is estimated that 66% of those afflicted have 1 or more comorbid conditions. Children with ADHD are often from socioeconomically challenged households. What is unclear from the literature is the relationship between socioeconomic status (SES), defined as education, employment, and income and the reporting of comorbidities with ADHD. The problem is that children with ADHD from low SES households may be reporting a higher prevalence of comorbid conditions, which can lead to misdiagnosis, improper treatment, and greater financial burden for families and the public health system. The purpose of this quantitative, descriptive, nonexperimental study was to examine the relationship between household SES and the reporting of a comorbidity (anxiety, depression, behavioral issues) in children with ADHD by analyzing secondary data from the National Survey of Children's Health (N = 99,677). Ecological systems theory guided this study which is based on the premise that individuals encounter many environments in their lives and these environments can impact health and well-being. Multiple logistic regression analysis revealed that parental education level, employment, and household income were significantly associated with the reporting of comorbidities for children with ADHD. This research may lead to positive social change by allowing resources to be allocated to low SES households of children with ADHD to decrease the number of children developing comorbid conditions.

A growing literature suggests that experiencing positive emotions provides psychological benefits (e.g., Coifman et al. 2007), and interventions increasing positive emotions may reduce depression risk (Geschwind et al., 2011). The present study tested whether reminiscence, a method of positive emotion savoring (Quoidbach et al., 2010), can mitigate depression risk by increasing positive emotions in an unselected sample and a subsample of at-risk anxious individuals. Female participants (n=336) were randomized to a reminiscence or control condition and asked to complete daily mental imagery exercises focusing on a positive memory (reminiscence) or a neutral laboratory memory (control) for one week. As expected, reminiscence exercises produced immediate positive emotion increases compared to control exercises. Contrary to prediction, reminiscence participants did not report higher positive affect or lower depression symptoms at the end of the study week or one month follow up period compared to controls. Future studies in treatment-seeking samples are needed before strong conclusions can be drawn about the long term affective benefits of reminiscence in at-risk or clinical populations. Findings in the anxious subsample revealed no greater benefit of reminiscence versus neutral mental imagery for those with high anxiety. However, across both conditions, anxiety was a strong predictor of positive emotional functioning, with high anxiety predicting low positive emotions even after accounting for depression symptoms. These findings add to prior work suggesting anxiety can blunt positive emotional functioning, and warrant future studies to further elucidate the impact of anxiety on positive emotional functioning and the potential utility of intervening on positive emotions in anxious individuals.

Aim: This study aims to investigate the genetic components of Attention Deficit Hyperactivity Disorder (ADHD), Reading Disability (RD), and their comorbidity. Methods: Three approaches were applied to data from 2610 Australian twin families. This data was obtained by parental completion of the ‘Twin and Sibling Questionnaire'. 1) Latent Class Analysis (LCA) was applied to generate genetically independent classes that defined ADHD subtypes and RD based on related cluster symptoms. 2) Genetic modelling was used to study the particular genetic and environmental effects of each ADHD subtype and of RD, and to examine whether children identified with comorbid ADHD-RD are a genetically distinct group from those who have only ADHD without RD. 3) A family-based genetic association, including haplotype block analysis, was applied to compare the efficacy of DSM-IV diagnostic criteria and LCA in the genotyping analysis, to test the genetic overlap of ADHD candidate genes on RD phenotypes.and vice versa, and to detect some of the risk alleles of ADHD alone, RD alone, and comorbid ADHD-RD. This analysis was performed on a data set that included 190 individuals from the original sample; it tested twenty-one Single Nucleotide Polyrnorphisms (SNPs) from five ADHD candidate genes (DRD4, DATI, SNAP25, COMT, and HTR1B), and four RD candidate genes (MRS2L, KIAA0319, TTRAP, and THEM2) from the 6p22.2 region. / Results: The LCA dissected the phenotypes for ADHD and RD into nine genetically informative classes. Univariate and bivariate results indicated the presence of unique genetic components on each ADHD subtype and RD category, and also showed the existence of genetic factors for comorbid ADHD-RD. The association findings, using continuous data represented by scores,of DSM-IV-defined ADHD and RD, showed two significant associations for ADHD and RD, whereas the association findings for the categorical data, represented by LCA, were richer as they showed 15 significant single-locus with ADHD and RD latent classes. Some of these association results were between ADHD candidate SNPs with RD latent classes and ADHD-RD comorbid classes. Some RD candidate SNPs were associated with ADHD latent classes and ADHD-RD comorbid classes. Haplotype block analysis detected a presence of one significant haplotype block containing two haplotype-tagging SNPs (ht-SNPs) of the COMT gene (rs4680 and rs165599), including three risk alleles ('AA', 'GC', and 'AC') that were associated with some phenotypic RD components. Conclusion: This study found that the use of ADHD-RD latent classes is more suitable for performing genetic association studies and haplotype block analysis than is DSM-IV- defined ADHD and RD definitions. Furthermore, there is an overlapping of genetic effect, as ADHD candidate genes contributed to RD phenotypes and vice versa. Thirdly, ADHD-RD comorbidity is caused by both ADHD and RD candidate genes.

Abstract not available

No description available.

Even among the most high-functioning individuals with autism, there is a wide range of variation in outcome. This study examined within-child factors, such as temperament, that contribute to variation in social outcomes, the most salient area of deficit among individuals with high-functioning autism (HFA). Approach/withdrawal tendencies and effortful control were used to predict variation in symptoms and social skills. A unique multi-method approach employing self- and parent-report measures, physiological assessment, and social observation was used to determine whether temperament could be used to predict variation in social skills and symptom presentation. Results indicated that compared with an age- and gender-matched control group, the HFA group self-reported higher levels of negative affect and lower levels of surgency and were observed to exhibit higher levels of approach tendencies and lower levels of social skills. Across all participants, higher levels of effortful control were predictive of more adaptive social skills and higher levels of observed approach behavior were predictive of higher levels of anxiety. These results are discussed in relation to the variability in outcomes seen among individuals with autism and the implications for the development of interventions to enhance adaptive outcomes.

Inom rättspsykiatrin vårdas många patienter med samsjuklighet missbruk/beroende. Patientgruppen är heterogen med komplexa och specifika vårdbehov. Vårdare är de som tillbringar mest tid med dessa patienter. Studiens syfte var att beskriva vårdares erfarenheter av att vårda patienter som lider av allvarlig psykisk störning med samsjuklighet missbruk/beroende, inom rättspsykiatrisk vård. Tio sjuksköterskor och tio skötare som arbetade på en rättspsykiatrisk regionvårdsklinik intervjuades och materialet bearbetades med kvalitativ innehållsanalys. Intervjuer gjordes med stöd av en semistrukturerad intervjuguide. Ur analysen framkom 14 subkategorier som bildade fyra kategorier; samverkan, skapa funktionellt vardagsliv, finnas kvar över tid och kunskap/kompetens. Resultatet visade att vårdares samverkan med patienter och övriga yrkeskategorier gav vårdprocessen en helhetssyn. Goda vårdrelationer kunde hjälpa patienter att bryta förnekelse av missbruksproblem. Individanpassade aktiviteter och praktisk färdighetsträning var betydelsefullt i patienters rehabilitering. Vårdprocessen kunde inte forceras och motivationsarbetet var centralt. Klinisk erfarenhet, livserfarenhet, teoretisk kunskap kombinerat med en trygg och stabil personlighet, var den kompetens som enligt vårdare behövdes för att vårda dessa patienter. Inom kunskapsområdet missbruk/beroende upplevde vårdare behov av teoretisk komplettering. / Many psychiatric patients with comorbidity of addiction /dependence are treating in forensic mental health. The patient group is heterogenic with complex and specific health needs. Nursing care staffs are those who spent the most time with these patients. The aim of this study was to describe caregivers' experiences of caring for patients suffering from severe mental disorder with comorbidity of addiction /dependence, in psychiatric care. Ten registered nurses and ten licensed mental nurses who worked at a forensic psychiatric clinic were interviewed, and the material was processed with content analysis. Interviews were conducted with support of a semi-structured interview guide. From the analysis revealed 14 subcategories to form four categories: collaboration, create functional everyday life, persist over time and knowledge / skills. The results showed that nursing care staff´s interaction with patients and other health care professionals gave a holistic approach. Good health care relationships could help patients to break the denial of substance abuse problems. Individualized activities and practical skill training was important in patients' rehabilitation. Nursing process could not be rushed and motivational work was crucial. Clinical experience, life experience, theoretical knowledge combined with a secure and stable personality, were the skills as nursing care staff´s needed to care for these patients. In the area of knowledge abuse/dependence experienced nurses need theoretical completion.

This paper describes the distribution of dependence criteria and diagnoses in a sample of 14- to 24-year-olds from Munich, Germany (n = 3,021; 71% response rate), evaluates differences between nondependent and dependent smokers and examines associations of smoking with other substances, affective and anxiety disorders. Assessment was made using the M-CIDI. The lifetime prevalence of DSM-IV nicotine dependence in the total sample is 19%, rising to 52% among regular smokers. No gender differences were seen in the progression from regular smoking to nicotine dependence, although men were more likely than women to initiate regular use. Analysis of daily cigarette use identified a significant dose-response relationship with the number of endorsed DSM-IV dependence criteria with unsuccessful cut-backs being the most prevalent criterion. As compared to nondependent smokers, dependent smokers were more likely to associate negative health effects with smoking and to have a desire to change and attempt a change in their pattern of use. Regular use of nicotine was found to be significantly associated with other substance and nonsubstance disorders, although dependent regular use was more strongly associated with these disorders than nondependent regular use. These results indicate that daily smoking is a behavior which is resistant to change despite an expressed desire and repeated cut-back attempts. Although initiation of regular smoking among nonsmokers does not occur frequently after the early twenties, the risk for dependent smoking among regular users persists into adulthood and is associated with a range of mental disorders.

Auf der Grundlage der Basisuntersuchung einer epidemiologischen prospektiven Verlaufsstudie (1995–1999) an 3021 Personen im Alter zwischen 14 und 24 Jahren werden epidemiologische Befunde zur Häufigkeit von somatoformen Beschwerden und somatoformen Syndromen/Störungen bei Jugendlichen und jungen Erwachsenen berichtet. Die Jugendlichen und jungen Erwachsenen wurden mit Hilfe des M-CIDI, einem standardisierten Interview zur Erfassung psychischer Symptome, Syndrome und Störungen nach dem DSM-IV, befragt. Die Ergebnisse der ersten Untersuchung zeigen, daß 50% der Jugendlichen einmal in ihrem bisherigen Leben unter einem somatoformen Symptom litten. Junge Frauen berichten häufiger von somatoformen Beschwerden als junge Männer (61 vs. 40%). Die im DSM-IV operationalisierten Kriterien einer somatoformen Störung werden nur von wenigen Jugendlichen und jungen Erwachsenen (2,7%) erfüllt. Die Prävalenz erhöht sich jedoch, wenn man nicht ausschließlich voll ausgeprägte somatoforme Störungen, sondern zusätzlich unterschwellige Syndrome in die Betrachtung einschließt: Hier berichten etwa 11% der Jugendlichen von somatoformen Syndromen. Somatoforme Störungen/Syndrome zeigen sich häufig im Verbund mit anderen psychischen Störungen, wobei die Komorbidität mit dem Alter zunimmt. Wie unsere Analysen ergaben, berichten Jugendliche und junge Erwachsene mit somatoformen Störungen, aber auch solche mit unterschwelligen Syndromen, vermehrt Beeinträchtigungen in verschiedenen sozialen Rollenbereichen und der Arbeitsproduktivität. / As part of a longitudinal study, prevalence findings of somatoform symptoms, syndromes and disorders are presented for a random sample of 3021 respondents aged 14 to 24 years. The response rate was 71%. Assessment was made using the computer- assisted Munich-Composite International Interview (M-CIDI). Findings of the first part of the study revealed that 50% (men: 40%; women: 61%) of the sample once had a somatoform symptom in their life. Threshold somatoform disorders were rare with 2.7%. However, when including subthreshold somatoform syndromes (11%), the lifetime prevalence of any somatoform disorder/syndrome was 13%. Somatoform disorders and syndromes are often comorbid with other mental disorders, and comorbidity rises with age. Further, they are associated with disabilities and impairments in social and work domains.