Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up addiction severity in a large sample of Kentucky substance abuse treatment participants (N = 1123). A conceptual model is tested to determine if social characteristics along with psychological distress, perceived stress, and economic hardship are predictors of substance use and follow-up addiction severity. In addition, since recovery support, efficacy, and self-control have been previously identified as mediators in the stress and relapse processes these factors were included as mediators in the model tested. The conceptual model was tested with three outcome variables, substance use between baseline and 12-month follow-up, follow-up alcohol addiction severity, and follow-up drug addiction severity. Bivariate and multivariate analyses, including logistic regression and ordinary least squares regression, were used to test conceptual models with the full sample and also with a subsample with baseline substance use indicative of potential substance dependence. Findings indicated that significance of predictors varied depending on outcome variable, although recovery support, efficacy, and self-control were significant predictors of all three dependent variables. Findings for each outcome variable are discussed, as well as limitations of the present study, implications for social work practice, and implications for future research.

Mindfulness-based Cognitive Therapy (MBCT) is a promising approach aimed at the prevention of relapse in people suffering from recurrent depression. However little is known about what factors support gains in the longer-term. This study examines participants’ experiences of the perceived benefits and barriers to MBCT reunion attendance. Thirteen people, who had participated in MBCT classes for recurrent depression within a primary care setting, were interviewed about their experiences of the reunion meetings or their reasons for not attending. Seven of these had completed their program within the previous 12 to 18 months at the time of interview, and six had completed their program between 20 months and 4 years prior to the time of the interview. Interpretative phenomenological analysis (IPA) was used to analyze participants’ accounts. Four themes highlighted the participants’ experiences: In terms of benefits, reunion attendees experienced the reunions as a booster reminding them of their mindfulness practices and as a sanctuary where these practices were further nurtured within an accepting and compassionate environment. Barriers to reunion attendance were difficulties around the group experience and wanting to put the experience behind them. This related to the memory of depression as well as to the program and group experience for some individuals. Theoretical, clinical and research implications are discussed.

In a quasi-experimental field study, two posttraining interventions composed of relapse prevention (RP) strategies were compared and tested for the effects on participant transfer outcomes. Participant retention of training content, skill maintenance, use of relapse prevention strategies, and self-efficacy served as the dependent variables. Self-efficacy was also tested as a mediator between the experimental treatment levels and both participant skill maintenance and participant use of RP strategies. Participants (n = 39) included managers, directors, and supervisors from various departments within a multi-national telecommunications organization located in a large southern city. After participating in a four-hour leadership development training, two of the three groups participated in a 30-40 minute training where they received one of two RP interventions. One intervention included the steps of (1) identifying potential obstacles to positive training transfer, (2) predicting the first lapse to pretraining behavior, and (3) applying relevant coping strategies to thwart a lapse. The alternative RP intervention included the same steps in addition to a goal setting step. Descriminant descriptive analysis was used to test for group differences across the response variables and to identify on which variables the groups differed. Three separate regression equations were used to test for the mediating relationship of self-efficacy between the RP treatment levels and participant skill maintenance and participant use of RP strategies. Results indicated minimal, but non-statistically significant results between treatment levels and each of the response variables. Self-efficacy was not found to mediate the relationship between RP treatment level and participant skill maintenance or participant use of RP strategies, but did function as a strong predictor of both variables. Suggestions for future research include using additional motivational and efficacy variables to better explore group differences and including efficacy-inducing methods both in training design and as part of a transfer intervention to enhance training transfer. Further, specific suggestions concerning conceptual and psychometric refinement of the RP construct are discussed.

Resurgence is the relapse of an extinguished instrumental behavior that can occur when an alternative behavior that was introduced to replace it is itself extinguished. In a typical resurgence experiment, rats are trained to make a response (R1) for food reinforcers. In a second phase, responses on R1 are no longer reinforced, but a new response (R2) is introduced and responses on it are reinforced. During a third phase, reinforcement for R2 is removed and behavior on R1 often returns (or "resurges") despite remaining on extinction. The current experiments were designed to examine the effects of the temporal distribution of reinforcers delivered during Phase 2 on later resurgence. The role of these alternative reinforcers is central to theories that have been proposed to account for resurgence. The experiments provided a special opportunity to contrast predictions made by the Shahan-Sweeney Model (Shahan & Sweeney, 2011) and a contextual account of resurgence (Winterbauer & Bouton, 2010). Experiments 1 and 2 examined resurgence when alternative reinforcement during Phase 2 was delivered according to the same set of daily reinforcement schedules presented in different orders. That is, one group received rich reinforcement rates that were gradually thinned to leaner ones (Group Thinning) and another group received lean rates that were gradually increased to richer ones (Group Reverse Thinning). Both procedures weakened resurgence compared to that in a group that received the richest rate (a variable interval, or VI 10-s schedule that arranged for a reinforcer to be available for a response every 10s on average) during all of the Phase 2 sessions. However, the forward thinning procedure was more effective than the reverse thinning procedure at eliminating the resurgence effect. Experiment 3 examined resurgence when alternative reinforcement was only available for R2 during every other session. The results indicated that daily alternations of a VI 10-s schedule with an extinction schedule for R2 weakened resurgence compared to groups that either received the same average rate over the entire phase (VI 17.5-s) or that received the same terminal rate (VI 10-s) in every session. The Shahan-Sweeney model cannot account for several of the current results. Instead, the results are most consistent with a contextual account of resurgence. That is, resurgence can be conceptualized as an ABC renewal effect in which extinguished R1 behavior returns when an animal is removed from an extinction "context" provided by R2 reinforcement. Lean reinforcement rates at any time during Phase 2 allow the animal to learn to inhibit R1 under conditions that generalize to the extinction conditions that prevail during the resurgence test. The results also suggest that experience with alternating extinction sessions or lean reinforcement rates close to the final resurgence test are especially effective at eliminating the resurgence effect.

The tendency of users to relapse severely hinders adequate treatment of addiction. Physical and psychological stressors often contribute to difficulties in maintaining behavior change, and may play a significant role in relapse. We have previously shown that the activation of pituitary adenylate cyclase activating peptide (PACAP) systems in the bed nucleus of the stria terminalis (BNST) mediates many consequences of chronic stressor exposure. Hence, chronic stress substantially increased BNST PACAP levels, intra-BNST PACAP infusions produced the behavioral and endocrine consequences of stressor exposure, and BNST PACAP antagonism blocked many of the consequences of chronic stress. In the present set of studies, we investigated the role of BNST PACAP in stress-induced reinstatement of cocaine seeking. Rats self-administered cocaine (3mg/ml; 0.5mg/ig/infusion, i.v.) for 1hr daily over 10 days, which was followed by extinction training in which lever pressing no longer resulted in cocaine delivery. In the first experiment we showed that intra-BNST PACAP infusion (1 μg; 0.5 μl per side) reinstated previously extinguished cocaine seeking behavior. In the second experiment intra-BNST infusions of the PAC1/VPAC2 antagonist, PACAP 6-38 (1 μg; 0.5 μl per side) blocked stress-induced reinstatement. Hence, stressor exposure (5 sec 2mA footshock) caused significant reinstatement of cocaine seeking behavior, which was blocked by intra-BNST PACAP6-38 infusion. Overall, these data suggest that BNST PACAP systems mediate stress-induced reinstatement to drug seeking. Understanding the neuropharmacology of BNST PACAP in stress-induced reinstatement and the role of PACAP systems may lead to viable targets for relapse prevention.

When breast tumor cells encounter stress due to cancer therapies, they may enter a dormant state, escaping from treatment-induced apoptosis. Dormant cells may eventually regain proliferative capabilities and cause recurrent metastatic disease, which is the leading cause of mortality in breast cancer patients. We sought to determine if a high dose of radiation therapy (RT) or combined chemo-immunotherapy, with and without the blockade of autophagy by chloroquine (CQ), could overcome treatment-induced tumor dormancy or relapse. We found that autophagy contributes in part to treatment-induced tumor dormancy. We also found that three therapeutic strategies were successful in inhibiting or preventing tumor relapse. These include: 18Gy/day RT, chemotherapy combined with the blockade of autophagy, and combined chemo-immunotherapy. Follow-up studies are needed to determine the feasibility of preventing tumor relapse by prolonging tumor dormancy versus eliminating dormant tumor cells.

The main goal of this essay is to show that lifestyle has an influence on alcohol addiction and its process, but most importantly on maintaining abstinence after a treatment. From various research, which where made, is clear, that most of relapses are directly related to lifestyle of addicts (or at least to its parts such as health, social situation, economic status, hobbies etc.). That is why it is important to work on a lifestyle change during a treatment so that the addicts are in balance during the abstinence and are not exposed to risky situations which they do not know how to react to and deal with them. There is Relapse Prevention to learn these pocedures and it should be applied also during the treatment and after. Part of my essay is qualitative research, which should reflect previously mentioned phenomenons among ten respondents of detoxification centre, who experienced relapses before. I tried to prove that lifestyle and its disorders influence and increase the potential of relapse after completed treatment and it is necessary to change it during abstinence.

The study deals with the predictive criteria of relapse of sexually deviant patients and builds on the previous older studies that have attempted to map out what are the significant predictors of relapsing by sexual deviants after successful completion of inpatient care. The aim was to verify whether reported predictors are really important for relapsing paraphiliaks. Given factors were age at onset of patients in inpatient care, employment, housing, education, family background and relationships in the family, relationships, sexual and nonsexual offenses (last sexology treatment), failure to complete treatment (running away from protective sexology treatment), sexology diagnosis and psychiatric diagnosis. The results of the work have been compared both with older Czech researches that have been conducted on this topic at the end of the 80ies, but also with foreign research. These works on recidivism of sexual offenders are presented in the theoretical part of this study, together with the definition of the concept of deviance and treatment options in the Czech Republic and abroad. Katamnestic research was conducted on patients who have successfully completed the institutional protective sexology treatment at the Psychiatric Hospital Prague Bohnice (since the inception of sexology department in...

Subject: How a drogue ex-user see a period of his addiction. Abstract: The work focus on the actual situation of ex-users. These people were fighting with an addiction and now they are a part of the majority society. The qualitative research, inspired by a grounded theory, try to approach their point of view. What they think about their past and how do they see their relations with a family, friends and a vicinage. Not just in that period but nowadays as well. Relationships with home-folks are stigmatized by a degree of drug addiction. The smaller addiction the smaller losses. Once a drug user is falling down into the drug trap, the losses depend on how deep he will fall. On the bottom there are no friends, no family, just nothing. Some of the drug users do not fall to the bottom, they do their decision earlier. We call that decision a break point ( a moment when they decide to abstain). A break point comes individually and it is connected to an "interior border" of each person. Anyway, it is a moment, when an individual concerned decide to live a different way. It is a very intense moment and very fundamental for a abstinence success. We have used an interview to study not just this phenomenon. During the interview we tried to find out how a life looks with and without an addiction. Key words: addiction,...

Foundations: Alcohol consumption affects negatively the whole organism and the organ that is damaged most often is liver. Liver diseases start developing subsequently. A whole range of diseases, from the lighter forms such as steatosis to a serious, life-shortening illness - the liver cirrhosis, can be caused by alcohol consumption. The degree of alcohol impact on liver depends on its dosage and length of usage. The degree of liver damage does not depend on the kind of the alcoholic drink but rather on its dosage. An important role in development of serious forms of liver diseases is played by other risk factors (mostly genetic) besides volume of consumed alcohol (Schiff et al, 2007). Therapeutic procedures for people with alcoholic liver damages include above all change of lifestyle including abstinence from alcohol consumption, ideally complete abstinence from cigarette smoking, weight reduction if indicated, and nutritional and farmacological therapy. Liver transplant surgery is required in serious cases. The main aim of my thesis is to chart and describe whether the quality of patients' everyday lives improves after liver transplant. In particular, I intend to focus on the physical, mental, and social areas of their lives. Another objective of this paper is to find out whether the patients'...