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Sixty alcoholic and 60 nonalcoholic women were compared on six variables chosen to represent the biological, psychological, and sociocultural approaches to alcoholism research. Significant differences were found between the two groups on all variables. Compared to the nonalcoholic women, the alcoholic women had more alcoholic relatives, had been treated for more health problems, were more depressed, had lower levels of self-esteem, were more deeply invested in meeting stereotypical feminine sex-role expectations, and perceived themselves as less successful in meeting the expectations of significant others. Scores on four variables--depression, number of alcoholic relatives, treatment for health problems, and meeting others' expectations--made linear contributions to discriminating the groups. These results suggest that alcoholism in women is a multifactorial problem and that theory-guided research may be more useful in elucidating the etiology of female alcoholism than unidimensional and/or atheoretical approaches. Clinical implications of the results are also discussed.
J Subst Abuse 1988
PMID:Biopsychosocial discriminators of alcoholic and nonalcoholic women. 248 80

One hundred cocaine abusers were evaluated with a full battery of psychological tests (Shipley Institute of Living Scale, MMPI, Millon Clinical Multiaxial Inventory, Rorschach, Beck Depression Inventory) by Norman J. Lesswing, Ph.D. These patients were treated in a 6-week program on a chemical dependency unit at the Benjamin Rush Center in Syracuse, New York, from 1984 to 1986. Information was gathered across a wide range of demographic and clinical variables (age, sex, marital status, race, education, family history, and cross addiction), and psychological features (MMPI profile types, intellectual functioning, personality disorders, depression ratings, and Rorschach variables). Results are presented through comprehensive description of the sample across these patient and psychometric characteristics with use of summary statistics. Support was not found for the notion that cocaine abusers are self-medicating affective disorders, but evidence for high frequency of personality disorders was revealed. Cross addiction and abuse of alcohol and other substances were very frequent.
J Subst Abuse Treat 1989
PMID:Inpatient cocaine abusers: an analysis of psychological and demographic variables. 270 73

The mean self-reinforcement score of 62 chronic alcoholics was significantly lower than the mean score of 18 age- and sex-matched normal controls. However, both groups scored higher than the mean score of 300 normal undergraduates in a study by Heiby: low self-reinforcement scores do not seem to be unique to alcoholics. In alcoholics, the self-reinforcement scores were significantly correlated with the majority of the MMPI clinical scales: the highest coefficients were with the Social Introversion, Depression, Psychasthenia, and Schizophrenia--lower self-reinforcement level was associated with more psychopathology.
Adv Alcohol Subst Abuse 1989
PMID:Self-reinforcement scores of alcoholics. 271 15

The relationship of parental closeness to current behavior and related psychopathological indices is studied among alcoholics. Seventy alcoholics from an inpatient treatment unit and thirty medical inpatients were given a battery of alcohol related measures. These measures included a scale assessing the psychological distance from mother and father, a social closeness measure, an index of anger, a locus of control measure, along with basic alcohol-related information. In addition, the alcoholic sample was given psychometric measures of depression and cognition. Results show that perceived distance from parents is greater among alcoholics than medical patients. Comparison analyses of mother and father distance scores on the study variables of alcohol-related and psychometric measures yielded only a few differences. Correlational analyses showed, however, that distance from mother and father is related to parental alcohol abuse and parents not being at home but not to current behavior (except anger).
Adv Alcohol Subst Abuse 1989
PMID:Distance from mother and father among alcoholics. 271 16

Early studies examining the relationship of personality disorders to opiate addiction attempted to define an "addictive personality." Later research found that personality disorders in opiate addicts were common but heterogeneous. We examined whether different comorbid personality disorders have prognostic specificity. Rates of depression and alcoholism as well as assessments of specific problems were measured in a 2.5-year follow-up of 150 treated opioid addicts. Using DSM-III criteria, we found that borderline personality disorder predicted more depressive disorders and alcoholism at follow-up; yet greater recovery from these disorders was seen. Borderline patients had more severe psychiatric problems as measured by the Addiction Severity Index. Other ASI outcomes differed by personality disorder; antisocial addicts had more legal problems, and narcissistic addicts had more medical problems. These results suggest that treatment for opiate addicts be tailored to the specific needs of the patients, which can be predicted, in part, by their comorbid personality disorder diagnosis.
J Subst Abuse Treat 1989
PMID:Personality disorders in opiate addicts show prognostic specificity. 279 5

Psychotropic agents are most helpful to opiate addicts when used to treat co-existing psychopathology. While such agents may not impact directly on the addiction itself, they might help keep patients available for rehabilitation efforts since concomitant severe psychopathology has been associated with poorer outcome. Neuroleptics for schizophrenia and lithium for manic disorders are generally agreed upon. Minor tranquilizers for anxiety and MAO inhibitors for depression may be too risky for this population. Tricyclic antidepressants clearly have a role in treating major depression in addicts but the lability of the syndrome over time argues against their routine use until the depression has persisted at least 3 months.
Adv Alcohol Subst Abuse
PMID:The use of psychotropic drugs in the treatment of compulsive opiate abusers: the rationale for their use. 287 Jun 23

Former opiate addicts (even those who have remained drug-free for several months) often report symptoms of opiate withdrawal (eg. nausea, gooseflesh, etc.) and/or intense drug craving when exposed to stimuli previously associated with the act of drug injection. This phenomenon of learned or "conditioned" withdrawal/craving is widely reported and is potentially important in explaining relapse to drug use. However, no effective, clinically applicable intervention had been available to "extinguish" these conditioned phenomena. An ongoing project to develop such an intervention has revealed: Conditioned withdrawal and craving are pervasive among both methadone maintained patients (even though actual physical withdrawal is blocked) and drug-free patients even after 30 days of inpatient Therapeutic Community rehabilitation. Conditioned withdrawal and craving can be effectively extinguished in an intensive, three-week, inpatient procedure. Emotional states such as anger, depression and anxiety can elicit and exacerbate conditioned withdrawal and craving. They may also act as an integral part of a conditioned stimulus complex. The authors discuss the problems associated with turning a laboratory-based procedure into a clinical intervention. Encouraging preliminary results from an integrated treatment "package" are presented.
J Subst Abuse Treat 1986
PMID:Extinguishing conditioned responses during opiate dependence treatment turning laboratory findings into clinical procedures. 287 32

A growing body of evidence points to the importance of life stressors and social resources in the development and course of alcoholism and other substance abuse disorders. This article describes the Life Stressors and Social Resources Inventory (LISRES), which provides an integrated assessment of life stressors and social resources in eight domains: physical health, home/neighborhood, financial, work, spouse/partner, children, extended family, and friends. The indices were developed on data obtained at two points in time 18 months apart from four demographically comparable groups: alcoholic patients, depressed patients, arthritic patients, and non-problem-drinking adults. As expected, alcoholic patients reported more acute and chronic stressors and fewer social resources than did non-problem-drinking adults. More important, the indices were predictively related to changes in alcohol consumption, drinking problems, depression, and self-confidence. Procedures such as the LISRES have some potential clinical and research applications and may be helpful in examining the process of recovery and relapse in substance abuse disorders.
J Subst Abuse
PMID:Assessing life stressors and social resources: applications to alcoholic patients. 298 Aug 65

Buspirone (Buspar) is a azaspirodecanedione anxiolytic agent. Its mechanism of action is extremely complex, but current investigations indicate that its main neuropharmacologic effects are mediated by the 5-HT1A receptors. Other neuroreceptor systems could be involved, as buspirone displays some affinity for DA2 autoreceptors and 5-HT2 receptors. It has been proposed that inhibition of synthesis and release of serotonin result through the combined interactions of neuroreceptors and secondary messenger systems. This action leads to inhibition of the firing rate of 5-HT-containing neurons in the dorsal raphe. From this novel profile, that differs from that of the benzodiazepines, buspirone lacks anticonvulsant and muscle-relaxant properties, and causes only minimal sedation. The drug is rapidly absorbed after oral administration, with a mean bioavailability of 3.9%. After a single oral dose, the mean elimination half-life is 2.1 hours. Buspirone is mainly bound to albumin and alpha 1-acid glycoprotein. It is metabolized to an active metabolite 1-(2-pyrimidinyl) piperazine (1-PP). The mean elimination half-life of 1-PP is 6.1 hours. Buspirone is indicated in the treatment of generalized anxiety disorders. Its efficacy is comparable to the benzodiazepines. Its use in depression and panic disorders requires further investigation. When combined with alcohol or given alone, psychomotor impairment was not detected. Abuse, dependence, and withdrawal symptoms have not been reported. The frequency of adverse effects is low, and the most common effects are headaches, dizziness, nervousness, and lightheadness. Buspirone should be added to drug formularies and could represent a significant addition in psychopharmacology.
 ...
PMID:Buspirone: an update on a unique anxiolytic agent. 304 84

Alcohol and drug addiction are defined in behavioral terms as the preoccupation with, compulsive use of, and relapse to drugs that are descriptive and confirmatory. The basis of addiction may involve neurochemical changes in the brain that distort and redirect the drive states (instincts). Tolerance and dependence may only be incidentally associated with addiction as a result of a nonspecific adaptation by the body to the presence of a drug. The cellular adaptation may be the same in all organs. Addiction to alcohol and drugs may have no specific relationship to tolerance and dependence. Addiction occurs in the absence of observable tolerance and dependence to alcohol and drugs. Alcohol and drug addiction is probably more complex than tolerance and dependence. Addiction is difficult to study because of the variability of behavioral phenomena and the underlying intricacies of the neurosubstrates. Tolerance and dependence are still useful as they are indicators of drug use. It is a misconception that long term chronic use is necessary for tolerance and dependence to develop. Some studies have shown that tolerance can develop within hours and days to a single dose of alcohol or other drugs. Anxiety, depression and insomnia can occur after a single dose of ethanol in humans. These symptoms of withdrawal from the alcohol or drug constitute dependence. Redefining the criteria for addiction tolerance and dependence to alcohol and other drugs may be in order. A neurochemical model may provide a more definitive and uniform basis for considering addiction, tolerance, and dependence to alcohol and drugs.
J Subst Abuse Treat 1987
PMID:The relationship of addiction, tolerance, and dependence to alcohol and drugs: a neurochemical approach. 332 55


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