| 1. |
- Forsström, David, 1981-, et al.
(författare)
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Feasibility and results of a pilot online survey to examine prevalence of gambling and problem gambling among Swedish substance abuse inpatients in compulsory care
- 2024
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Ingår i: Cogent Psychology. - : Taylor & Francis. - 2331-1908. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- The comorbidity between problem gambling and substance use/abuse is high in many populations previously studied. However, the occurrence of problem gambling among individuals with substance abuse has not been thoroughly studied, which is especially true for individuals in inpatient or compulsory care. The present early-stage study explored the presence of gambling and problem gambling among inpatients in compulsory care in Sweden who has been court-ordered to treatment for their substance abuse (alcohol and/or drugs). The study furthermore investigates the use of preventive measures and treatment seeking. The most effective strategy to recruit participants (no incentive, incentive and incentive and face-to-face recruitment) was also explored. Twenty-one participants were recruited and seven of them had at-risk or problem gambling and none of them had accessed treatment. The best way of recruiting was to offer a gift certificate and inform about the study face-to-face. The implications are that individuals in compulsory care for substance abuse need to be screened for problem gambling, that recruitment for studies in this population is best carried out by offering incentives and educational efforts and that it might be beneficial for the clients in compulsory care to be offered gambling treatment.
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| 2. |
- Hedman, Linnea, et al.
(författare)
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Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms
- 2018
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Ingår i: Jama Network Open. - : American Medical Association (AMA). - 2574-3805. ; 1:3
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. OBJECTIVES To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23 753 participated (response rate, 50.1%). MAIN OUTCOMES AND MEASURES Electronic cigarette use, smoking habits, and respiratory symptoms. RESULTS Of 30 272 participants (16 325 women [53.9%]). 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%). 30 to 39 years; 5082 (16.8%). 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371(14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%). and e-cigarette use was more common among men (275 of 12 347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14 022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers. 350 of 3566 (9.8%; 95% CI, 8.8%10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15 832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P < .001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n = 525). 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P < .001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI. 1.12-1.62); age groups 20 to 29 years (OR. 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44). and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR. 2.37; 95% CI, 1.73-3.24); and current smoking (OR. 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.
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| 3. |
- El Ansari, Walid, et al.
(författare)
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Prevalence and socio-demographic, academic, health and lifestyle predictors of illicit drug/s use among university undergraduate students in Finland
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14, s. 1-20
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Tidskriftsartikel (refereegranskat)abstract
- Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P < 0.001), singles (AOR 0.51, P < 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P < 0.001), heavy episodic drinking (AOR 2.38, P < 0.001) and possible alcohol dependency (AOR 2.55, P < 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38–3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
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| 4. |
- Jemberie, Wossenseged Birhane, 1985-, et al.
(författare)
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Substance Use Disorders and COVID-19 : Multi-Faceted Problems Which Require Multi-Pronged Solutions
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.
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| 5. |
- Boson, Karin, 1984, et al.
(författare)
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Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences
- 2022
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Ingår i: Substance Abuse Treatment, Prevention, and Policy. - : Springer Science and Business Media LLC. - 1747-597X. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored. Methods A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed. Results The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6-10 co-occurring risk factors. Conclusions Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.
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| 6. |
- Billsten, Johan, 1971-, et al.
(författare)
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Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study
- 2018
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Ingår i: Journal of Substance Abuse Treatment. - Amsterdam : Elsevier. - 0740-5472 .- 1873-6483. ; 84, s. 9-16
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Tidskriftsartikel (refereegranskat)abstract
- Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. Aim The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. Design and recruitment The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Statistics Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. Results A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α = 0.67 to α = 0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α = 0.64), institutional resources (α = 0.52), staff attributes (α = 0.76), and organizational climate (α = 0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n = 614), Profile 2 (n = 934), and Profile 1 (n = 246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile. Conclusion In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users. © 2017
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| 7. |
- Tedgård, Eva, et al.
(författare)
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Struggling with one’s own parenting after an upbringing with substance abusing parents
- 2018
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.
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| 8. |
- Cruce, Gunilla, et al.
(författare)
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Recovery-promoting Care as Experienced by Persons with Severe Mental Illness and Substance Misuse
- 2012
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Ingår i: International Journal of Mental Health and Addiction. - : Springer Science and Business Media LLC. - 1557-1874 .- 1557-1882. ; 10:5, s. 660-669
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores recovery-promoting care as experienced by persons with concomitant severe mental illness and substance misuse. Sixteen in-depth interviews, based on an interview guide concerning their experiences of health, life situation and care, were held with eight participants in an outpatient treatment programme. The analysis aimed to identify themes reflecting the diversity and complexity of the phenomenon recovery-promoting care. Six themes emerged: "entirety", "participation and reciprocal relations", "stability", "symptom control", "mindfulness", and "dignity and autonomy". The participants reported that care conveying experiences of meaningfulness and providing empowerment increased their motivation and their capacity to take an active part in the recovery process. The findings of the study underscore the importance of incorporating the patients' perspectives on what promotes recovery when offering mental health services.
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| 9. |
- Blindow, Katrina J., et al.
(författare)
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Gender-based harassment in Swedish workplaces and alcohol-related morbidity and mortality : A prospective cohort study
- 2023
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 49:6, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The study investigated experiences of different types of work-related gender-based harassment (GBH), specifically sexual and gender harassment, as risk factors for alcohol-related morbidity and mortality (ARMM).Methods: Information about experiences of (i) sexual harassment (SH-I) and (ii) gender harassment (GH-I) from inside the organization and (iii) sexual harassment from a person external to the organization (SH-E) were obtained from the Swedish Work Environment Survey 1995–2013, a biannual cross-sectional survey, administered to a representative sample of the Swedish working population. The survey responses from 86 033 individuals were connected to multiple registers containing information about alcohol-related diagnoses, treatment, or cause of death. Cox proportional hazard models were fitted to assess hazard ratios (HR) of incident ARMM during a mean follow-up of eight (SH-I and GH-I) and ten (SH-E) years.Results: A higher prospective risk estimate of ARMM was found among participants who reported experiences of SH-E [HR 2.01, 95% confidence interval (CI) 1.61–2.52], GH-I (HR 1.33, CI 1.03–1.70), or SH-I (HR 2.37, CI 1.42–3.00). Additional analyses, distinguishing one-time from reoccurring harassment experiences, indicated a dose–response relationship for all three harassment types. Gender did not modify the associations. Under the assumption of causality, 9.3% (95% CI 5.4–13.1) of the risk of ARMM among Swedish women and 2.1% (95% CI 0.6–3.6) among Swedish men would be attributable to any of the three types of GBH included in this study.Conclusions: Experiences of GBH in the work context may be a highly relevant factor in the etiology of ARMM.
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| 10. |
- Wall, Håkan, et al.
(författare)
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Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents With Alcohol Use Problems : Randomized Controlled Trial
- 2024
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Ingår i: Journal of Medical Internet Research. - 1438-8871. ; 26:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. Objective: This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. Methods: Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). Results: For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d=–0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. Conclusions: The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence.
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