Interventions that focus on changing environmental contingencies through exposure to alternative reinforcers, in order to provide a lifestyle that is more rewarding than one that includes high levels ...of alcohol consumption, have been shown to be highly efficacious. The objective of this study was to examine the relationship between activity engagement in terms of pleasant substance related and non-substance activities (SRA/non-SRA) and levels of alcohol consumption among university students. A study involving 286 students looked specifically at levels of alcohol consumption and non-SRA/SRA. Levels of alcohol consumption were strongly and positively correlated with SRA (
r
= 0.69), but also with non-SRA (
r
= 0.28). A finer-grained analysis showed that the relationship between positive SRA and level of alcohol consumption is weakened by the inclusion of non-SRA as a third variable. Non-SRA seem to attenuate the level of alcohol consumption in the context of SRA. Alcohol consumption among university students could plausibly be reduced by focusing on promoting appealing and healthy non-substance-related rewarding activities.
Objectives
To assess the image quality of T2-weighted (T2w) magnetic resonance imaging of the prostate and the visibility of prostate cancer at 7 Tesla (T).
Materials & methods
Seventeen prostate ...cancer patients underwent T2w imaging at 7T with only an external transmit/receive array coil. Three radiologists independently scored images for image quality, visibility of anatomical structures, and presence of artefacts. Krippendorff’s alpha and weighted kappa statistics were used to assess inter-observer agreement. Visibility of prostate cancer lesions was assessed by directly linking the T2w images to the confirmed location of prostate cancer on histopathology.
Results
T2w imaging at 7T was achievable with ‘satisfactory’ (3/5) to ‘good’ (4/5) quality. Visibility of anatomical structures was predominantly scored as ‘satisfactory’ (3/5) and ‘good’ (4/5). If artefacts were present, they were mostly motion artefacts and, to a lesser extent, aliasing artefacts and noise. Krippendorff’s analysis revealed an α = 0.44 between three readers for the overall image quality scores. Clinically significant cancer lesions in both peripheral zone and transition zone were visible at 7T.
Conclusion
T2w imaging with satisfactory to good quality can be routinely acquired, and cancer lesions were visible in patients with prostate cancer at 7T using only an external transmit/receive body array coil.
Key Points
•
Satisfactory to good T2-weighted image quality of the prostate is achievable at 7T.
•
Periprostatic lipids appear hypo-intense compared to healthy peripheral zone tissue at 7T.
•
Prostate cancer is visible on T2-weighted MRI at 7T.
Background: The relationship between the use of alcohol and aggression is complex and represents major public health issues. Delving into the nature of this association is vital, since various ...underlying factors may contribute to the expression of aggression. Objective: This study examined trait aggression by assessing correlates and, subsequently, the unique contribution of alcohol craving, and dysfunctional impulsivity, by means of correlational and mediational analyses. Methods: Forty inpatient detoxified alcohol-dependent patients were recruited. These participants completed the Desire for Alcohol Questionnaire (DAQ), Dickman Impulsivity Inventory (DII), and the Aggression Questionnaire (AQ). Results: The findings indicated that aggression, dysfunctional impulsivity, and alcohol craving were all positively intercorrelated. The association between dysfunctional impulsivity and aggression was robust. The mediational analyses yielded that craving partially mediated this relationship, although not very substantial. Conclusion: It was shown that impulsivity, as a personality characteristic, is strongly associated with aggressive behaviors, whereby the impact of craving on the relationship between impulsivity and trait aggression in alcohol-dependent inpatients was weak. Scientific Significance: Since it has been posited that factors such as impulsivity and craving may contribute to the lucid association between substance use and aggression, these findings mirror previous research on stimulant users and, subsequently, substantiates that craving exerts only a minor weight on the strong impulsivity-aggression relationship.
A study is made of a two-dimensional stochastic system with small stochastic fluctuations arising in population biology. At the boundary of the state space the diffusion matrix becomes singular. By ...an asymptotic analysis, expressions are derived that determine the probability of exit at each of the two boundaries and the expectation and variance of the exit time. These expressions contain constants that can be computed numerically.
ABSTRACT
Aims Many individuals with substance use disorders are opposed to seeking formal treatment, often leading to disruptive relationships with concerned significant others (CSOs). This is ...disturbing, as untreated individuals are often associated with a variety of other addiction‐related problems. Community Reinforcement and Family Training (CRAFT) provides an option to the more traditional treatment and intervention approaches. The objective of this systematic review was to compare CRAFT with the Alcoholics Anonymous/Narcotics Anonymous (Al‐Anon/Nar‐Anon) model and the Johnson Institute intervention in terms of its ability to engage patients in treatment and improve the functioning of CSOs.
Methods The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were consulted. Four high‐quality randomized controlled trials were identified, with a total sample of 264 CSOs. Data were synthesized to quantify the effect with 95% confidence intervals, using the random effects model.
Results CRAFT produced three times more patient engagement than Al‐Anon/Nar‐Anon relative risk (RR) 3.25, 95% confidence interval (CI) 2.11–5.02, P < 0.0001; numbers needed to treat (NNT) = 2 and twice the engagement of the Johnson Institute intervention (RR 2.15, 95% CI 1.28–3.62, P = 0.004; NNT = 3). Overall, CRAFT encouraged approximately two‐thirds of treatment‐resistant patients to attend treatment, typically for four to six CRAFT sessions. CSOs showed marked psychosocial and physical improvements whether they were assigned to CRAFT, Al‐Anon/Nar‐Anon or the Johnson Institute intervention within the 6‐month treatment window.
Conclusion CRAFT has been found to be superior in engaging treatment‐resistant substance‐abusing individuals compared with the traditional programmes.
Background: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. ...The effects of this compound are probably more favorable when combined with a psychosocial intervention such as the Community Reinforcement Approach (CRA). Aim: To explore the effects of a combination therapy (naltrexone plus CRA treatment) and the predictive value of sociodemographic and psychopathologic characteristics. Method: Using a before-and-after design, heroine addicts (n = 24) receiving a combined naltrexone plus CRA treatment are compared with a group (n = 20) on methadone maintenance therapy (reference group). Results: Over a period of 6 months, 58% (14/24) did not relapse, after 1 year at least 55% (12/22) still met the initial goal of continuous abstinence. At baseline, the treatment group and the reference group were similar on nearly all variables except for the number of times clients were arrested. Within the treatment group, a comparison was made between the continuous abstinent and those who relapsed into frequent opioid use. Differences were significant in the cluster-B personality disorders and in polydrug users. Conclusion: The combination of naltrexone plus intensive CRA in an outpatient setting appears to be promising. A high score on cluster-B and polydrug use is associated with relapse.
The community reinforcement approach (CRA) has been applied in the treatment of disorders resulting from alcohol, cocaine and opioid use. The objectives were to review the effectiveness of (1) CRA ...compared with usual care, and (2) CRA versus CRA plus contingency management. Studies were selected through a literature search of RCTs focusing on substance abuse. The search yielded 11 studies of mainly high methodological quality. The results of CRA, when compared to usual care: there is strong evidence that CRA is more effective with regard to number of drinking days, and conflicting evidence with regard to continuous abstinence in the alcohol treatment. There is moderate evidence that CRA with disulfiram is more effective in terms of number of drinking days, and limited evidence that there is no difference in effect in terms of continuous abstinence. Furthermore, there is strong evidence that CRA with ‘incentives’ is more effective with regard to cocaine abstinence. There is limited evidence that CRA with ‘incentives’ is more effective in an opioid detoxification program. There is limited evidence that CRA is more effective in a methadone maintenance program. Finally, there is strong evidence that CRA with abstinence-contingent ‘incentives’ is more effective than CRA (non-contingent incentives) treatment aimed at cocaine abstinence.
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