Global strategy for asthma management and prevention

The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.

The Self-medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

http://library.um.ac.id/free-contents/downloadpdf.php/buku/focus-groups-as-qualitative-research-by-morgan-david-l-11476.pdf

Focus groups as qualitative research / by Morgan, David L.

This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements (pushing a joystick) in response to alcohol pictures, or to one of two control conditions, in which they received no training or sham training. Four brief sessions of experimental CBM preceded regular inpatient treatment. In the experimental conditions only, patients’ approach bias changed into an avoidance bias for alcohol. This effect generalized to untrained pictures in the task used in the CBM and to an Implicit Association Test, in which alcohol and soft-drink words were categorized with approach and avoidance words. Patients in the experimental conditions showed better treatment outcomes a year later. These findings indicate that a short intervention can change alcoholics’ automatic approach bias for alcohol and may improve treatment outcome.

/pdf/retraining-automatic-action-tendencies-changes-alcoholic-5e3oci2a3d.pdf

Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1524-4733.2004.71273.x

Assessment of Health-Related Quality of Life in Children: A Review of Conceptual, Methodological, and Regulatory Issues

To date, little research has endeavoured to discriminate between cognitive and somatic dimensions of trait anxiety and, consequently, it remains uncertain whether these anxiety dimensions can be reliably distinguished at the trait level. The four studies presented here support the validity of the distinction between cognitive and somatic anxiety at both state and trait levels. The research involved the development and validation of a self-report questionnaire, the State-Trait Inventory for cognitive and somatic anxiety (STICSA). The nature of the anxiety dimensions assessed by this new measure was then investigated. The results indicate that the state scales of this new measure assess the degree of cognitive and somatic anxiety experienced at a particular point in time. The trait scales of the STICSA predict the situations in which different individuals will display elevations in cognitive and somatic state anxiety. Trait cognitive and somatic anxiety are indeed distinct constructs that can be reliably and validly assessed. Theoretical and applied implications of this finding are discussed.

Distinguishing cognitive and somatic dimensions of state and trait anxiety : development and validation of the state-trait inventory for cognitive and somatic anxiety (STICSA)

Background: The General Health Questionnaire (GHQ) is a measure of current mental wellbeing that has been extensively validated with adults. The instrument has also been used with adolescents.Objective: (i) To assess the psychometric properties of the GHQ-12 among school students in grades 7–10; (ii) to validate it against other psychological tests; and (iii) to suggest a threshold score.Method: The survey was conducted in single sex and mixed schools from the state and private system in Perth, Western Australia. The survey contained the GHQ-12 and measures of anxiety, depression, self-esteem, stress, generalized self-efficacy, social desirability and negative affectivity.Results: There were 336 students (female 55%) with an age range of 11–15 years (median 13). The GHQ showed good internal consistency (alpha 0.88). Girls had higher mean GHQ-12 scores than boys (F (1,326) 15.0, p < 0.001) and scores for both genders increased with school grade (F (3,326) 4.2, p < 0.01). Multiple linear regression showed t...

Validity and psychometric properties of the General Health Questionnaire-12 in young Australian adolescents.

The aim of this study was to compare the self-reported health-related quality of life (HRQL) of children and adolescents with diabetes, asthma or cystic fibrosis (CF) with the HRQL of a large community sample, to assess the extent to which the HRQL of the children and adolescents with chronic illness changes over time, and to examine the consistency of changes in different HRQL domains. One hundred and twenty three young people aged 10–16 years with asthma, diabetes, or CF were recruited from specialist paediatric clinics. Children rated their HRQL using the Child Health Questionnaire (CHQ) and three disease-specific measures at baseline, 6, 12, 18 and 24 months post-baseline. In several areas, the HRQL of children with chronic illness was significantly worse than that of children in the community sample. Over the 2 years of the study, although children with asthma and diabetes did not report significant changes in CHQ scores rating their physical health, they reported significant improvements in scores rating the extent to which health problems interfered with physical and family activities. CHQ scores describing their physical health reported by children with CF declined significantly but there was no significant change in scores rating interference with physical and family activities.

Health-related quality of life of children and adolescents with chronic illness--a two year prospective study.

Aims The aim of study 1 was to develop a three-factor Approach and Avoidance of Alcohol Questionnaire (AAAQ), designed to assess mild and intense inclinations to drink, as well as inclinations to avoid drinking. The aims of study 2 were to cross-validate the AAAQ with an independent sample and to test the goodness-of-fit of three models of craving for alcohol: (a) the traditional unidimensional model; (b) a two-dimensional, approach–avoidance ambivalence model; and (c) an expanded two-dimensional neuroanatomical model that retains avoidance, while positing a threshold that partitions approach into two distinct levels and relates all three factors involved in craving to brain pathways associated with inhibitory processes, reward and obsessive–compulsive behaviour, respectively.



Design, setting and participants  The survey was administered to 589 Australian university students (69% women) in study 1 and to 523 American university students (64% women) in study 2.



Measurements  Inclinations to drink and to not drink (AAAQ), drinking behaviour (quantity and frequency), drinking problems (Young Adult Alcohol Problems Screening Test; YAAPST) and readiness for change (Stages of Change Readiness and Treatment Eagerness Scale; SOCRATES).



Findings  The expanded two-dimensional neuroanatomical model provided the best fit to the data. The AAAQ explained a substantial proportion of the variance in drinking frequency (41–53%), drinking quantity (49–60%) and drinking problems (43%). AAAQ profiles differed as a function of drinking-related risk, and the three AAAQ scales differentially predicted readiness for change.



Conclusions  Approach and avoidance inclinations toward alcohol are separable constructs, and their activation may not be invariably reciprocal. Craving can be defined as the relative activation of substance-related response inclinations along these two primary dimensions. There may be a threshold of intensity that separates mild from intense approach inclinations.

Comparison of three models of alcohol craving in young adults: a cross-validation.

The General Health Questionnaire-12 [8] (GHQ-12) has been
extensively validated with adults, but its validity with young
adolescents is questionable. Further, the dimensionality of the
survey remains in doubt. Confirmatory factor analysis was used
to compare five competing models for the GHQ-12 using an adult
sample (n = 235). The best model was then applied to a young
adolescent dataset (n = 236, aged 11–15): all fit indices were
“adequate” or “good” (i. e. Comparative Fit Index 0.97).
Measurement invariance for the combined data was demonstrated
for item loadings and factor covariance but not for error
variance. These data provide support for the validity of the
survey with young adolescents and suggest that adolescents
interpret the GHQ-12 in a similar manner to adults.

Davina J. French

Papers

Distinguishing cognitive and somatic dimensions of state and trait anxiety : development and validation of the state-trait inventory for cognitive and somatic anxiety (STICSA)

Validity and psychometric properties of the General Health Questionnaire-12 in young Australian adolescents.

Health-related quality of life of children and adolescents with chronic illness--a two year prospective study.

Comparison of three models of alcohol craving in young adults: a cross-validation.

Measurement invariance in the General Health Questionnaire-12 in young Australian adolescents.