scispace - formally typeset
Search or ask a question
Journal ArticleDOI

A programme of intervention for substance abuse following traumatic brain injury.

01 Apr 1995-Brain Injury (Taylor & Francis)-Vol. 9, Iss: 3, pp 221-236
TL;DR: Clinical experience and initial programme evaluation results suggest that substance abuse and vocational rehabilitation goals can be effectively attained using this model of service delivery.
Abstract: This article describes a pilot programme initiated in 1991 to address the problems of substance abuse among persons who have experienced traumatic brain injury (TBI). The model of treatment is comm...
Citations
More filters
Journal ArticleDOI
TL;DR: This manuscript reviews literature on pre- and post-Injury substance use patterns, abuse risk factors, and dangers of post-injury use and discusses the need for quantitative assessment, records review, corroboration, and long-term monitoring.
Abstract: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Accidents are a major cause of brain injury, and many accidents are alcohol or drug related. Evidence indicates that a vast majority of victims test positive for alcohol or illicit drugs at the time of hospital admission. Research also suggests that a majority of TBI survivors were moderate to heavy drinkers pre-injury. This manuscript reviews literature on pre- and post-injury substance use patterns, abuse risk factors, and dangers of post-injury use. Assessment is discussed in detail with information provided on the need for quantitative assessment, records review, corroboration, and long-term monitoring. Information is also provided on critical features of treatment, prevention, and education, and on the role of psychologists in substance abuse assessment and treatment. The manuscript concludes with a section addressing issues, questions, and concerns commonly encountered by clinicians.

151 citations


Cites background from "A programme of intervention for sub..."

  • ...Corrigan, Lamb-Hart, and Rust (1995a) described a community-based model of intervention called the Traumatic Brain Injury and Substance Abuse Vocational Rehabilitation Centre, or TBI Network, which provides services for individuals with co-morbid TBI and substance abuse problems....

    [...]

Journal ArticleDOI
TL;DR: The literature on substance abuse after TBI is reviewed to explore the state of knowledge on TBI as a risk factor for substance abuse and an emerging literature suggests mild TBI may cause subtle impairments in cognitive, executive, and decision‐making functions that are often poorly recognized in early diagnosis and treatment.
Abstract: Traumatic brain injury (TBI) is a leading cause of mortality and morbidity among young adults. Substance abusers constitute a disproportionate percentage of these patients. A history of substance abuse predicts increased disability, poorer prognosis, and delayed recovery. While consensus in the literature indicates that substance-abuse rates decline following injury, conflicting literature shows a significant history of brain injury in addicts. We reviewed the literature on substance abuse after TBI to explore the state of knowledge on TBI as a risk factor for substance abuse. While recent reviews regarding substance abuse in TBI patients concur that substance-abuse rates decline even after mild TBI, an emerging literature suggests mild TBI may cause subtle impairments in cognitive, executive, and decision-making functions that are often poorly recognized in early diagnosis and treatment. When combined with difficulties in psychosocial adjustment and coping skills, these impairments may increase the risk for chronic substance abuse in a subset of TBI patients. Preliminary results from veterans indicate these patterns hold in a combat-related post-traumatic stress disorder population with TBI. This increasingly prevalent combination presents a specific challenge in rehabilitation. While this comorbidity presents a challenge for the successful treatment and rehabilitation of both disorders, there is sparse evidence to recommend any specific treatment strategy for these individuals. Mild TBI and substance abuse are bidirectionally related both for risks and treatment. Further understanding the neuropsychiatric pathology and different effects of different types of injuries will likely improve the implementation of effective treatments for each of these two conditions.

146 citations

Journal ArticleDOI
TL;DR: Although drinking and alcohol-related problems decreased after TBI, there appears to be an ongoing need for prevention and intervention efforts.

127 citations

Journal ArticleDOI
TL;DR: Many persons experiencing TBI report having unmet service needs 1 year after hospital discharge, and receipt of services significantly increased satisfaction with life.
Abstract: Objectives Assess unmet needs of persons with traumatic brain injury (TBI) 1 year after hospital discharge; compare perceived need with needs based on deficits (unrecognized need); determine major barriers to services; evaluate association of needs with satisfaction with life. Participants Representative sample of 1830 community-dwelling persons with TBI aged 15 years and older. Measures Perceived and unrecognized unmet needs, barriers to receiving services, and satisfaction with life as a function of met service needs. Results 35.2% of participants reported at least 1 unmet need, 51.5% had unrecognized needs, 47% reported at least 1 barrier to receiving help. Receipt of services significantly increased satisfaction with life. Conclusions Many persons experiencing TBI report having unmet service needs 1 year after hospital discharge.

127 citations

Journal ArticleDOI
TL;DR: Seven clusters of lifetime history of TBI were characterized by the severity of injuries, age at occurrence and presence of a period of time when multiple mild injuries were incurred, often receiving no medical attention.
Abstract: Objective: Determine (a) if there are sub-groups of individuals with substance use disorders distinguished by their pattern of sustaining traumatic brain injury (TBI) over the lifetime and (b) whether sub-group membership affects current functioning.Design: Secondary analysis.Settings: Outpatient substance abuse treatment programme and state prison.Participants: Two hundred and fifty-seven participants with lifetime histories of both TBI and substance used disorder drawn from two previous studies of (a) persons in substance abuse treatment and (b) prison inmates.Main outcome measures: Ohio State University TBI Identification Method, speed of information processing, working memory, disinhibition, cognitive complaints, sociopathy and substance use disorder severity.Results: Seven clusters of lifetime history of TBI were characterized by the severity of injuries, age at occurrence and presence of a period of time when multiple mild injuries were incurred, often receiving no medical attention. Cluster members...

81 citations


Cites background from "A programme of intervention for sub..."

  • ...One hundred and three subjects were drawn from a study of clients of the OSU TBI Network, a specialized communitybased treatment programme for adults with brain injury and substance use disorders [19, 25]....

    [...]

References
More filters
Journal ArticleDOI
TL;DR: In this article, the authors summarized research on self-initiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change.
Abstract: How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages—precontemplation, contemplation, preparation, action, and maintenance—and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a transtheoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.

7,606 citations

Posted Content
TL;DR: The Satisfaction With Life Scale (SWLS) as discussed by the authors was developed to assess satisfaction with the respondent's life as a whole, which does not assess the individual's satisfaction with life domains such as health or mental health but allows subjects to integrate and weight these domains in whatever way they choose.
Abstract: The Satisfaction With Life Scale (SWLS) was developed to assess satisfaction with the respondent’s life as a whole. The scale does not assess satisfaction with life domains such as health or finances but allows subjects to integrate and weight these domains in whatever way they choose. Normative data are presented for the scale, which shows good convergent validity with other scales and with other types of assessments of subjective well-being. Life satisfaction as assessed by the SWLS shows a degree of temporal stability (e.g., 0.54 for 4 years), yet the SWLS has shown sufficient sensitivity to be potentially valuable to detect change in life satisfaction during the course of clinical intervention. Further, the scale shows discriminant validity from emotional well-being measures. The SWLS is recommended as a complement to scales that focus on psychopathology or emotional well-being because it assesses an individuals’ conscious evaluative judgment of his or her life by using the person’s own criteria.

4,255 citations

Journal ArticleDOI
12 Oct 1984-JAMA
TL;DR: Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism and their use in clinical and research studies is described.
Abstract: Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The acronym "CAGE" helps the physician to recall the questions. How these questions were identified and their use in clinical and research studies are described.

4,225 citations

Journal ArticleDOI
TL;DR: The MAST responses of 15 subjects who were found to be alcoholic in the record search were analyzed to determine where the screening failures had occurred and recommendations are made for reducing the number of such "falsė negatives."
Abstract: The Michigan Alcoholism Screening Test (MAST), devised to provide a consistent, quantifiable, structured interview instrument to detect alcoholism, consists of 25 questions that can be rapidly administered. Five groups were given the MAST: hospitalized alcoholics, a control group, persons convicted of drunk driving, persons convicted of drunk and disorderly behavior, and drivers whose licenses were under review. The validity of the MAST was assessed by searching the records of legal, social, and medical agencies and reviewing the subjects' driving and criminal records. The MAST responses of 15 subjects who were found to be alcoholic in the record search were analyzed to determine where the screening failures had occurred. Recommendations are made for reducing the number of such "falsė negatives."

3,422 citations

Book ChapterDOI
TL;DR: The Satisfaction With Life Scale (SWLS) as discussed by the authors was developed to assess satis-faction with the respondent's life as a whole, which does not assess satisfaction with life domains such as health or finances but allows subjects to integrate and weight these domains in whatever way they choose.
Abstract: The Satisfaction With Life Scale (SWLS) was developed to assess satis-faction with the respondent’s life as a whole. The scale does not assess satisfaction with life domains such as health or finances but allows subjects to integrate and weight these domains in whatever way they choose. Normative data are presented for the scale, which shows good convergent validity with other scales and with other types of assessments of subjective well-being. Life satisfaction as assessed by the SWLS shows a degree of temporal stability (e.g., 0.54 for 4 years), yet the SWLS has shown sufficient sensitivity to be potentially valuable to detect change in life satis-faction during the course of clinical intervention. Further, the scale shows discrim-inant validity from emotional well-being measures. The SWLS is recommended as a complement to scales that focus on psychopathology or emotional well-being because it assesses an individuals’ conscious evaluative judgment of his or her life by using the person’s own criteria.

3,372 citations

Trending Questions (1)
What can you do with a substance abuse certification?

Clinical experience and initial programme evaluation results suggest that substance abuse and vocational rehabilitation goals can be effectively attained using this model of service delivery.