Martha Canfield

Maternal substance use and child protection: a rapid evidence assessment of factors associated with loss of child care

This article reviews the literature on the factors associated with mothers who use substances losing care of their children. A rapid evidence assessment was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Medline and PsycINFO databases were searched to identify primary research studies published in English during January 2000-September 2016. Studies were included if they presented individual, formal support (e.g., receiving substance use treatment) or informal support (e.g., receiving social and family support) factors associated with mothers who use substances retaining or losing care of their child/ren (losing care refers to child protection services placing child/ren under the custody of a family relative, foster care, child care institution, or adoption). Evaluation studies or trials of interventions were excluded as were studies that focused on reunification or re-entering care as the outcome. Thirteen studies were included. Factors associated with mothers who use substances losing care of their children included: maternal characteristics (low socioeconomic status, younger age of first child, criminal justice involvement); psychological factors (mental health co-morbidity, adverse childhood experiences); patterns of substance use (use of cocaine prenatally, injection drug use); formal and informal support (not receiving treatment for substance use, fewer prenatal care visits, lack of social support). There is not enough evidence to determine the influence of substance use treatment in preventing mothers losing care of their children. Factors identified in this review provide the evidence to inform a prevention agenda and afford services the opportunity to design interventions that meet the needs of those mothers who are more likely to lose care of their children.

Psychometric Proprities of the Substance Use Risk Profile Scale - Brazilian Version

The Substance Use Risk Profile Scale (SURPS) was developed to screen four types of personality risk types related to substance use disorders (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking). In this study, we evaluated the psychometric proprieties and reliability of the Brazilian Portuguese adaptation of the SURPS. It was also explored in this study whether the four personality types measured by the SURPS would differentially associate with motivation for specific psychoactive substance use. A cross-sectional design study was adopted in which 325 Brazilian participants took part (mean age of 27.82, SD = 5.65). Internal consistency and factor model evaluation of the scale were carried out. Results indicated the SURPS Brazilian version has good internal consistency and is a valid instrument for measuring four distinct personality dimensions within the Brazilian population (RMSEA = .05; SRMR = .07; CFI = .90). Additionally, results suggested that the hopelessness, anxiety sensitivity and sensation seeking subscales were associated with preferential substances of use.

The burden experienced by Brazilian family members affected by their relatives’ alcohol or drug misuse

Abstract Purpose: There is a virtual absence of previous research about the experiences of people affected by the presence of a substance misuser in the family in Brazil. Materials and methods: A diverse sample of 3158 (80.6% female) affected family members (AFMs) was recruited in the largest cities in all five Brazilian regions. A Brazilian Portuguese translation of a set of standard measures for the assessment of AFM stress, strain, coping, hopefulness and total family burden, based on the stress–strain–coping–support (SSCS) model, was employed. Results: Mothers and wives reported the greatest burden. Burden was also related to a number of other demographic and background variables, notably being higher for AFMs of lower socio-economic status and for those whose substance misusing relatives were currently receiving hospital treatment. Results offer some support for additive and moderation coping hypotheses, suggesting that greater engaged and tolerant-inactive coping add to stressful impact in the prediction of symptoms, and that lower engaged and tolerant-inactive coping in the face of relatively high stressful impact may be particularly useful in reducing symptom levels. Conclusions: This is the first national sample of AFMs to be studied in Brazil and the largest to have been reported from any country. The results should help build an emerging picture of how AFMs are affected and assist in planning services for AFMs.

Measuring stress, coping, strain and hopefulness of Brazilian family members of substance misusers: Factor structure of a set of measures

ABSTRACT Objectives: We evaluated the psychometric properties of the Brazilian version of a set of measures designed to assess four psychological constructs associated with having a substance misusing relative in the family: the Family Member Impact (FMI), the Symptom Rating Test (SRT), the Coping Questionnaire (COPE) Hopefulness-hopelessness scale (HOPE). Methods: Secondary data from 3056 affected family members (AFMs) was analyzed. Factor structure of the measures and group invariance across gender were assessed using confirmatory factor analysis. Results: The Brazilian version of COPE showed that a four-factor model with 24 items fit the data better than the original three-factor model with 30 items. The FMI measure showed that a three-factor model is more appropriated to the Brazilian version of the scale than the original two-factor model. HOPE and SRT (29 items) Brazilian’s version had the same two-factor model structure. This set of measures presented full measurement and structural invariance for both male and female. Conclusions: Findings provide support for the structural validity of the Brazilian version of a set of standard measures for the assessment of stress, coping, strain and hopefulness of AFMs by their relatives’ substance misuse. As this is the first study to explore the factorial model of the measures, it provides further support for the use of these instruments for future studies aiming to explore means on supporting AFMs in Brazil and elsewhere.

Predictors of hazardous drinking among home drinkers

ABSTRACT Introduction and Aims: The United Kingdom has witnessed a shift from drinking in bars to drinking at home; to date, this phenomenon has received little international attention. The aim of this study was to examine the predictors of hazardous drinking (HD) levels when drinking at home. Design: An internet survey of university staff (n = 488) was given. Methods: Following an elimination process (p ≤ 0.05), a regression analysis was conducted using AUDIT scores as cutoffs of ≥6 females, and ≥8 males; these are consistent with most international research. Results: There were 286 hazardous drinkers (HD) (181, females 63.3%) and (105, males 36.7%). The variables that predicted HD were female (OR = 5.42 95% CI 1.87–15.66), younger age, greater frequency of consuming alcohol at home, preloading (drinking before going out), purchasing alcohol in an off license, and drinking alcohol at home because it is cheaper than drinking out. Discussion and Conclusions: These findings point to an interaction of gender, age purchasing patterns, and motivations contributing to hazardous drinking at home and indicate further profitable areas of national and international research.

Brief Report: Factors Associated With Attrition Rate in a Supportive Care Service for Substance Using Pregnant Women in Brazil

BACKGROUND AND OBJECTIVES Retaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant. METHODS Records of 166 womens antenatal consultations were analyzed. RESULTS Attrition rate was high (75/166, 45.2%), and was associated with women having no schooling/primary schooling only, no family contact, having child(ren), crack-cocaine use, poly drug use, and substance use problems by the expected childs father. DISCUSSION AND CONCLUSIONS Attrition may be the outcome of socio-demographic, family, individual, and substance use issues not fully addressed in prenatal interventions. SCIENTIFIC SIGNIFICANCE Identification of who are at risk for dropping out affords services with an opportunity to prevent its occurrence. (Am J Addict 2017;26:676-679).

Factors associated with attrition rate in a supportive care service for substance using pregnant women in Brazil

BACKGROUND AND OBJECTIVES Retaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant. METHODS Records of 166 womens antenatal consultations were analyzed. RESULTS Attrition rate was high (75/166, 45.2%), and was associated with women having no schooling/primary schooling only, no family contact, having child(ren), crack-cocaine use, poly drug use, and substance use problems by the expected childs father. DISCUSSION AND CONCLUSIONS Attrition may be the outcome of socio-demographic, family, individual, and substance use issues not fully addressed in prenatal interventions. SCIENTIFIC SIGNIFICANCE Identification of who are at risk for dropping out affords services with an opportunity to prevent its occurrence. (Am J Addict 2017;26:676-679).

Factors associated with attrition rate in a supportive care service for substance using pregnant women in Brazil: Supportive Service for Substance Using Pregnant Women

BACKGROUND AND OBJECTIVES Retaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant. METHODS Records of 166 womens antenatal consultations were analyzed. RESULTS Attrition rate was high (75/166, 45.2%), and was associated with women having no schooling/primary schooling only, no family contact, having child(ren), crack-cocaine use, poly drug use, and substance use problems by the expected childs father. DISCUSSION AND CONCLUSIONS Attrition may be the outcome of socio-demographic, family, individual, and substance use issues not fully addressed in prenatal interventions. SCIENTIFIC SIGNIFICANCE Identification of who are at risk for dropping out affords services with an opportunity to prevent its occurrence. (Am J Addict 2017;26:676-679).