Rafael J. Engel

Changes in depressive-symptom experiences among older women.

Changes in depressive-symptom experiences over a 5-year period were investigated in a community sample of 251 women between the ages of 51 and 92 years. Findings from a confirmatory factor analysis of the SCL-90-R Depression and Additional Symptoms scales (Derogatis, 1983) indicate that two phenomenally different syndromes underlie symptom-reporting patterns. A depressive syndrome, more classic in form, shows decreasing levels with increasing age, although a depletion syndrome, marked by feelings of enervation and a loss of interest in things, shows increasing levels with advancing age. The relative independence of the two syndromes, as well as their differing relations to four more delimited forms of distress that were identified in the analyses, have important implications for future research on the age-depression relation.

Depressive symptom patterns among older women.

The structure of depressive symptom patterns was investigated in a community sample of 344 women between the ages of 51 and 92 who were administered the SCL-90-R Depression and Additional Symptoms Scales. Confirmatory factor analysis was used to test alternative measurement hypotheses implied by clinical formulations of depressive symptom patterns among elderly persons. The findings show support for the hypothesis that 2 somewhat different depressive syndromes, along with 4 more delimited forms of distress, underlie symptom-reporting patterns. Implications of these findings for future research on the relation between aging and depression are discussed.

Evaluating the Efficacy of Traditional and Web-Assisted Instruction in an Undergraduate Social Work Practice Class

SUMMARY This article addresses the dearth of research utilizing a quasi-experimental design and student performance measures in assessing web-assisted instruction in social work undergraduate practice courses. Social work students were randomly placed into two sections of a practice course. The experimental section (n = 18) students received 50% of course lectures with web-assisted instruction while the comparison class (n = 18) received identical lectures delivered in traditional face-to-face format. There were no statistically significant differences on assignments, the midterm exam and a final videotaped exam project between the two sections. These results suggest students in an undergraduate social work practice course learn similarly regardless of course format.

Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.

Measuring race and ethnicity

Asian and Pacific Islanders.-Hispanics.- African Americans.- Caucasians.- Native Americans.- Generic.

Risk Factors for Symptoms of Prescription Opioid Misuse: Do Older Adults Differ from Younger Adult Patients?

ABSTRACT Limited research is available regarding the health risks associated with opioid medication misuse among middle age (50–64 years) and older adults (65 and older). Understanding the misuse symptom risk profiles of these populations has potential to advance the national opioid epidemic response. A survey was conducted in four community pharmacies in southwestern Pennsylvania among adult, non-cancer patients filling opioid medications (N = 318) regarding opioid medication misuse symptoms and misuse risk factors. Descriptive and multivariate statistical analyses compared respondent characteristics, misuse symptoms, and misuse risks among those 65 and older, 50 to 64, and those less than 50 years old. Those 65 and older (Incidence Rate Ratio [IRR] = 2.4, 95% CI = 1.46–3.95) and those 50 to 64 years (IRR = 1.26, 95% CI = 1.03–1.54) who reported illicit drug use had increased rates of misuse symptoms. Those 50–64 with posttraumatic stress disorder also had an increased rate of misuse symptoms (IRR = 1.29, 95% CI = 1.08–1.54). Misuse behaviors of those 65 and older and 50–64 involved shortening time between dosages (≥65 = 11.4%, 50–64 = 27.6%), taking higher dosages than prescribed (≥65 = 11.4%, 50–64 = 13.6%), and early refills (≥11.8%, 50–64 = 12.7%). Gerontological social workers must continue to work to understand and identify individuals engaged in misuse in order to develop and provide age appropriate care.

Older Adults and Substance-Related Disorders: Trends and Associated Costs

Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from

Beating the Odds: Preparing Graduates to Address Gambling-Related Problems

2.1 million in 2000 to

Pathological gambling and treatment outcomes for adults age 50 or older in methadone maintenance treatment.

9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs.

An Assessment of Service Learning in a University Living-Learning Community: Implications for Community Engagement

As gambling opportunities proliferate, social workers are likely to see clients with gambling-related problems, but they often lack the expertise to address these concerns. This descriptive study assessed the inclusion of content on gambling-related problems in graduate social work curricula. Responses to an online survey from 86 (43.7%) of the 197 accredited MSW programs were received. Thirty-three (38.4%) schools include gambling-related content typically taught in an addictions, mental health, or practice course. Fifty-three (61.6%) lacked such content, noting a lack of faculty expertise, low-priority content, and the lack of interest in gambling-related issues. Recommendations are offered as to how to infuse gambling identification, treatment, and policy content in social work curricula.