Sarah Dewane

Knowledge, attitudes, and behaviors of health, education, and service professionals as related to fetal alcohol spectrum disorders

ObjectivesWe explored differences in fetal alcohol spectrum disorders (FASD) knowledge, attitudes, and behaviors across six groups of professionals in key position to provide primary and secondary prevention efforts (physicians, educators, correctional staff, social workers, public health nurses, and substance abuse counselors).MethodsAchieving a 60.1% response rate, 2,292 professionals returned surveys, providing data on basic knowledge of FAS, FASD-associated risks and cognitive deficits, and willingness to confront and recommend treatment to alcohol-consuming pregnant women.ResultsAcross groups, findings revealed ample FASD knowledge and willingness to confront and recommend treatment to alcohol-consuming pregnant women that increases as consumption becomes more frequent and severe. However, results revealed significant between-group differences data that provide valuable guidance for targeted future FASD education efforts.ConclusionsPublic health initiatives regarding FASD have been effective in increasing knowledge among a broad range of professionals. However, between-group differences indicate the need for targeted, discipline-specific interventions. These differences highlight the need for all professional groups to provide a consistent public health message regarding maternal alcohol consumption.

Community-Based Participatory Research for Improved Mental Health.

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery.

Changes in sexual activity following substance dependence treatment

Individuals who abuse alcohol and other drugs are at increased risk for HIV/AIDS, although time of greatest risk is unclear. Although many studies have documented decreased sexual risk behaviours following substance abuse treatment, some evidence indicates that sexual risk behaviours may actually increase with sobriety. In this study, individuals involved in a substance abuse treatment programme were asked about their sexual activity for the month prior to treatment and 6 months after treatment. Results showed higher levels of sexual activity, including risky sexual activity, 6 months after discharge from treatment. This increase was found for individuals regardless of whether they were abstaining from substance use at follow-up, with highest levels of sexual activity and risky sexual activity reported by those still consuming alcohol or other drugs. These findings support the need for inclusion of HIV/AIDS prevention and educational programmes during substance abuse treatment.

Comparing depressed Psychiatric inpatients with and without coexisting substance use disorders

ABSTRACT Objectives: To better understand the complexities of coexisting substance abuse, this study explored psychosocial and clinical differences between individuals diagnosed only with a depressive disorder and those diagnosed with a depressive disorder coexisting with a substance use disorder. Methods: Rates and sequelae of comorbidity were explored based on the medical records of patients admitted to the Alaska Psychiatric Institute (the only state-funded psychiatric hospital in Alaska) between January 1, 1993 and April 30, 2004. During this period, there were a total of 13,894 admissions for 7,317 patients. Of these patients, 469 met criteria for pure depressive disorders (with no past or current other psychiatric diagnoses); of these, 321 (68.4%) had coexisting substance use disorder and 148 (31.6%) had no coexisting substance use disorder. Results: Findings revealed that patients with a depressive disorder and coexisting substance use have greater complexity in terms of psycho-social circumstances, demographics, and clinical presentation than do patients with a depressive disorder only; however, such patients have fewer admissions, shorter lengths of stay, and fewer total days in hospital. Conclusions: These findings suggest that care must be taken when diagnosing individuals with depression as the presence of a coexisting substance use disorder may call for a different intervention strategy. These results differ from prior research examining coexisting schizophrenia and substance use disorders, suggesting that a substance use disorder has differing sequelae depending upon the type of coexisting psychiatric disorder.