Shelly A. Wiechelt

Introduction to the special issue on resilience.

This article introduces this special issue on resilience by briefly reviewing its history and how contemporary researchers and theorists deliberate it today. Resilience, as a concept, emerged primarily from the work of Norman Garmezy, Emmy Werner, and Ruth Smith. It has transformed the field and shifted research, theory, and practice paradigms to a focus on strengths rather than deficits.

The Specter of Shame in Substance Misuse

This article provides an introduction to the concept of shame as it relates to substance misuse. Empirical research on shame and addiction and the theoretical and operational definitions that underpin them are discussed. Potential areas of further inquiry are highlighted. Implications for clinical practice are discussed.

The Role of Shame in Women's Recovery from Alcoholism

Abstract This study compares the recovery experience of female members of Alcoholics Anonymous (AA) who reported a history of childhood sexual abuse (68%) with those who did not report experiencing childhood sexual abuse. A sample of 53 women was obtained from AA. A significant relationship was found between shame and two measures of difficulties in recovery-problems in social adjustment and relapse. Though the hypothesis that experiences of child sexual abuse predicted difficulty in recovery was not supported, these data suggest that shame may be an important variable in both the etiology and treatment of alcoholism in women.

Converging on Empathy: Perspectives on Baltimore City's Specialized Prostitution Diversion Program

This article explores perceptions of 17 women currently or formerly engaged in prostitution regarding Baltimore Citys Specialized Prostitution Diversion program. Findings indicate that most perceive the program positively because they are in desperate need of services and because they hope it augurs the readiness of the criminal justice system to understand what leads them to engage in prostitution. Their desire to be treated like “human beings” in need of assistance, which undergirds requests for concrete services, reveals gendered understandings of responsibility and dependence that are compatible with problem-solving models of justice. It is therefore likely to resonate with criminal justice stakeholders.

Trauma and Substance Abuse Among Women in Prostitution: Implications for a Specialized Diversion Program

This study was undertaken to inform the implementation of a specialized prostitution diversion program to help women quit prostitution and avoid criminal prosecution. Data on 17 womens experience of trauma and substance abuse and their views on how these experiences affected their involvement in prostitution were gathered in focus groups and face-to-face interviews (including measures of substance abuse, trauma, and PTSD) conducted at a drop-in program in Baltimore, Maryland. The results indicate that the women experienced high levels of trauma and substance abuse interwoven with prostitution. Trauma-informed services and integrated substance abuse and trauma-specific treatment are needed.

Introduction to the Special Issue: International Perspectives on Women's Substance Use

Substance misuse by and among women was once considered to be rare and unusual. Substance use and misuse, as well as related problems, were more associated with men; hence, research and treatment efforts were geared toward the experience of males. A research initiative aimed at understanding women’s substance use behaviors in the United States was launched in the 1970s, and since that time, knowledge regarding women’s substance use, substance misuse, and its effects has increased. Although prevalence and incidence studies continue to find that males use substances more than females (except among adolescents where use is more even), they clearly show that women do use and misuse substances. The 2006 National Survey on Drug Use and Health (Substance Abuse and Mental Health Services Administration [SAMHSA], 2007) reports that of the females age 12 years or older in the United States, approximately 41% used an illicit drug(s) at some point in their lives and that currently, 6% use illicit drugs, 23% use tobacco, and 45% use alcohol (3% use alcohol heavily and 15% are binge drinkers). A total of 6% met criteria for substance abuse or dependence in the past year. In contrast, 50% of males report using an illicit drug(s) at some point in their lifetime and 11% currently use illicit drugs, 36% use tobacco, and 57% use alcohol (11% use alcohol heavily and 31% use alcohol in binges). Twelve percent of males met criteria for substance abuse or dependence during the past year. It has been suggested that males have more opportunity to choose to use drugs, and given equal opportunity, females are equally likely to choose to use drugs and develop associated problems and dependency (Zickler, 2000). Research has shown variations in the etiology and consequences of substance use and misuse between women and men. A 3-year study sponsored by the National Center on Addiction and Substance Abuse (CASA; 2003) indicated that girls and young women are more

Drug Use, Self-Efficacy, and Coping Skills Among People with Concurrent Substance Abuse and Personality Disorders: Implications for Relapse Prevention

ABSTRACT This study investigated drug use antecedents, abstinence self-efficacy and coping skills among people with concurrent substance abuse and personality disorders. Fifty inpatients with recent polydrug abuse were divided into two groups based upon the presence (PD) or absence (NPD) of a personality disorder. The PD group reported more often using drugs when experiencing unpleasant emotions, physical discomfort, and conflict with others. They also reported lower self-efficacy for situations involving physical discomfort and interpersonal conflict, more use of a self-blaming coping style, and lower levels of interpersonal competence. Implications for treatment are discussed in light of these findings.

Crime and compassion: Women in prostitution at the intersection of criminality and victimization

Women who are charged with prostitution sit at an intersection of victimization and criminality. It is widely acknowledged that many women who engage in prostitution, especially those engaged in street prostitution, suffer from a variety of problems including past and current trauma and abuse, substance abuse, mental and physical health disorders, and housing instability. Our interviews and focus groups with 17 women currently and formerly engaged in prostitution reveal that survival needs and coercion are factors in their involvement in prostitution. They are also commonly victimized prior to and during their involvement in prostitution. In August 2007, the State’s Attorney’s Office of the City of Baltimore began an initiative to create an alternative for people who are charged with prostitution, which is a crime in Maryland. These efforts stem from what may be considered a discomfort and ambivalence with a criminological approach to offenders who are simultaneously considered victims. Diversionary approaches are an attempt to manage these ambivalent and often conflicting constructions of women who engage in prostitution. However, such programs will largely serve as a palliative rather than a long term solution if they fail to address the personal and structural factors that severely circumscribe the choices available to this marginalized population.

HIV/AIDS, Substance Abuse, and Hepatitis Prevention Needs of Native Americans Living in Baltimore: In Their Own Words

A needs assessment funded by the Center of Substance Abuse Prevention was conducted in 2005-2006 to determine the HIV/AIDS, substance abuse, and hepatitis prevention needs of Native Americans living in Baltimore, Maryland. We used a community-based participatory approach to gain an in-depth understanding of local Native American health service needs. Community stakeholders and key informants embedded in the local Native American population were consulted at each stage of the research planning process. Two complementary methodologies (focus groups and surveys) produced a holistic assessment of the populations needs, risks, and strengths and uncovered the social and cultural contexts in which health risk behaviors unfold. The use of these methods within a participatory framework produced a more complete portrait of the service needs of the Native American population in Baltimore. Findings from this study support the necessity for future HIV/AIDS, substance abuse, and hepatitis prevention programming for urban Native Americans.

Historical Trauma Among Urban American Indians: Impact on Substance Abuse and Family Cohesion

Historical trauma theory suggests that many American Indians are still affected by the cultural losses and injustices endured by previous generations. The current study examines historical trauma in an urban American Indian sample using validated measures of historical loss and associated symptoms (N = 120). Urban American Indians reported high degrees of historical trauma compared to reservation samples in past research. Generalized linear models showed that historical trauma symptoms were significantly associated with past month alcohol use, lifetime use of non-marijuana illicit drugs, and lower family cohesion. However, frequent thoughts about historical losses were positively associated with family cohesion. Implications are discussed.