William Feigelman

Problem gamblers, problem substance users, and dual-problem individuals: an epidemiological study

OBJECTIVES This study compared problem gamblers, problem substance users, dual-problem individuals, and persons without these problems in the general population. METHODS On the basis of computer-assisted telephone interviews of a random sample of Texas adults (n = 6308) standard instruments were used to gauge substance use and gambling problems in the general population. RESULTS Compared with those having a substance use or gambling problem only, dual-problem individuals were more likely to be young, never-married men, without conventional religious affiliations. There was more dysfunctionality (as evidenced by treatment-seeking and problems with the law) among dual-problem respondents than among those troubled exclusively by gambling or substance use problems. CONCLUSIONS Screening and treatment for gambling problems should be offered in drug treatment and criminal justice arenas.

Adjustments of Transracially and Inracially Adopted Young Adults

This study follows up a sample of transracial and inracial children adopted in infancy in the mid-1970s. The present report, based on 1993 data, covers parental assessments when children were in their early twenties (subjects mean age = 23). In this report I compare inracially adopted White young adults (N = 37), with transracially adopted Asians (N = 151), African-Americans (N = 33) and Latinos (N = 19). Comparisons show no significant adjustment deficits for the subgroups of transracial adoptees in comparison with their inracially adopted White peers. Adjustment problems vary considerably among the transracially adopted young adults; discrimination against the transracial adoptee, and discomfort about their appearance are found as significant correlates associated with adjustment difficulties. Parents report fewer adoptees feeling uneasy about their appearances, when adoptive families live in racially heterogenous settings.

Stigmatization and suicide bereavement.

With survey data collected primarily from peer support group participants, the authors compared stigmatization responses of 462 parents losing children to suicide with 54 other traumatic death survivors and 24 child natural death survivors. Parents who encountered harmful responses and strained relations with family members and non-kin reported heightened grief difficulties. After controlling for time since the death and whether a childs death was traumatic or not, stigmatization continued to be associated with grief difficulties, depression, and suicidal thinking. Suicide survivors reported little differences in stigmatization from other-traumatic-death survivors, a result consistent with other recent studies, suggesting more convergence between these two populations than divergence.

Pathological gambling among methadone patients

This paper examines the correlates of problem gambling among a population of 220 methadone patients receiving treatment in the New York metropolitan area. Like most methadone patients, respondents were primarily adult males, ethnically mixed, of limited educational accomplishment and had long experiences with intravenous drug use. More than two-thirds of subjects had been convicted of one or more criminal offences. Analysis of the data showed seven percent of respondents to be probable pathological gamblers according to the South Oaks Gambling Screen (SOGS), indicating a high rate of gambling problems among this treatment population. Consistent with past studies, problem gamblers are more likely to be men, with histories of alcohol abuse, and with extensive criminal participation dating back to their teenage years. The data also suggested that problem gamblers who were also drug dependent were more likely to show greater evidence of social dysfunctionality compared to those who were exclusively substance abusers. More dually addicted respondents reported higher levels of recent heroin use, greater unemployment, and more reported hallucinations. Probable pathological gamblers who were substance abusers were also more likely to report being in conflict with their close friends. A multiple regression analysis suggested this to be the closest linked correlate to being a pathological gambler. Evidently, pathological gamblers create antipathy towards themselves as their compulsion to gamble is expressed; this in turn, may drive them toward further gambling, as they respond to this perceived opposition. These last preliminary findings will require further confirmation in future research.

Internet support groups for suicide survivors: a new mode for gaining bereavement assistance

Taken among parents who sustained the loss of a child to suicide this study explores the participation of parents in Internet support groups, comparing their demographic and loss-related characteristics (N = 104) to other parent survivors participating in face-to-face support groups (N = 297). Contrary to expectations that Internet affiliates would be concentrated in under-served rural areas, we found similar levels of urban, suburban, small city and rural residents in both Internet and face-to-face subsamples. Bivariate and multivariate analyses suggested several important factors contributing to interest in Internet grief support including: 24/7 availability and opportunities to invest more time into this type of support group experience. Compared to their face-to-face group counterparts, Internet affiliates experienced greater suicide stigmatization from their families and other associates. Unable to find ready comfort and support from their personal communities, Internet users—and especially highly depressed survivors—sought and obtained valuable help from the Internet support resource.

How they died, time since loss, and bereavement outcomes

This analysis explores associations between differing death circumstances and the course of bereavement among a sample of 540 bereaved parents. Comparisons were made between parents whose children died by suicide (n = 462), those losing children from other traumatic death circumstances (n = 54), and others whose children died from natural causes (n = 24). Results were mixed, showing suicide survivors with more grief difficulties and other mental health problems on some criteria, though most findings showed no substantive differences between these subgroups. Results also showed, in the first years after loss, repeated suicide attempts and prior negative relationships with the decedent were associated with greater grief difficulties. However, as more time passed, all death circumstance differences were overshadowed by the importance of the time span since loss. This data also suggested that between 3 and 5 years usually marks the turning point, when acute grief difficulties accompanying a suicide loss begin to subside.

Day-care Treatment for Multiple Drug Abusing Adolescents: Social Factors Linked with Completing Treatment

By identifying some of the social correlates linked with completing day-care drug abuse treatment, the present study has sought to broaden understanding of how drug rehabilitations are effected. As the findings have demonstrated, completing care is a result of a complex array of causes and their interaction. The disposition of the entering patient (i.e., their determination and other strengths) has a great bearing on treatment outcome. It is also a result of the patients family, their motivations, resources and perseverance in enduring a long course of demanding therapeutic interventions. In addition, it is the product of meanings shared and transmitted between the patients family and the treatment staff. Patients and their families project positive attitudes about the value of the therapeutic enterprise as well as a compliant demeanor. As staff recognize that patients and parents are acting cooperatively, then such perceptions tend to create self-fulfilling prophecies. The data has established that older adolescent patients are more likely to possess the motivational resources needed for program completion than younger patients. Apparently, self-referred patients are also more inclined to meet the demands of program requirements than those referred by the courts or other outside social agencies, although the differences fell short of the .05 level of statistical significance. Those completing the program are less likely to be diagnosed as depressed at intake. Parental characteristics comprise another group of variables that are related to treatment completion. Parents of higher occupational rank, who have had mental health care for themselves, and who are of Jewish ethnicity appear to possess useful strengths for meeting program challenges. The pattern of spouse mutuality in dealing with a childs needs as it exists preceding and during treatment seems to be another useful asset for successfully getting through this form of treatment. While parents with the above characteristics possess resources that help them to endure the rigors inherent in this form of care, these attributes help project positive images to professional staff about family and patient commitment to treatment. The results of the present study also suggest that certain familial structural arrangements either facilitate or impede program completion. Three particular types of family structures were linked with remaining in treatment longer or finishing: (1) children who were the only children in their families who were living at home; (2) children with siblings who had been in treatment at the program; and (3) children without older brothers.(ABSTRACT TRUNCATED AT 400 WORDS)

Assessing the Effects of Peer Suicide on Youth Suicide.

Using data from all waves of the National Longitudinal Survey of Adolescent Health, we investigated the short-term and long-term impact of an adolescent friends suicide on an adolescents depression and suicidality. Results suggest that a friends suicide is associated with heightened suicide thoughts and attempts and greater depression during the first year after loss. Six years later, analyses show concurrent behaviors most relevant to explain suicidality fluctuations. Findings suggest the importance of therapeutic availability, especially during the first year, for those losing a friend to suicide.

Toward Explaining the Higher Incidence of Cigarette Smoking Among Black Americans

Using the 1987 General Social Survey data, the factors related to the disproportionately higher rates of cigarette smoking by Black Americans were investigated. Previous studies have found smoking to be highly correlated with age, social class, and occupational stress, among other factors. It is uncertain whether race is an independent predictor of smoking rates or whether it is primarily a correlate of other demographic variables. Loglinear modeling and logit regression analysis suggested that racial differences between Blacks and Whites in smoking may be spurious. The multivariate analysis established that class and stress differences remained more potent than race in accounting for variations in smoking behavior.

PARENTAL GRIEF AFTER A CHILD'S DRUG DEATH COMPARED TO OTHER DEATH CAUSES: INVESTIGATING A GREATLY NEGLECTED BEREAVEMENT POPULATION

This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.