RESUMEN
INTRODUCTION AND AIMS: Aim of this study was to evaluate the relationship of relapse with impulsivity, novelty seeking (NS) and craving during 12 month follow up after inpatient treatment in male alcohol dependents. DESIGN AND METHODS: Among 156 consecutively admitted male alcohol dependents, 102 were examined by face to face interview 12 months after discharge from hospital. Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the NS dimension of the Temperament and Character Inventory, the Penn Alcohol Craving Scale (PACS) and Michigan Alcoholism Screening Test at the end of 12 months. RESULTS: Among 102 alcohol-dependent inpatients 61.8% (n = 63) were considered as relapsed to alcohol use during 12 month follow up. Sociodemographic variables did not differ between relapsed and non-relapsed groups. Mean scores of BIS-11 and NS and subscales of these scales were higher in relapsed group than non-relapsed group. BIS-11 and NS and their subscales were positively correlated with each other. PACS was also positively correlated with these scales and their subscales. Only exception was 'exploratory excitability' (NS1) subscale of NS, which did not differ between groups and did not correlate with PACS or BIS-11. Extravagance (NS3) and BIS-11 non-planning impulsiveness (NPI) scores were associated with craving in Stepwise Linear Regression model. Only NS3 showed an association with relapse in the first Forward Wald logistic regression model. When severity of craving was included in the second model, as an independent variable, it was also associated with relapse additional to NS3. DISCUSSION AND CONCLUSIONS: Both impulsivity and NS seem to be related with craving and relapse. Particularly, NS3 may be related with relapse both directly and indirectly via craving, whereas NPI may be related with relapse only indirectly via craving. Thus severity of craving may be a final pathway to relapse in these relationships of NS3 and NPI with relapse. These findings suggest that impulsivity, NS and craving are important variables to predict outcome and also for the treatment plan.
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Alcoholismo/rehabilitación , Conducta Exploratoria , Conducta Impulsiva/epidemiología , Adulto , Alcoholismo/psicología , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Psicometría , Recurrencia , Centros de Tratamiento de Abuso de Sustancias , TemperamentoRESUMEN
OBJECTIVE: The aim of this study was to evaluate possible interactions between childhood trauma, temperament, character, and psychopathology among alcohol-dependent men. METHODS: Participants were 156 alcohol-dependent men consecutively admitted to a dependency treatment unit. The Childhood Abuse and Neglect Questionnaire, the Temperament and Character Inventory, and the Symptom Checklist-Revised were administered to all participants. RESULTS: Childhood abuse and neglect did not have any effect on temperament and character scores in multivariate analysis. Whereas childhood abuse had a significant main effect on all types of clinical psychopathology except depression and psychoticism scores, childhood neglect only had a significant main effect on depression scores. There was no interaction between childhood abuse and neglect on these analyses. CONCLUSIONS: Among alcohol-dependent men, childhood abuse and neglect contribute to general psychopathology through distinct clinical consequences, independently of temperamental and characterological features.
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Adultos Sobrevivientes del Maltrato a los Niños/psicología , Alcoholismo/psicología , Carácter , Trastornos Mentales/psicología , Temperamento , Adulto , Alcoholismo/diagnóstico , Análisis de Varianza , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
The aim of this study was to investigate the impact of lifetime posttraumatic stress disorder (PTSD), dissociation and a history of childhood trauma on quality of life (QoL) among men with alcohol dependency. A consecutive series of alcohol-dependent men (N=156) admitted to an inpatient treatment unit were screened using the Michigan Alcoholism Screening Test, the Clinician Administered PTSD Scale, the Dissociative Experiences Scale, and the Childhood Trauma Questionnaire. QoL was assessed using the Medical Outcomes Study Short-Form 36-item health survey. Fifty (32.1%) patients had lifetime diagnosis of PTSD. Besides problems related to severity of alcohol use, the lifetime PTSD group was impaired on several physical and mental components of QoL. While the lifetime PTSD group and remaining patients did not differ on reports of childhood trauma and dissociation, in lifetime PTSD group, dissociative patients had higher scores of childhood emotional abuse than those of the non-dissociative patients. In multivariate covariance analysis, both dissociation and lifetime PTSD predicted impairment in physical functioning, general health, vitality, and mental health components of QoL. Among alcohol-dependent men with lifetime PTSD, a history of childhood emotional abuse contributes to impairment of QoL through its relationship with dissociation.
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Alcoholismo/complicaciones , Alcoholismo/psicología , Maltrato a los Niños/psicología , Calidad de Vida , Adulto , Niño , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Emociones/fisiología , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Escalas de Valoración Psiquiátrica , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Encuestas y CuestionariosRESUMEN
The aim of this study was to investigate the relationship between self-mutilation (SM) and posttraumatic stress disorder (PTSD) in male alcohol-dependent inpatients, and to examine whether there is something unique about self-mutilaters with the PTSD/alcohol-dependence co-morbidity, compared with self-mutilaters without PTSD in this population. Participants were 156 consecutively admitted male alcohol-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire (SMBQ), the Traumatic Experiences Checklist (TEC), the Clinician Administered PTSD Scale (CAPS), the Symptom Checklist-Revised (SCL-90-R) and the Michigan Alcoholism Screening Test (MAST). Among alcohol-dependent inpatients, 34.0% (n=53) were considered as group with SM. Rate of being unemployed, history of any trauma, history of suicide attempt and lifetime PTSD diagnosis were higher, whereas being married, current age, age at onset of regular alcohol use and duration of education were lower in the group with SM. Mean scores of SCL-90 subscales, TEC and MAST were higher in the SM group. Although SM might be related with PTSD among male alcohol-dependent inpatients, predictors of SM were age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and hostility. Age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and somatisation predicted SM in the subgroup of patients without PTSD, whereas hostility predicted SM alone in the subgroup of patients with PTSD. Results support the anti-suicide and the affect-regulation models of SM in the non-PTSD group, whereas they support the hostility model of SM in the subgroup with PTSD in alcohol-dependent inpatients. Thus, to reduce self-mutilative behaviour (SMB)among alcohol-dependent patients, clinicians must address different subjects in different subgroup patients; that is, focussing hostility in those with PTSD co-morbidity.
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Alcoholismo/complicaciones , Automutilación/epidemiología , Automutilación/etiología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/etiología , Adulto , Alcoholismo/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
INTRODUCTION AND AIMS: The aim of this study was to investigate the relationship of life quality with alexithymia, temperament and character dimensions of personality. DESIGN AND METHODS: Participants were 156 consecutively admitted male alcohol dependents. Patients were investigated with the Toronto Alexithymia Scale, the Temperament and Character Inventory, the Michigan Alcoholism Screening Test and the Medical Outcomes Study Short Form 36-item health survey. RESULTS: Among alcohol-dependent inpatients 30.1% were considered as alexithymic. Severity of alcohol related problems was higher in alexithymic group, whereas quality of life (QoL) was lower. Alexithymia, novelty seeking (NS) and harm avoidance (HA) were negatively, reward dependence, self-directedness and cooperativeness were positively correlated with QoL scores. 'Difficulty in identifying feelings' (DIF) factor of alexithymia and HA were the determinants of physical dimension of Life Quality in Linear Regression model, whereas DIF, HA and NS were the predictors of mental dimension score. DISCUSSION AND CONCLUSIONS: Among alcohol-dependent men, DIF factor of alexithymia and personality dimensions, particularly HA and NS are associated with impairment of QoL. Direction of this relationship and factors that may mediate this relationship is unclear.
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Síntomas Afectivos/psicología , Alcoholismo/psicología , Calidad de Vida , Adulto , Síntomas Afectivos/complicaciones , Alcoholismo/complicaciones , Encuestas Epidemiológicas , Humanos , Pacientes Internos , Modelos Lineales , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Recompensa , Índice de Severidad de la EnfermedadRESUMEN
AIMS: The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions. METHODS: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). RESULTS: Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self-directedness (S) were lower. Among age and other factors of TAS-20, 'difficulty in identifying feelings (DIF)' predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, 'impulsiveness versus reflection' (NS2) and 'congruent second nature versus bad habits' (S5) predicted PTSD. CONCLUSIONS: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.