RESUMEN
INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.
Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Alcohólicos/psicología , Depresión/terapia , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Intoxicación Alcohólica/psicología , Alcoholismo/diagnóstico , Colombia/epidemiología , Comorbilidad , Atención a la Salud , Depresión/psicología , Trastorno Depresivo/psicología , Trastorno Depresivo/terapia , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , México/epidemiología , Persona de Mediana Edad , Perú/epidemiología , Atención Primaria de Salud/métodos , Atención Primaria de Salud/tendencias , Derivación y Consulta , Detección de Abuso de Sustancias/métodosRESUMEN
In one rural community in Yucatán, many residents express concerns about the disruption alcohol use poses to the calm of everyday life and the wellbeing of individuals, families, and society. At the same time, men who drink point to tangible ways in which alcohol consumption relieves them of suffering and brings pleasure. Aware of the often-negative effects of their drinking, these men root their desire to get drunk in structural inequalities and resultant stress. Through analysis of extended ethnographic research, this paper explores drinking as a practice through which the complex and sometimes contradictory nature of care in modern life in rural Yucatán is exposed. Care through and against alcohol consumption reveals a convergence of suffering and privilege, one that is, in some ways, uniquely local and, in other ways, reflective of working-class masculinity in many parts of the world.
Asunto(s)
Intoxicación Alcohólica/psicología , Satisfacción Personal , Población Rural , Intoxicación Alcohólica/economía , Intoxicación Alcohólica/epidemiología , Humanos , Masculino , México/epidemiologíaRESUMEN
BACKGROUND: Policies that establish maximum blood alcohol concentrations (BACs) or breath alcohol concentration (BrACs) for drivers while driving can reduce traffic accidents by approximately 20%. In Brazil, the National Transit Council (CONTRAN) considers positive BAC and/or BrAC tests or signs of psychomotor capacity alterations as evaluated by a police authority to be an administrative infraction or even a crime. The observed clinical symptoms of alcohol intoxication based on a subject's appearance may not necessarily reflect the quantified BAC and/or BrAC. This study compared the clinical symptoms identified by a medical authority (M) and a non-medical authority (NM) with BAC and BrAC measurements. METHODS: Brazilian health volunteers (nâ¯=â¯15) drank ethanol (40% v/v) and, at scheduled times, the subjects underwent blood draws for BAC analysis, were tested for BrAC analysis, and underwent psychomotor alteration assessments performed by M and NM. RESULTS: Concentration-time profiles of the BACs and BrACs of the volunteer subjects were generated. The BAC values reached a peak at 60â¯min and subsequently decreased with time. The average BrAC values decreased with time after ingestion. During the evaluations, M was able to identify a lack of static equilibrium until 240â¯min and a lack of dynamic equilibrium until 120â¯min. A lack of upper limb motor coordination was observed until 90â¯min, and a lack of coordination in the lower limbs was observed only during the first hour. Regarding the tests performed by NM, the signs related to the subjects' appearances were observed more frequently, until 60â¯min. The other analyzed symptoms were not identified. Naturally, the signs reported by both M and NM disappeared with time. CONCLUSION: The evaluations of psychomotor changes performed by Brazilian M were superior to those performed by NM. However, independent of the examiner, at the alcohol concentrations reached in this study, the psychomotor alteration evaluations were ineffective compared with the BAC and BrAC results.
Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/psicología , Intoxicación Alcohólica/diagnóstico , Nivel de Alcohol en Sangre , Conducir bajo la Influencia , Etanol/efectos adversos , Etanol/sangre , Toxicología Forense/métodos , Desempeño Psicomotor/efectos de los fármacos , Adulto , Intoxicación Alcohólica/sangre , Intoxicación Alcohólica/psicología , Análisis Químico de la Sangre , Brasil , Pruebas Respiratorias , Etanol/farmacocinética , Humanos , Tasa de Depuración Metabólica , Destreza Motora/efectos de los fármacos , Equilibrio Postural/efectos de los fármacos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
INTRODUCTION AND AIMS: The practice and adverse consequences of pre-drinking have been documented within a dozen countries, but little remains known about the differences between countries or the country-specific determinants of pre-drinking. This study aims to estimate the percentage of pre-drinkers in different countries and the impact of country-level indicators such as the price of alcohol and the prevalence of drinkers and of heavy drinkers. DESIGN AND METHODS: Using data from the Global Drug Survey, the percentage of pre-drinkers was estimated for 25 countries from 65 126 respondents. Bivariate and multivariate multilevel models were used to model the impact of the on-premise/off-premise drinks price ratio, the prevalence of current drinkers and of heavy drinkers on the percentage of pre-drinkers. RESULTS: The estimated percentage of pre-drinkers per country ranged from 17.7% (Greece) to 85.4% (Ireland). Across all countries, the higher the prevalence of current drinkers, the higher the percentage of pre-drinkers. In addition, an interaction between the prevalence of heavy drinkers and the price ratio was found. In countries with a low price ratio, the higher the prevalence of heavy drinkers, the higher the percentage of pre-drinkers. The opposite effect was observed in countries with high price ratios. DISCUSSION AND CONCLUSIONS: Pre-drinking appears to be a worldwide phenomenon. The significant effects of all three indicators demonstrate the role of country-level determinants underpinning the prevalence of pre-drinking across countries. Policy makers could use the reported findings for initiating campaigns to reduce pre-drinking behaviour. [Labhart F, Ferris J, Winstock A, Kuntsche E. The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries.
Asunto(s)
Consumo de Bebidas Alcohólicas/economía , Consumo de Bebidas Alcohólicas/psicología , Bebidas Alcohólicas/economía , Intoxicación Alcohólica/economía , Intoxicación Alcohólica/psicología , Comercio/economía , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Intoxicación Alcohólica/epidemiología , Australasia/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , Internacionalidad , Masculino , América del Norte/epidemiología , América del Sur/epidemiología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Family relationships are widely recognized as playing a role in adolescent alcohol use. Although family relationships and parenting vary by culture, limited research has explored these relationships in Latin America. OBJECTIVES: We sought to determine which family factors are associated with adolescent alcohol use in Callao, Peru. METHODS: Data come from a cross-sectional survey conducted in a public secondary school in Callao, Peru in 2007. A total of 180 11th grade students are included in the analysis. Our main outcome measure was problem drinking, defined as self-report of having ever consumed beer, wine, spirits, or hard alcohol to a point of drunkenness. Logistic regression was used to determine if odds of problem drinking varied by level of parental monitoring (knowledge of activities and whereabouts), positive family relationships, or family conflict, while controlling for demographic and peer variables. RESULTS: Low levels of parental monitoring and low levels of positive family relationships were each associated with significantly higher odds of lifetime problem drinking in analyses adjusted for deviant peer affiliation along with sociodemographic variables (odds ratio (OR) = 4.2; 95% confidence interval (CI): 1.3-13.5; OR = 4.4; 95% CI: 1.5-13.0, respectively). Although family conflict was associated with elevated odds of lifetime problem drinking, this did not reach significance (adjusted OR = 2.01; 95% CI: 0.8-5.1). Conclusions/Importance: Interventions designed to prevent adolescent alcohol use in urban Peru may benefit from promoting positive family interactions and parental monitoring skills.
Asunto(s)
Intoxicación Alcohólica/psicología , Conflicto Familiar/psicología , Familia/psicología , Consumo de Alcohol en Menores/psicología , Adolescente , Conducta del Adolescente/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Responsabilidad Parental , Grupo Paritario , Perú , Instituciones Académicas , Autoinforme , Estudiantes , Población Urbana , Poblaciones VulnerablesRESUMEN
BACKGROUND: Levels of drinking are unusually elevated among young adults on the U.S.-Mexico border, and this elevation can be largely explained by young border residents' unusually high frequency of bar attendance. However, this explanation complicates interpretation of high alcohol problem rates that have also been observed in this group. Because bar environments can lower the threshold for many types of problems, the extent to which elevated alcohol problems among young border residents can be attributed to drinking per se-versus this common drinking context-is not clear. METHODS: Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). After developing structural models of acute alcohol problems, estimates were subjected to path decompositions to disentangle the common and distinct contributions of drinking and bar attendance to problem disparities on and off the border. Additionally, models were estimated under varying degrees of adjustment to gauge the sensitivity of the results to sociodemographic, social-cognitive, and environmental sources of confounding. RESULTS: Consistent with previous findings for both drinking and other problem measures, acute alcohol problems were particularly elevated among young adults on the border. This elevation was entirely explained by a single common pathway involving bar attendance frequency and drinking. Bar attendance did not predict acute alcohol problems independently of drinking, and its effect was not moderated by border proximity or age. The common indirect effect and its component effects (of border youth on bar attendance, of bar attendance on drinking, and of drinking on problems) were surprisingly robust to adjustment for confounding in all parts of the model (e.g., fully adjusted indirect effect: b = 0.11, SE = 0.04, p < 0.01). CONCLUSIONS: Bar attendance and associated increases in drinking play a key, unique role in the high levels of acute alcohol problems among the border's young adult population that cannot be entirely explained by sociodemographic or social-cognitive characteristics of young border residents, by contextual effects of bars on problems, or by broader neighborhood factors. Bar attendance in particular may represent an early modifiable risk factor that can be targeted to reduce alcohol problem disparities in the region.
Asunto(s)
Consumo de Bebidas Alcohólicas/etnología , Intoxicación Alcohólica/etnología , Americanos Mexicanos/etnología , Características de la Residencia , Adolescente , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/psicología , Consumo de Bebidas Alcohólicas/tendencias , Intoxicación Alcohólica/diagnóstico , Intoxicación Alcohólica/psicología , Alcoholismo/diagnóstico , Alcoholismo/etnología , Alcoholismo/psicología , Femenino , Humanos , Masculino , Americanos Mexicanos/psicología , México/etnología , Factores de Riesgo , Estados Unidos/etnología , Adulto JovenRESUMEN
BACKGROUND: Binge drinking during adolescence is common and may predict increased drinking in young adulthood and enhanced risk of alcohol dependence. Variation in level of response to the hedonic and adverse effects of alcohol is in part an inherited factor that may also influence its use, abuse, and dependence. This study investigated, in young adults, whether an association could be demonstrated between variation in self-reported responses to alcohol and a history of binge drinking during adolescence. METHODS: Young adult (18 to 30 years, n = 790) Native Americans and Mexican Americans were recruited from the community and completed a structured diagnostic interview. Response to alcohol was indexed using the expectation version of the Subjective High Assessment Scale (SHAS-E). An adolescent history of regular binge drinking was defined as drinking 5 or more drinks for boys and 4 or more drinks for girls per drinking occasion at least once a month during their highest drinking period prior to the age of 18. RESULTS: An adolescent history of regular binge drinking was found to be associated with a lower level of self-reported responses to the negative aspects of alcohol intoxication (feeling terrible) as well as to the overall level of intoxication, but not to the positive impressions of intoxication (feeling great) on the SHAS-E. A history of regular adolescent binge drinking was also correlated with less feelings of the "terrible" and "total" effects of alcohol, as indexed by the SHAS-E, in a linear regression model that included several diagnostic and demographic variables such as a history of conduct disorder and current levels of drinking. CONCLUSIONS: These data suggest that a history of adolescent binge drinking is associated with a reduction in the self-reported level of intoxication in young adulthood, a factor that could theoretically lead to increased risk of alcohol dependence.
Asunto(s)
Conducta del Adolescente/psicología , Consumo Excesivo de Bebidas Alcohólicas/psicología , Conocimientos, Actitudes y Práctica en Salud , Indígenas Norteamericanos/psicología , Americanos Mexicanos/psicología , Adolescente , Adulto , Intoxicación Alcohólica/psicología , Femenino , Humanos , Masculino , Autoinforme , Adulto JovenRESUMEN
AIMS: The aim of the study was to analyze independent and potential interactive effects of age at drinking onset and family history of alcohol abuse on subsequent patterns of alcohol drinking, alcohol-related problems and substance use. METHODS: Participants were college students (60.3% females, mean age = 20.27 ± 2.54 years) from the city of Córdoba, Argentina. Several measures were used to assess alcohol, tobacco and drug use. The Spanish version of the Brief Young Adult Alcohol Consequences Questionnaire was used to assess alcohol-related problems. Factorial analyses of variance, or its non-parametric equivalent, were performed to explore differences in substance use behaviors and alcohol-related problems in subjects with early or late drinking onset and with or without family history of alcohol abuse. Chi-square tests were conducted to analyze the association between these two risk factors and categorical measures of alcohol, tobacco and drug use. RESULTS: Early onset of drinking was associated with amount of consumption of alcohol including up to hazardous levels, as well as tobacco and drug use. However, the frequency of alcohol problems and frequency of episodes of alcohol intoxication were only related to age of onset in those with a positive family history of alcohol problems. CONCLUSION: Delaying drinking debut is particularly important in the prevention of future alcohol problems in those adolescents who have a family history of such problems.
Asunto(s)
Consumo de Bebidas Alcohólicas/genética , Consumo de Bebidas Alcohólicas/psicología , Salud de la Familia , Trastornos Relacionados con Sustancias/genética , Trastornos Relacionados con Sustancias/psicología , Adolescente , Factores de Edad , Edad de Inicio , Consumo de Bebidas Alcohólicas/epidemiología , Intoxicación Alcohólica/epidemiología , Intoxicación Alcohólica/genética , Intoxicación Alcohólica/psicología , Anticipación Psicológica , Argentina/epidemiología , Actitud Frente a la Salud , Femenino , Humanos , Conducta Impulsiva/epidemiología , Conducta Impulsiva/genética , Conducta Impulsiva/psicología , Masculino , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios , Universidades , Adulto JovenRESUMEN
OBJECTIVE: The present study used an empirically based method to characterize substance use in a sample of Argentinean adolescents and analyzed the association between age at drinking onset and substance use behaviors. Differences in alcohol expectancies and personality traits as a function of different patterns of substance use were also explored. METHOD: Data were obtained from 583 adolescents aged 13-18years (M=15.01years; SD=1.5years; 59.5% female) from the city of Cordoba, Argentina. Alcohol, tobacco, and drug use and age at first alcohol use were measured. Personality traits, including extroversion, conscientiousness, impulsivity, and aggression, and positive and negative alcohol expectancies were assessed. Latent Class Analysis was applied to examine the structure of five co-occurring substance use behaviors: frequency of alcohol use, quantity of alcohol use, prevalence of drunkenness episodes, tobacco use, and drug use. RESULTS: Latent Class Analysis revealed five distinct patterns of substance use. The classes differed in substance use behaviors, personality traits, and alcohol expectancies. Adolescents with early drinking onset were more likely to show heavier alcohol use, more drunkenness episodes, and more drug use than adolescents with late drinking onset. CONCLUSIONS: Latent Class Analysis allowed the detection of groups of adolescents with distinct patterns of substance use. These groups exhibited significantly different personality and alcohol expectancy profiles, likely representing subgroups who are at greater risk for developing alcohol-related problems.
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Consumo de Bebidas Alcohólicas/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Afecto/fisiología , Factores de Edad , Edad de Inicio , Agresión/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Intoxicación Alcohólica/epidemiología , Intoxicación Alcohólica/psicología , Anticipación Psicológica , Argentina/epidemiología , Actitud Frente a la Salud , Femenino , Humanos , Conducta Impulsiva/epidemiología , Conducta Impulsiva/psicología , Relaciones Interpersonales , Masculino , Personalidad/fisiología , Sexualidad/psicología , Fumar/epidemiología , Fumar/psicología , Trastornos Relacionados con Sustancias/clasificación , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Alcohol hangover is a temporary state described as the unpleasant next-day effects after binge-like drinking. Hangover begins when ethanol is absent in plasma and is characterized by physical and psychological symptoms. Affective behavior is impaired during the acute phase of alcohol intoxication; however, no reports indicate if similar effects are observed during withdrawal. The aim of this work was to study the time-extension and possible fluctuations in affective behavior during a hangover episode. Male Swiss mice were injected i.p. either with saline (control group) or with ethanol (3.8g/kg BW) (hangover group). Anxiety, fear-related behavior and despair phenotype were evaluated at a basal point (ZT0) and every 2h up to 20h after blood alcohol levels were close to zero (hangover onset). Also, anhedonia signs and pain perception disabilities were studied. Mice exhibited an increase in anxiety-like behavior during 4h and 14h after hangover onset when evaluated by the elevated-plus maze and open field test respectively (p<0.05). Fear-related behavior was detected in hangover animals by the increase of freezing and decrease of line crossings and rearing frequency during 16h after hangover onset (p<0.001). Depression signs were found in hangover mice during 14h (p<0.05). Hangover mice showed a significant decrease in pain perception when tested by tail immersion test at the beginning of hangover (p<0.05). Our findings demonstrate a time-extension between 14 and 16h for hangover affective impairments. This study shows the long lasting effects of hangover over the phase of ethanol intoxication.
Asunto(s)
Afecto/efectos de los fármacos , Intoxicación Alcohólica/psicología , Depresores del Sistema Nervioso Central/efectos adversos , Etanol/efectos adversos , Anhedonia , Animales , Ansiedad/psicología , Defecación/fisiología , Miedo/psicología , Preferencias Alimentarias , Suspensión Trasera/psicología , Calor , Inmersión/fisiopatología , Masculino , Ratones , Actividad Motora/fisiología , Dimensión del Dolor , Percepción del Dolor/efectos de los fármacos , Estimulación Luminosa , Sacarosa , Natación/psicologíaAsunto(s)
Humanos , Consumo de Bebidas Alcohólicas/psicología , Intoxicación Alcohólica/psicología , Conducción de Automóvil/psicología , Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Intoxicación Alcohólica/sangre , Conducción de Automóvil/legislación & jurisprudencia , BrasilAsunto(s)
Consumo de Bebidas Alcohólicas/psicología , Intoxicación Alcohólica/psicología , Conducción de Automóvil/psicología , Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Intoxicación Alcohólica/sangre , Conducción de Automóvil/legislación & jurisprudencia , Brasil , HumanosRESUMEN
PURPOSE: This study evaluated if the probability of postpartum depression (PPD) increases with an upward gradient of physical intimate partner violence (IPV) during pregnancy and whether substance use by any member of the couple modifies this relationship. METHODS: The sample comprised 811 randomly selected mothers of children under 5 months old attending primary health services of Rio de Janeiro, Brazil. The Revised Conflict Tactics Scale (CTS2) gauged physical IPV, and the Edinburgh Postnatal Depression Scale (EPDS) assessed PPD. A hierarchical logistic regression model was employed to deal with confounding. Specific interaction terms between physical IPV and alcohol misuse or use of illicit drugs were also tested. RESULTS: Physical IPV during pregnancy was reported by 37.8% of respondents and 24.3% were presumably depressed (EPDS score ≥ 12). Interaction between physical IPV and partners' alcohol misuse was statistically significant (p = 0.026). Although there was a significant increase in PPD with just one act of physical IPV in the absence of a partners' alcohol misuse, mounting acts did not have any further influence. Conversely, when partners misused alcohol, the probability progressively and steeply increased from two acts onwards, reaching almost sevenfold by six cumulative physical IPV events as opposed to none. CONCLUSIONS: The results reinforce the relevance of physical IPV as a risk factor to PPD. They also suggest that context matters, partners' alcohol misuse acting as an important effect modifier. These evidences justify tailored preventive, screening and intervention procedures for IPV and alcohol misuse during pregnancy and the postpartum period.
Asunto(s)
Intoxicación Alcohólica/psicología , Depresión Posparto/epidemiología , Depresión Posparto/etiología , Violencia Doméstica/psicología , Parejas Sexuales , Adulto , Brasil/epidemiología , Femenino , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
While it is clear that alcohol use among immigrants from Mexico has serious consequences, limited data exist on the correlates of this behavior for Mexican immigrants residing in rural, traditionally non-Hispanic settings. A cross-sectional survey with an outreach approach was used to target 173 male Mexican immigrants in rural eastern North Carolina. Questionnaires including demographics, pre and post immigration alcohol use, acculturation, stress, social support, and depressive symptoms were administered through oral interview by trained bilingual interpreters. Results show a higher prevalence of binge drinking in the study sample compared to rate of alcohol use by Hispanics in the United States. Relationships were identified between Pre-immigration alcohol use, lower perceived social support, socialization within one's own cultural group, and binge drinking. These findings provide a preliminary basis in the development of interventions to address the problem of binge drinking in this population. Further exploration of the interaction between social isolation and social support is also needed.
Asunto(s)
Intoxicación Alcohólica/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Americanos Mexicanos/estadística & datos numéricos , Adulto , Intoxicación Alcohólica/psicología , Distribución de Chi-Cuadrado , Estudios Transversales , Depresión/etnología , Emigrantes e Inmigrantes/psicología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , North Carolina/epidemiología , Oportunidad Relativa , Prevalencia , Medición de Riesgo , Población Rural , Aislamiento Social/psicología , Estrés Psicológico/etnología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Among the known effects of alcohol on behavior, the modulation of cognitive functions (such as attention and memory), emotion, risk-taking and aggressive behavior are noteworthy. Here, we performed literature review in order to reinterpret alcohol effects on behavior according to the Alcohol Myopia Theory. According to this construct, there is a reduction of attentional resources during alcohol intoxication, which are primarily allocated to the most salient events in a given situation. The consequence is a hyperfocus directed to emotional situations when they are sufficiently relevant to grab attention, or a reduced attentional focus to emotional events in the presence of a relevant demanding task. The understanding of the mechanism mentioned above support the discussion of propositions toward the prevention of problems related to alcohol consumption. Importantly, the attentional allocation model provides inputs for a discussion on the scientifically-supported public health propositions aimed at preventing problems related to acute alcohol intoxication.
Dentre os efeitos associados ao consumo alcoólico, destaca-se a modulação sobre funções cognitivas, como atenção e memória, bem como sobre as emoções, comportamento de risco e agressividade. No presente estudo apresentamos uma revisão crítica da literatura propondo uma reinterpretação para os efeitos comportamentais do álcool com base na teoria da Miopia Alcoólica. Durante a intoxicação, existiria uma redução de recursos atencionais, os quais seriam direcionados para eventos mais relevantes. A repercussão, então, seria um aumento do foco atencional para situações emocionais, quando estas fossem suficientemente relevantes ou, em contrapartida, uma diminuição para tais situações na presença de uma tarefa-alvo demandante. A reinterpretação dos efeitos do álcool, com base na teoria da Miopia Alcoólica, fornece subsídios para a mudança de paradigma na intervenção clínica.
Asunto(s)
Atención , Emociones , Intoxicación Alcohólica/psicología , CogniciónRESUMEN
Among the known effects of alcohol on behavior, the modulation of cognitive functions (such as attention and memory), emotion, risk-taking and aggressive behavior are noteworthy. Here, we performed literature review in order to reinterpret alcohol effects on behavior according to the Alcohol Myopia Theory. According to this construct, there is a reduction of attentional resources during alcohol intoxication, which are primarily allocated to the most salient events in a given situation. The consequence is a hyperfocus directed to emotional situations when they are sufficiently relevant to grab attention, or a reduced attentional focus to emotional events in the presence of a relevant demanding task. The understanding of the mechanism mentioned above support the discussion of propositions toward the prevention of problems related to alcohol consumption. Importantly, the attentional allocation model provides inputs for a discussion on the scientifically-supported public health propositions aimed at preventing problems related to acute alcohol intoxication.(AU)
Dentre os efeitos associados ao consumo alcoólico, destaca-se a modulação sobre funções cognitivas, como atenção e memória, bem como sobre as emoções, comportamento de risco e agressividade. No presente estudo apresentamos uma revisão crítica da literatura propondo uma reinterpretação para os efeitos comportamentais do álcool com base na teoria da Miopia Alcoólica. Durante a intoxicação, existiria uma redução de recursos atencionais, os quais seriam direcionados para eventos mais relevantes. A repercussão, então, seria um aumento do foco atencional para situações emocionais, quando estas fossem suficientemente relevantes ou, em contrapartida, uma diminuição para tais situações na presença de uma tarefa-alvo demandante. A reinterpretação dos efeitos do álcool, com base na teoria da Miopia Alcoólica, fornece subsídios para a mudança de paradigma na intervenção clínica.(AU)
Asunto(s)
Intoxicación Alcohólica/psicología , Atención , Emociones , CogniciónRESUMEN
Adolescent initiation of ethanol consumption is associated with subsequent heightened probability of ethanol use disorders. The present study examined the relationship between motivational sensitivity to ethanol initiation in adolescent rats and later ethanol intake. Experiment 1 determined that ethanol induces locomotor activation shortly after administration but not if tested at a later post-administration interval. In Experiment 2, adolescent rats were assessed for ethanol-induced locomotor activation on postnatal Day 28. These animals were then evaluated for ethanol-mediated conditioned taste aversion and underwent a 16-day-long ethanol intake protocol. Ethanol-mediated aversive effects were unrelated to ethanol locomotor stimulation or subsequent ethanol consumption patterns. Ethanol intake during late adolescence was greatest in animals initiated to ethanol earliest at postnatal Day 28. Females that were more sensitive to ethanol's locomotor-activating effects showed a transient increase in ethanol self-administration. Blood ethanol concentrations during initiation were not related to ethanol-induced locomotor activation. Adolescent rats appeared sensitive to the locomotor-stimulatory effects of ethanol. Even brief ethanol exposure during adolescence may promote later ethanol intake.
Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Intoxicación Alcohólica/psicología , Período Crítico Psicológico , Etanol/toxicidad , Actividad Motora/efectos de los fármacos , Factores de Edad , Animales , Reacción de Prevención/efectos de los fármacos , Condicionamiento Clásico/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Etanol/sangre , Femenino , Masculino , Motivación , Ratas , Ratas Wistar , Factores Sexuales , Gusto/efectos de los fármacosRESUMEN
PURPOSE OF REVIEW: To present a summary of estimates of the risk of suicidal behaviour (ideation, plan and attempt) among those with substance use disorders in the general population and risk estimates for those with acute alcohol and drug consumption (intoxication) immediately prior to a suicide attempt. RECENT FINDINGS: In Mexico and elsewhere studies have emerged on the risk of suicidal behaviour among those with substance use disorders that are not affected by treatment selection bias or by psychiatric comorbidity. In developed and developing groups of nations, alcohol use disorders were associated with increased odds ratio (OR) of ideation (range 2.0-2.5) and attempt (2.6-3.7), whereas drug use disorders were associated with increased risk of ideation (2.3-3.0) and attempt (2.0-4.0). Follow-up studies of general population samples reported an OR for drug use disorders from 1.9 to 3.7 for ideation, and an OR of 3.0 for attempt. Alcohol dependence increased suicide ideation with an OR of 1.5. Those drinking alcohol prior to the suicide attempt had ORs in the range of 6.2-9.6. This increase may have a dose-response relationship. We found no studies providing risk estimates for drug use prior to a suicide attempt. SUMMARY: Current evidence points to a causal role of alcohol and drug use disorders exerting a distal effect on suicidal behaviour. Evidence for the proximal role of alcohol and drug use, as triggers of suicidal behaviour, are still very limited in number, analytical techniques and scope of substances other than alcohol.
Asunto(s)
Intoxicación Alcohólica/epidemiología , Intoxicación Alcohólica/psicología , Alcoholismo/epidemiología , Alcoholismo/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Ideación Suicida , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Intoxicación Alcohólica/etnología , Alcoholismo/etnología , Causalidad , Estudios Transversales , Humanos , Incidencia , México , Medición de Riesgo/estadística & datos numéricos , Trastornos Relacionados con Sustancias/etnología , Intento de Suicidio/etnologíaRESUMEN
OBJETIVO: Analisar as situações de violência domiciliar ocorridas com o agressor sob efeito do álcool. MÉTODOS: Foi realizado um levantamento domiciliar que incluiu as 108 cidades brasileiras com mais de 200 mil habitantes em 2005. A amostragem foi por conglomerados, estratificada, probabilística e autoponderada, obtida em três estágios de seleção: setores censitários, domicílios e respondentes (população entre 12-65 anos de idade). O instrumento utilizado para obtenção dos dados foi o Substance Abuse and Mental Health Services Administration, com perguntas sobre dados sociodemográficos e uso de drogas psicotrópicas. RESULTADOS: Foram pesquisados 7.939 domicílios. Em 33,5 por cento foi relatado histórico de violência domiciliar, sendo 17,1 por cento com agressores alcoolizados. Os tipos de violência em associação com uso de álcool mais freqüentes foram: discussões direcionadas a pessoas do domicílio (81,8 por cento), escândalos não direcionados a alguém específico (70,9 por cento), ameaça de agressão física (39,5 por cento) e de quebra de objetos (38,7 por cento), agressões físicas (27,8 por cento), com armas (5,5 por cento) e abuso sexual (3,2 por cento). Mais da metade dos agressores era morador do domicílio, 88,8 por cento deles do sexo masculino. A maioria das vítimas era do sexo feminino (63,9 por cento); 33,9 por cento eram esposas e 18,2 por cento filhos. Quanto às reincidências, 14,1 por cento dos casos perduraram por período entre um a cinco anos e em 14,3 por cento ultrapassaram uma década. A maior parte das vítimas (86 por cento) e dos agressores (77,9 por cento) não procurou por ajuda em serviço de saúde e/ou delegacia. CONCLUSÕES: Além da alta proporção de domicílios brasileiros com histórico de violência com agressores alcoolizados, as agressões apresentaram várias especificidades. A baixa procura por ajuda em serviços de saúde/segurança indica a importância da detecção ativa de casos de violência domiciliar.
OBJECTIVE: To describe situations of domestic violence committed by perpetrators under the influence of alcohol in the largest Brazilian cities. METHODS: A household survey was carried out in the 108 Brazilian cities with more than 200,000 inhabitants in 2005. A multistage probabilistic self-weighted sample stratified in terms of conglomerate units was performed in three selection stages: census tracts, households, and respondents (population between 12 and 65 years old). The instrument to collect the data was the Substance Abuse and Mental Health Services Administration, with questions on sociodemographics and psychotropic drug abuse.. RESULTS: The survey encompassed 7,939 households. In 33.5 percent of them there were reports of domestic violence, 17.1 percent out of which involving intoxicated perpetrators. The most frequently reported types of violence associated with the use of alcohol were: arguments among the people in the household (81,8 percent), loud arguments not aimed at a specific person (70.9 percent), threats of assault (39.5 percent), and breaking households objects (38.7 percent). The respondents also reported physical assault (27.8 percent), physical assault with weapon (5.5 percent), and sexual abuse (3.2 percent). More than half of perpetrators lived in the household and 88.8 percent were male. Most of the victims were female (63.9 percent); 33.9 percent were wives and 18.2 percent were children. In terms of recidivism, 14.1 percent of the cases lasted for a period between 1 and 5 years, and in 14.3 percent they lasted for over a decade. Most of the victims (86 percent) and perpetrators (77.9 percent) did not look for the help of either the health services or the police. CONCLUSIONS: In addition to the considerable number of Brazilian households with a history of violence involving intoxicated abusers, this kind of abuse has many specific characteristics. The low rate for the search for help at the health services/police ...
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Agresión , Consumo de Bebidas Alcohólicas/epidemiología , Intoxicación Alcohólica/epidemiología , Violencia Doméstica/estadística & datos numéricos , Agresión/psicología , Consumo de Bebidas Alcohólicas/psicología , Intoxicación Alcohólica/psicología , Brasil/epidemiología , Salud de la Familia , Relaciones Familiares , Encuestas Epidemiológicas , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: To describe situations of domestic violence committed by perpetrators under the influence of alcohol in the largest Brazilian cities. METHODS: A household survey was carried out in the 108 Brazilian cities with more than 200,000 inhabitants in 2005. A multistage probabilistic self-weighted sample stratified in terms of conglomerate units was performed in three selection stages: census tracts, households, and respondents (population between 12 and 65 years old). The instrument to collect the data was the Substance Abuse and Mental Health Services Administration, with questions on sociodemographics and psychotropic drug abuse.. RESULTS: The survey encompassed 7,939 households. In 33.5% of them there were reports of domestic violence, 17.1% out of which involving intoxicated perpetrators. The most frequently reported types of violence associated with the use of alcohol were: arguments among the people in the household (81,8%), loud arguments not aimed at a specific person (70.9%), threats of assault (39.5%), and breaking households objects (38.7%). The respondents also reported physical assault (27.8%), physical assault with weapon (5.5%), and sexual abuse (3.2%). More than half of perpetrators lived in the household and 88.8% were male. Most of the victims were female (63.9%); 33.9% were wives and 18.2% were children. In terms of recidivism, 14.1% of the cases lasted for a period between 1 and 5 years, and in 14.3% they lasted for over a decade. Most of the victims (86%) and perpetrators (77.9%) did not look for the help of either the health services or the police. CONCLUSIONS: In addition to the considerable number of Brazilian households with a history of violence involving intoxicated abusers, this kind of abuse has many specific characteristics. The low rate for the search for help at the health services/police stations point to the importance of actively identifying cases of domestic violence.