Confirmatory factor analysis (CFA) of the Crack Use Relapse Scale (CURS)

Abstract Background When it comes to crack/drug use, relapse is a relatively common event in the first weeks after the end of treatment. However little is known about what happens to patients who relapse after discharge. Objective To report the confirmatory factor analysis (CFA) of the Crack Use Relapse Scale (CURS) in an inpatient population. Methods A five-point Likert scale with 25 items and, initially, 9 theoretical factors was generated and utilized in a cross-sectional study with a sample of 333 hospitalized male crack users. Results CFA indicated a well-fitting model for the CURS. Discussion The CFA shows that the CURS model is appropriate and well-fitting for assessment of latent variables common to psychiatric and psychological constructs – in this case, relapse of crack cocaine use after inpatient treatment.

Perceptions of parental bonding in freebase cocaine users versus non-illicit drug users.

Background & objectives: Evidence has suggested that parenting styles have peculiar characteristics in families with drug-related issues. This study was undertaken to investigate the perception of crack (smoke cocaine) users and non-users about parental bonding quality regarding care and control in Brazil. Methods: A total of 198 hospitalized crack users and 104 users of any non-illicit drug were assessed using the Parental Bonding Instrument (PBI), the sixth version of the Addiction Severity Index (ASI) and Mini International Neuropsychiatric Interview (MINI). Results: Adjusted logistic regression analysis showed that crack users were more likely (ORadj = 9.68; 95% CI: 2.82, 33.20) to perceive neglectful mothers, as well as more likely (ORadj = 4.71, 95% CI: 2.17, 10.22) to perceive controlling and affectionless fathers in comparison with non-illicit drug users who were more likely to perceive optimal parenting. Interpretation & conclusions: Our findings indicate that the perception of neglectful mothers and affectionless controlling fathers may be associated with the tendency of the children to be less resilient when facing stressful events, leading them to a greater risk to use crack.

Resgatando a resiliência de famílias em crise / Rescuing the resilience of families in crisis

É interessante observar como indivíduos e muitas famílias, diante de intempéries da vida, buscam dentro de si recursos outrora desconhecidos para transformar uma crise familiar em oportunidade de crescimento. OBJETIVO: O objetivo deste estudo foi criar um espaço terapêutico que representasse um "espelho"; assim, as três famílias envolvidas no tratamento poderiam visualizar recursos internos para o enfrentamento de suas diferentes crises. MÉTODO: Este estudo de caso clínico foi realizado com três famílias que buscaram atendimento em uma instituição especializada no tratamento familiar. Os pacientes foram tratados de acordo com a abordagem familiar sistêmica integrativa. As sessões familiares foram intercaladas com atendimentos individuais, de acordo com os critérios de avaliação da terapeuta, acordados com os integrantes das famílias. Cada família foi atendida separadamente. RESULTADOS: Durante o estudo com as três famílias, foram identificados e fortalecidos novos padrões de funcionamento. Os períodos de crises foram gradualmente transformados em processo de amadurecimento, de modo que cada integrante pudesse reconhecer suas habilidades e reconstruir uma configuração familiar resiliente. CONCLUSÃO: Os vínculos familiares foram considerados fortes aliados para que as famílias pudessem desenvolver novas habilidades funcionais, transformando os momentos de crises em um processo de fortalecimento das relações.(AU)

It is interesting to note how many individuals and families, facing the issues of life, seek resources within themselves, that were once unknown, to transform a family crisis into an opportunity for growth. OBJECTIVE: The objective of this study was to create a therapeutic space that represented a "mirror"; thus, the three families involved in treatment could visualize internal resources to cope with their various crises. METHOD: This clinical case study was conducted with three families seeking care in an institution specialized in family therapy. Patients were treated according to the integrative family systemic approach. Family sessions were interleaved interspersed with individual assistance, according to the therapist's evaluation criteria, and agreed upon with the members of the families. Each family was taken care of separately. RESULTS: During the study of the three families, new patterns of functioning were identified and strengthened. Periods of crisis were gradually transformed into the maturing process, so that each member could recognize their skills and rebuild a resilient family configuration. CONCLUSION: Family ties were considered strong allies for families to develop new functional abilities, transforming moments of crises into a process of strengthening of relations process.(AU)

Crack: da pedra ao tratamento / Crack: from rock crystal to treatment

Nas duas últimas décadas, houve crescimento importante do consumo de crack no Brasil e no mundo, tornando-se um problema de saúde pública. Embora com baixa prevalência no Brasil, em torno de 1%, em estudos populacionais, o crack tem alto poder dependógeno e seu consumo é responsável por até 70% das internações por cocaína. Um fenômeno, pelo impacto individual e social que causa, inúmeros estudos correlacionam o consumo desta droga ao aumento da violência e criminalidade. O tratamento do crack é difícil e tem desafiado os especialistas, mas algumas intervenções têm apresentado resultados promissores. Este artigo tem como objetivo trazer subsídios teóricos para o enfrentamento do consumo do crack. Para a atualização, do tema realizamos uma procura nos bancos de dados MEDline, LILACS, CAPES, SciELO e Biblioteca Cochrane

Within the last two decades, there has been an increase in crack consumption in Brazil and worldwide, being already considered a public health problem. Although the prevalence in our country is low, around 1% in population studies, the crack consumers get easily addicted to it, and its consumption is responsible for up to 70% of the number of patients hospitalized for cocaine dependence. Because of the individual and social impact which is caused by this drug, countless studies correlate its consumption to the increasing violence and criminality rates. Treating crack addiction is very difficult and it has challenged specialists, but some interventions have shown positive results. This article aims at bringing theoretical subsidies to cope with this problem. MEDline, LILACS, CAPES, SciELO and Cochrane Library databases were consulted for the update of the theme

Uso de substâncias psicoativas e violência / Psychoactive substance use and violence

As implicações causadas pelo uso de drogas são variadas. A literatura temdemonstrado que usuários de substâncias psicoativas apresentam prejuízossignificativos em seus relacionamentos familiares e sociais. O objetivo dessetrabalho foi analisar os possíveis fatores de risco que pudessem estar associadosao uso de substâncias psicoativas e a tentativa de matricídio do“estudo de caso Raul”. De acordo com o histórico clínico do paciente e com arevisão bibliográfica realizada, podem-se identificar potenciais fatores devulnerabilidade individual, familiar e social associados ao uso de substânciaspsicoativas e ao desencadeamento do comportamento agressivo/criminal nopaciente. Desse modo, é consenso entre pesquisadores que, devido à complexidadeetiológica envolta ao uso de drogas, é fundamental uma abordagemmultiprofissional que abarque todas as áreas afetadas pelo uso de drogas,bem como as suas consequências.

The implications caused by drug use are varied. The literature shows thatdrug users have significant losses in their family and social relationships. Theaim of this study was to examine possible risk factors that could be associatedwith the use of psychoactive substances and attempted matricide in “Raul’scase study”. According to the patient’s medical history and the literature review,we can identify potential individual, familiar and social vulnerability factorsassociated with the use of psychoactive substances and the onset ofaggressive/criminal behavior in the patient. Thus, there is a consensus among researchers that due to the etiological complexity wrapped with drug use, amultidisciplinary approach that encompasses all areas affected by drug useand its consequences turns out to be imperative.