Treatment settings for persons with alcoholism: evidence for matching clients to inpatient versus outpatient care.

This study compared inpatient, intensive outpatient, and standard outpatient treatment settings for persons with alcoholism and tested a priori hypotheses about the interaction of setting with client alcohol involvement and social network support for drinking. Participants (N = 192) were assigned randomly in cohorts to 1 of the 3 settings. The settings did not differ in posttreatment primary drinking outcomes, although inpatients had significantly fewer jail and residential treatment days combined than outpatients. Clients high in alcohol involvement benefited more from inpatient than outpatient care; the opposite was true at low alcohol involvement levels. Network drinking support did not moderate setting effects. Clients low in cognitive functioning also appeared to benefit more from inpatient than outpatient care. Improved outcomes might be achieved by matching degree of alcohol involvement and cognitive functioning to level of care.

AIDS risk behaviors and knowledge among heterosexual alcoholics and non-injecting drug users.

The disinhibitory effects of abusable substances on sexual behavior and the increasing HIV prevalence among heterosexuals suggest that alcoholics and non-injection drug users may be at risk for HIV infection. We examined alcohol and non-injection drug use as AIDS risk factors, AIDS risk knowledge, and the effect of AIDS education upon voluntary HIV testing among 91 heterosexual male inpatients in a VA alcohol rehabilitation program. Questionnaire data revealed relationships between age, the use of alcohol, marijuana and intranasal cocaine just prior to sex and an increase in the number of female sexual partners. Use of alcohol just prior to sex was also associated with an increased number of unprotected sexual behaviors. AIDS risk knowledge in our sample was comparable to norms from previous studies. Inpatients received education concerning alcohol and sexuality either with or without an AIDS component. AIDS education and offer of HIV testing were associated with increased requests for HIV testing.

Patterns of appraisal and coping across different stressor conditions among former prisoners of war with and without posttraumatic stress disorder.

Little is known about how survivors of extreme events cope with traumatic memories and subsequent negative life experiences. The present study compared (a) repatriated prisoners of war (RPWs) from World War II (WW II) with chronic posttraumatic stress disorder (PTSD), (b) RPWs without PTSD, and (c) noncombat veterans on measures of general psychological functioning, appraisal, and coping. Appraisal and coping were assessed under 2 stressor conditions: memories of war/captivity and recent negative life events. RPWs with PTSD reported poorer general psychological functioning; significantly less control over memories of WW II: and more frequent use of self-isolation, wishful thinking, self-blame, and social support in an effort to cope with these memories than did the 2 comparison groups. Fewer between-groups differences were found for the recent stressor condition. Findings are discussed in terms of factors that may explain the perseverance of coping difficulties associated with PTSD.

Exercise as a treatment for hypertension in low-socioeconomic-status black children.

Low-socioeconomic-status (SES) Black children have a higher mean blood pressure than most other groups. The antihypertensive effects of a 12-week aerobic exercise program were examined on 11 low-SES Black children, ages 8-12, who had blood pressure above the 95th percentile. A multiple baseline across three groups of children with baseline and exercise conditions was conducted. After the introduction of the exercise program, there were significant decreases in diastolic and systolic blood pressure. Cardiovascular fitness improved concurrently. The results suggest that vigorous exercise can decrease the blood pressure of low-SES hypertensive Black children.

Behavioral management of exercise training in vascular headache patients: an investigation of exercise adherence and headache activity.

A behavioral package was used to shape and maintain the adherence of 5 subjects with vascular headache to a program of aerobic exercise training. Repeated measures of exercise behavior were examined through the use of a bidirectional changing criterion design. Repeated measures of headache activity were also collected. Results demonstrated a functional relationship between the behavioral package and exercise adherence, because all 5 subjects showed exercise behavior that matched bidirectional changing exercise criteria. The results also indicated clinically significant collateral reductions in vascular headache activity in 4 subjects. Subjects whose aerobic fitness levels were not masked by vasoactive medication also showed measurable increases in aerobic fitness. The results are discussed in terms of the methodology used to demonstrate a functional relationship between the adherence package and exercise behavior and the possible mechanism(s) by which aerobic exercise activity might affect vascular headache activity.