Healing men and community: predictors of outcome in a men's initiatory and support organization.

Men have poorer health and declining social outcomes when compared to women, and research suggests that behaviors related to restrictive and traditional male gender roles contribute to this disparity. This study is an examination of The ManKind Project International (MKPI), a community-based organization that provides alternative male gender norms and a community support system to help reinforce them. The MKPI runs an intensive, experiential "Training Adventure Weekend" (TAW), followed by voluntary, on-going peer-led support and integration groups (I-Groups). One hundred men completed a pre-TAW questionnaire, an interview, and a long-term follow-up (>18 mo.) questionnaire. The study examined if there was change on the primary study variables at follow-up, and the relationship of background characteristics (age, self-help group experience) and factors related to participation (MKPI beliefs, social support, I-Group participation) to the criterion variables (depression symptoms, gender role conflict, and life satisfaction) at follow-up. Results indicated significant change in the expected directions on the primary study variables, suggesting that for these men, participation has a positive impact. Most importantly, changes in MKPI-related beliefs and social support significantly predicted positive outcomes. Also, more positive outcomes were found among men 30-44 years of age, but not among those with more prior self-help experience or I-Group participation. Possible explanations for these findings and directions for further research are discussed.

Assessing traumatic event exposure: comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for DSM-IV.

Post-traumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. The authors compared a behaviorally specific comprehensive multiple-item traumatic event measure with a single-item measure to determine their impact on traumatic event identification and subsequent PTSD diagnosis. In a within-subject, counterbalanced design, the Traumatic Life Events Questionnaire (TLEQ; E. S. Kubany et al., 2000) was compared with the single-question traumatic event assessment in the Structured Clinical Interview for DSM-IV (SCID; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1998) in 129 participants in opioid-dependence treatment. The TLEQ produced a 9-fold higher rate of traumatic events reported by the participants, compared with the SCID. As a result, PTSD diagnoses in the sample increased to 33% after the TLEQ measure from 24% after the SCID. The increase in potential traumatic event identification and PTSD diagnosis was greater in women than in men. This study provides strong support for the use of comprehensive traumatic event assessments to measure traumatic events and PTSD diagnoses, particularly in women.

Sleep problems reported by patients entering opioid agonist treatment.

Treatment-seeking opioid-dependent individuals frequently report sleep-related problems. This study provides a detailed assessment of sleep duration and quality in this population, including their effect on daily functioning and relationship to psychiatric severity and drug use. Samples of newly admitted patients to opioid agonist maintenance treatment (n = 113) completed a series of questionnaires to assess sleep functioning, psychiatric severity, and drug use due to sleep problems over the past 30 days. The results showed that study participants reported considerable sleep-related difficulties that had little effect on their appraisals of daily functioning. Nevertheless, sleep problems were associated with psychiatric distress, and those reporting substance use specifically to increase or decrease sleepiness endorsed more sleep problems and lower levels of daily functioning. Overall, these results replicate and extend previous work showing poor sleep functioning in this population and show that sleep problems are associated with variables that often have an adverse impact on substance abuse treatment outcome.