Associations between alcohol use and outcome of psychological treatment in specialist psychiatric care - a cohort study.

Background: Alcohol-related issues are widespread worldwide and are fairly substantial. Numerous studies have identified and clarified the effects and prevalence of alcohol use across different contexts. However, when it comes to the prevalence of alcohol in psychiatry and its impact on treatment outcomes compared to other patient groups, studies are relatively scarce, and results often vary, sometimes with different outcomes. This study focuses on investigating the effectiveness of psychological treatment in psychiatric clinics for outpatients, considering those with and without hazardous alcohol use under naturalistic conditions. Methods: Patients were recruited between 2012 and 2016 from psychiatric clinics in Sormland, Sweden, as part of the regular services. Patients completed symptom assessment instruments regarding depression, anxiety, quality-of-life, and alcohol consumption at the beginning of their psychological treatment, upon completion, and during a follow-up 1 year after completion. Completion of questionnaires was ongoing for some patients until 2021. A total of 324 patients were included in the study, distributed among 59 participating therapists. Results: Among all patients in the study, 30.2% showed hazardous alcohol use at the start of their psychological treatment, with a higher proportion being men. There was a significant reduction in the proportion of patients with hazardous use and a notable decrease in the mean audit score upon completion of psychological treatment. At follow-up, there was no significant change compared to completion. There were 31.2% of the patients who achieved recovery or improvement in the audit score upon completion of treatment. Patients with hazardous alcohol use consistently scored higher mean values on the symptom assessment instruments and lower on the quality-of-life instrument at the beginning. More individuals with hazardous alcohol use typically achieved better results across all outcome instruments at both at completion and follow-up. Conclusion: Patients with hazardous alcohol use demonstrate significant improvements in their alcohol consumption through standard psychological treatment in psychiatry, despite the treatment not specifically focusing on alcohol consumption. The progress/improvement appears to be largely maintained at follow-up. Moreover, patients with hazardous alcohol use tend to show greater progress across all outcome instruments. No significant gender differences were detected in this context.

[Methadone and buprenorphine maintenance therapy of opioid dependence - 10 years of experience]. / LARO med buprenorfin/metadon ­ en säker och effektiv behandling.

Methadone and buprenorphine maintenance therapy of opioid dependence is an effective and safe treatment method. We used careful diagnostics, simultaneous psychosocial efforts were given, the outcome was continously evalutated and the dosage was administered according to the principle of lowest effective dose. The overall retention was 75 procent. Early occurrence of side substance use during treatment was the most important predictor of involuntary discharge. Benzodiazepines were the most commonly illegaly used addictive drugs during treatment.

A breastfeeding support program changed breastfeeding patterns but did not affect the mothers' self-efficacy in breastfeeding at two months.

BACKGROUND: Even though the biological norm in humans is frequent on demand breastfeeding, sparse feeding intervals have become the cultural norm in most Western countries due to a history of on schedule breastfeeding. This discrepancy between the biological basis and the culturally driven practice continues to interfere with women's ability to breastfeed. AIM: Our aim was to describe breastfeeding patterns in 2-month-old infants before and after the implementation of a breastfeeding support program. A secondary aim was to investigate the relationship between breastfeeding patterns and the mother's self-efficacy in breastfeeding. METHODS: The study had a baseline/intervention design and was part of a larger project aiming to revive the Ten Steps to Successful Breastfeeding program. The larger project included breastfeeding training for health care professionals and provision of breastfeeding information to parents, including information about on demand breastfeeding. Data were gathered via breastfeeding diaries (n = 79 mothers from each group) and the Breastfeeding Self-efficacy Scale-Short Form (n = 83 in the baseline group and n = 79 in the intervention group). RESULTS: On demand breastfeeding patterns were more common in the intervention group (97.5%) than in the baseline group (74.7%) (p < 0.001), and breastfeeding sessions were more frequent in the intervention group (a median of 14 times per 24 h versus 11 times in the baseline group; p = 0.026). Self-efficacy in breastfeeding did not differ between the groups, but was higher in mothers with exclusive breastfeeding. CONCLUSIONS: Knowledge about infants' breastfeeding behavior can strengthen on demand breastfeeding. Exclusive breastfeeding is associated with higher self-efficacy.

Aggression and withdrawal related behavior within conflict management progression in preschool boys with language impairment.

OBJECTIVE: This study examined conflict behavior in naturalistic preschool settings to better understand the role of non-affiliative behavior and language in conflict management. METHOD: Free-play at preschool was filmed among 20 boys with typically developing language (TL) and among 11 boys with Language Impairment (LI); the boys 4-7 years old. Conflict behavior was coded and analyzed with a validated system. Post-conflict non-affiliative behavior (aggression and withdrawal) displays, and the links between the displays and reconciliation (i.e., former opponents exchange friendly behavioral shortly after conflict termination) was examined. RESULTS: Group comparisons revealed boys with LI displayed aggression in a smaller share of conflicts, but exhibited [Symbol: see text]active' withdrawal (left the room), in a larger conflict share. Boys with TL overcame aggression (more common TL behavior) and after reconciled, to a greater extent than the boys with LI after active withdrawal (more common LI behavior). Also, after reciprocal or only verbal aggression, boys with LI reconciled to a lesser extent than boys with TL. CONCLUSIONS: The boys with LI demonstrated difficulties confronting conflict management, as well as concluding emotionally heightened and aggressive behavioral turns.

Interaction before conflict and conflict resolution in pre-school boys with language impairment.

BACKGROUND: Children with language impairment (LI) experience social difficulties, including conflict management. The factors involved in peer-conflict progression in pre-school children with LI, and which of these processes may differ from pre-school children with typical language development (TL), is therefore examined. AIMS: To describe the relationship between opponents interacting before conflict, aberrant conflict causes, the conflict-resolution strategy reconciliation (i.e. friendly contact between former opponents shortly following conflict termination), and conflict outcome in the form of social interaction after a conflict has run its course. It is hypothesized that without social interaction before conflict, children with LI will experience increased difficulties attaining reconciliation. METHODS AND PROCEDURES: Unstructured play of 11 boys with LI (4-7 years old), at a specialized language pre-school, and 20 boys with TL (4-6 years old), at mainstream pre-schools, were video filmed. Conflicts were identified and recorded according to a validated coding system. Recorded conflict details include social interaction between conflict in the pre-conflict period, behavioural sequences constituting conflict cause (conflict period), reconciliatory behaviours in the post-conflict period, and social interaction between former opponents in the succeeding non-conflict period. The group's mean proportion of individual children's conflicts in which specific behavioural sequences occurred were calculated and compared between and within the groups. OUTCOMES AND RESULTS: When conflicts with and without pre-conflict social interaction were analysed separately, aberrant caused conflicts occurred more often in LI group conflicts than in TL group conflicts. However, in conflicts without social interaction in the pre-conflict period, boys with LI exhibit reconciliatory behaviours in, and reconcile a comparatively smaller proportion of, conflicts. Social interaction in the succeeding non-conflict period was proportionately less for boys with LI. This appears to stem from lower reconciliation rates in LI conflicts that do not begin with social interaction in the pre-conflict period. It was also confounded by the larger number of aberrant caused LI conflicts that were rarely reconciled. In turn, non-reconciliation and aberrant caused conflicts were independently associated with comparatively less social interaction in the succeeding non-conflict period. CONCLUSIONS: The results suggest that in addition to traditional psycholinguistic training, children with LI may gain from interventions that support concluding behavioural turns, as in aberrant caused conflicts; and in initiating contact in conflict situations, even when a frame of reference is not immediately available, as was the case when opponents have not established social interaction in the pre-conflict period.

Behavioural patterns of conflict resolution strategies in preschool boys with language impairment in comparison with boys with typical language development.

BACKGROUND: Children with language impairment (LI) experience social difficulties, including conflict management. This paper is therefore motivated to examine behavioural processes guiding preschool peer conflict progression, which ultimately contributes to overall development. AIMS: To describe behavioural sequences in conflicts between children with typically developing language (TL) and between children with LI. Attention is particularly focused on the conflict resolution strategy reconciliation, i.e. friendly contact between former opponents shortly following conflict termination. It is hypothesized that children with LI, with weaker language skills, experience difficulties attaining effective reconciliation. METHODS & PROCEDURES: Unstructured play of 11 boys with LI (4-7-years-old), at a specialized language preschool, and 20 TL boys (4-6-years-old), at mainstream preschools, were video filmed. Conflicts were identified and recorded according to a validated coding system. Recorded conflict details included behavioural sequences constituting conflict cause (conflict period) and in the post-conflict period, reconciliatory behaviours that were classified into six 'categories' (Invitation to play, Body contact, Object offer, Verbal apology, Self-ridicule, Cognition, i.e. offering privileges/negotiating) and the verbal character of accepted behaviours were determined. The mean proportion of individual target children's conflicts in which specific behavioural sequences had occurred were calculated and thereafter compared between and within the groups. OUTCOMES & RESULTS: Boys with LI reconcile fewer conflicts than TL boys (LI: 47.3 +/- 4.5%; TL: 63.6 +/- 2.0%). Contributory factors include the occurrence of conflicts caused by aberrance, i.e. conflicts initiated by inappropriate behavioural play intensities (i.e. 'a pillow fight' where one partner swings so intensively the other partner cannot participate as a player in the game) and protests that are no longer directed to the opponent within reciprocal exchanges, but escalate to screaming/physical ranting. Aberrant caused conflicts were rarely observed as the conflict cause for TL boys, but represent nearly 15% of LI conflicts and aberrant caused conflicts are reconciled at lower rates than conflicts not caused by aberrance. Displayed reconciliatory behaviours were accepted by opponents at similar rates in both groups and the distribution of reconciliatory behavioural 'categories' was similar between the groups. However, boys with LI attempt reconciliation in relatively fewer conflicts. In addition, the individual boys with LI attain reconciliation with strictly verbal reconciliatory behaviours in a smaller proportion of conflicts. CONCLUSIONS: The findings suggest that in addition to traditional psycholinguistic remediation, intervention programmes for children with LI should address that learned language and communication skills are applied effectively in initiating and maintaining naturalistic peer interactions.

Impaired reconciliation in rhesus macaques with a history of early weaning and disturbed socialization.

An attempt had been made to create five social groups from rhesus macaques with a history of early separation from their mothers, early weaning and hand feeding and, in most cases, previous housing in single cages. We investigated the exchange of affiliative behaviours after an aggressive encounter and selective attraction to the former opponent, a phenomenon previously well described in rhesus monkeys and called reconciliation. Evidence for reconciliation was only found in one of the five groups studied (corrected conciliatory tendency=13%). This group consisted of younger animals that had, at least temporarily, been living together after separation from their mothers. In the other groups studied, containing animals with a varied background, aggressive interactions were not followed by affiliative behaviours or attraction between former opponents. Our results indicate that the use of reconciliatory behaviours in adult monkeys is dependent upon social training. Lack of functional reconciliation might be one of the explanations to the severe and uncontrolled aggression previously found in groups of rhesus macaques created from animals with disturbed early socialization.