The impact of minor stressful life events and social support on cravings: a study of inpatients receiving treatment for substance dependence.

This study examined the incidence of cravings and minor stress events, whether stress predicted cravings, and whether social support predicted cravings or moderated the relation between stress and cravings. Participants included 39 inpatients being treated for substance dependence. Minor stress was assessed with the Daily Stress Inventory, social support was measured using the Interpersonal Support Evaluation List, and cravings were measured using the Daily Urge Record Sheet. Compared to normative data, participants reported a similar number of minor stressors and rated the impact of these events as somewhat, but not significantly, more stressful. A total of 64.10% of the sample did not experience cravings. A logistic regression revealed that number of minor stressors (b = 0.59, p < .05) and perceived impact of stress (b = 0.49, p < .05) predicted cravings. Social support moderated the association between incidence of stressors and cravings (b = -0.10, p < .05). These findings suggest that minor stress may contribute to cravings, and supports the social support buffering hypothesis. Implications for theory and future research about the role of minor stress and cravings in substance abuse are discussed.

Posttraumatic stress disorder and substance abuse: use of research in a clinical setting.

The goal of the present investigation was to evaluate whether the process of assessing posttraumatic stress disorder (PTSD) in substance abuse/dependence inpatients (N = 95) as part of a research protocol influenced the diagnostic assessment conducted by clinical staff. The prevalence of current crime-related PTSD (CR-PTSD) observed with a research interview was 40% (n = 38), whereas the rate of current CR-PTSD documented in (the same) patients' discharge summaries was 15% (n = 14). An even lower CR-PTSD prevalence rate of 8% (n = 5) was obtained from a new sample of patient discharge summaries (N = 59) collected after the cessation of the research project. On chart intake reports, clinical staff documented a history of sexual and/or physical assault in approximately one-half of these patients, but PTSD was not evaluated. PTSD appears to be under-diagnosed by clinical staff in patients with substance use disorders.

Epileptic amnesic attacks: benefit from antiepileptic drugs.

We studied two sexagenarians who had recurrent circumscribed attacks of amnesia. Their EEGs showed frequent bilateral spikes that arose independently from the temporal lobes, primarily from mesiobasal structures. Amnesic attacks ceased after treatment with antiepileptic drugs. Neuropsychological tests demonstrated selective cognitive impairments, and short-term memory improved after treatment in one patient. Epileptic amnesic attacks should be distinguished from transient global amnesia, which is clinically similar.

Temporal stability of the Experienced Control Scale within an alcoholic male population.

Several reports have suggested relations of alcohol abuse to level of control experienced over various life pressures or forces. This study assessed test-retest reliability of the Experienced Control Scale (EC) (Tiffany, 1967) within a male alcoholic sample. The EC was completed on two occasions 1 week apart by 48 inpatients on an alcoholism treatment unit. Resulting test-retest reliability coefficients were .57 for the Internal ratio score, .79 for the External ratio score, .72 for the sum of the two ratio scores, and from .56 to .69 for the four basic scores used in computing ratio scores. Intellectual ability as assessed by the Shipley Institute of Living Scale was unrelated to EC scores and occasionally but conflictingly related to temporal stability of EC scores. Neither age nor education showed a significant relationship to temporal stability of the EC or to ratio scores. Implications of findings for clinical and research applications of the EC are discussed, particularly support for combining the ratio scores rather than treating them separately. Possible determinants of the obtained stability of the EC also are explored.

Aging, alcoholism, anxiety, and sensation seeking: an exploratory investigation.

Aging alcoholic (n = 36) and aging nonalcoholic (n = 35) male veterans were compared on biographic/demographic variables and psychological characteristics. Results indicated that aging alcoholics and nonalcoholics were married at approximately the same ages, married roughly the same number of times, and produced similar numbers of offspring, but aging alcoholics were better educated and had fewer persons economically dependent on them. They had higher scores than aging nonalcoholics on objective measures of state anxiety, trait anxiety, overall fears, tissue damage fears, social-interpersonal fears, miscellaneous fears, and failure/loss of self-esteem fears. Aging alcoholics also had higher scores on the sensation-seeking variable of boredom susceptibility and disinhibition, suggesting the existence of a relationship between need for sensory stimulation and maladaptive drinking among aging alcoholics.

Disulfiram acceptors and refusers: do they differ?

The present study examined possible personality and mood state correlates of alcoholics' decisions to accept or refuse disulfiram (Antabuse) as past of their treatment program. Subjects were 104 male veterans in an inpatient alcohol treatment program who were offered disulfiram after detoxification and evaluation. All subjects completed the Minnesota Multiphasic Personality Inventory, the Profile of Mood States, and the State-Trait Anxiety Inventory. Subjects were classified as acceptors (n = 78) or refusers (n = 26) based on their response to staff encouragement to undergo a trial of disulfiram. There were no significant group differences on age, racial composition, or any of the personality or mood state measures, with the exception of a trend (p less than .06) for acceptors to score higher than refusers on the masculinity-femininity scale of the MMPI. Examinations of distributions of MMPI profile code types similarly showed no differences between the two groups. Possible contextual explanations of these results are examined. Findings offer no support for the assumption that agreement to take disulfiram signifies greater motivation or intention to remain abstinent.