فهرست مطالب

High Risk Behaviors & Addiction - Volume:6 Issue: 1, Mar 2017

International Journal of High Risk Behaviors and Addiction
Volume:6 Issue: 1, Mar 2017

  • تاریخ انتشار: 1396/01/20
  • تعداد عناوین: 29
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  • Paria Ahookhosh, Bahman Bahmani, Ali Asgari, Hossein Hassanian Moghaddam* Page 1
    Background
    Several studies have shown that the suicide trend in Iran is rising. Although there is a growing number of studies that identify a number of the risk and protective factors associated with suicidal behaviors in adolescents, only a few studies have integrated this knowledge for the purpose of validating more complex models of adolescent suicidal behaviors in the Middle East.
    Objectives
    The purpose of this study was to explore a theoretically derived model positing that anxiety, depression, and hopelessness mediate between family relationships as indicators of burdensomeness and belongingness in interpersonal-psychological theory and suicide ideation among adolescent suicidal attempters.
    Patients and
    Methods
    This study develops and tests a model of suicide ideation with family relationships as antecedents, and latent variables as depression, hopelessness, and anxiety. In particular, we investigated 120 consecutive adolescent suicidal attempters who were assessed in terms of their Family Environment Scale (FES) and Beck Depression Inventory (BDI-II), Beck Hopelessness Scale (BHS), Beck Anxiety Inventory (BAI), and Beck Suicide Ideation Scale (BSSI). The final structural models have shown to be fitted to the considered data.
    Results
    The results showed that family cohesion and expressiveness were stronger predictors of suicide ideation than family conflict. Indeed, family cohesion exerted direct and indirect effects through depression, hopelessness, and anxiety on suicide ideation, and family expressiveness was also directly related to suicide ideation. It was shown that latent variables (depression, hopelessness, and anxiety) were positively correlated with suicide ideation.
    Conclusions
    The results of the study imply that family cohesion and family expressiveness act as predictive factors against depression, hopelessness, anxiety, and suicide ideation.
    Keywords: Anxiety, Dysthymic Disorder, Depression, Family Conflict, Suicide, Attempted
  • Sergei V. Jargin * Page 2
    Context: Many studies on alcohol misuse and related topics such as the use of condoms are based on surveys. However, some surveys are not free from biases. There are international differences in the attitudes of people to surveys, which should be taken into account reviewing the literature.
    Evidence Acquisition: The search of the international literature was performed predominantly using PubMed. Russian-language professional publications were searched in the internet and the electronic library of eLIBRARY.ru. The literature was reviewed and summarized on the basis of the author’s observations since 1970.
    Results
    The use of condoms in relation with alcohol drinking is largely dependent on personal characteristics; but, taken on overage, heavy binge drinking and alcohol consumption in sexual relations are risk factors for the nonuse of condoms. Besides, slowly progressing personality changes after a prolonged alcohol abuse and heavy binge drinking interfere with the risk perception and may contribute to the nonuse of condoms.
    Conclusions
    Surveys and opinion polls are valuable research tools and feedback mechanisms for administrative decisions; they should not be discredited by obtrusive questioning or asking for private information, with commercial or other purposes.
    Keywords: Alcohol Abuse, Condoms, Sexually Transmitted Infections
  • Thomas F. Kresina *, Robert Lubran Page 3
    Context: Young adults comprise roughly one-quarter of the global population and are at the developmental stage where personal life goals are formulated and personal independence is obtained. It is also the time of sexual debut and exposure to illicit drug and alcohol. Thus, young adulthood is a time of high-risk for HIV transmission due to drug and alcohol use in the context of sexual activity.
    Evidence Acquisition: Social-networking, gender norms, economic, educational, familial, personal identity and development factors, among others, play a role in linkage of illicit drug and alcohol use and HIV infection in young adults.
    Results
    It is estimated that young adults account for 42% of new HIV infections globally, and that 4 million young adults living with HIV reside in sub-Saharan Africa. In Central Asia, Eastern Europe and the United States key populations are important subpopulations of young adults at high-risk for living with HIV. Subpopulations of young adults, particularly key populations, consume illicit drug and alcohol along with high-risk sexual activity thereby establishing linkage between substance use/ substance use disorders and HIV infection.
    Conclusions
    Globally, interventions that comprise evidence-based prevention, care and treatment of substance use disorders in young adults are vital to reduce the transmission of HIV infection and promote good clinical outcomes for young adults at-risk for living with HIV.
    Keywords: Young Adults, Drug Use, Drug Use Disorder, HIV Infection, Alcohol
  • Zahra Nikmanesh *, Mohammad Hossin Baluchi, Ali Akbar Pirasteh Motlagh Page 4
    Background
    Addiction is a physiological and psychological and social disorder that consider as a huge-health problem in many societies.
    Objectives
    The present study aimed to investigate the role of self-efficacy beliefs and social support on prediction of addiction relapse.
    Patients and
    Methods
    The research method was a causal-comparison. The population of the study included all subjects who sought medical advice in the centers for addiction treatment in Saravan and Iranshahr, south-east of Iran. The study population included 166 participants (83 participants without relapse and 83 participants with relapse) selected using snowball sampling during a four-month period of voluntary participation in the centers. The variables were measured by general self-efficacy scale and Multidimensional Scale of Perceived Social Support. The data were analyzed by MANOVA.
    Results
    Findings revealed significant differences between participants without relapse and participants with relapse in terms of “self-efficacy beliefs” and “social support”. The two variables of self-efficacy beliefs and social support were the best predictors of addiction relapse.
    Conclusions
    Based on the findings of the study, it can be concluded that self-efficacy beliefs and social support play effective roles in preventing patients from addiction relapse.
    Keywords: Behavior, Addictive, Recurrence, Self Efficacy, Social Support
  • Sahar Eshrati *, Iran Davoudi, Yadollah Zargar, Esmail Hashemi Sheikh Shabani, Masoumeh Imanzad Page 5
    Background
    A fundamental question in addiction tendency is which factors propel people toward substance use. Various studies found that unsafe fields of interest are a criterion for the adoption of substance use and addicts are people with unsafe development in various areas that propel them toward substance use.
    Objectives
    The aim of this study was to model, assay, and plan a model to reveal the structural relations between psychological factors, including parenting, novelty seeking, problem behavior, and coping strategies, for addiction potential.
    Patients and
    Methods
    Structural equation modeling (SEM) was used to evaluate the relationship between parenting styles and addiction potential with mediator variables, namely novelty, coping strategies, and behavioral problems, among 572 high school students (328 male, 244 female), randomly selected in Mashhad, Iran. Data were collected using the parenting style questionnaire, temperament, and character inventory, the Achenbach youth self-report scale, the coping inventory for stressful situations, and the Iranian addiction potential scale (IAPS). AMOS-16 software was applied for evaluating the proposed model. The final model, achieved after deleting non-significant paths and the co-varying of some errors, has favorable fitness indexes (CFI = .90, RMSEA = .07).
    Results
    The study found significant relationships between parenting styles and addiction potential with mediator variables, although the most of the purposed paths between permissive parenting style and other variables were not significant.
    Conclusions
    According to standard coefficients, emotion-oriented, problem-oriented, and avoidance-oriented coping strategies, as well as behavior problems, respectively, have the largest effect on addiction potential.
    Keywords: Behavioral Problems, Coping Behavior, Novelty Seeking Behavior
  • Mina Mahdavian, Farzaneh Zolala * Page 6
    Background
    Gender differences play an important role in risky behaviors such as drug use, of the youth. Despite having a substantial youth population in the Middle East North Africa (MENA) region there are limited studies on this issue.
    Objectives
    The present study explores the parental and individual factors related to risky behaviors of boys and girls.
    Patients and
    Methods
    This cross-sectional study used a multistage cluster sampling method. The five main areas of Kerman were classified as clusters. Within the clusters, a systematic random sampling was used to select the street, where five houses were examined for eligible candidates. A self-administered questionnaire (created by the author) assessed the 500 candidates (aged 15 - 29 years) on parental styles, level of education, social capital, modern leisure activities, and risky behavior in 2013. Data were analyzed using logistic regression with SPSS 19 (statistical package of social sciences) at a significance level of 5%.
    Results
    Parental styles affecting the risky behaviors of both girls and boys were as follow: neglecting parental styles increased the risk of drug use (OR = 8.63, P = 0.04 and OR = 33.44, P = 0.001 in boys and girls, respectively). In addition, having a stay-at-home mother reduced the risk of drug use (OR = 0.09, P = 0.002) in boys, and reduced the risk of drug use and smoking in girls (OR = 0.34, P = 0.03 and OR = 0.38, P = 0.04, respectively). Also, engaging in modern leisure activities raised the risk of all risky behaviors for boys and girls (eg, alcohol drinking: OR = 1.23, P = 0.000). In boys, higher level of education reduced the risk of drug use (OR = 0.13, P = 0.05), whereas it increased the risk of sexual behaviors (OR = 2.03, P = 0.03). In girls, higher level of education was related to an increase in alcohol use (OR = 2.44, P = 0.05).
    Conclusions
    Parental style could play a different role in conducting risky behaviors among girls and boys. Therefore, appropriate parental styles should be used in bringing up children based on their gender.
    Keywords: Sexual Behaviors, Parents, Gender, Iran
  • Alia Saberi, Amir Reza Ghayeghran, Sara Janeshin, Glareh Biazar *, Ehsan Kazemnezhad Page 7
    Background
    One of the supposed risk factors of ischemic stroke is opium addiction, while the researches about its prevalence among patients with stroke are limited.
    Objectives
    The aim of this study was comparing the prevalence of opium addiction between subjects with thrombotic ischemic stroke and healthy individuals.
    Patients and
    Methods
    In this comparative cross-sectional study carried out in a number of academic hospitals affiliated to Guilan University of Medical Science in the north of Iran from April 2013 to March 2014, 83 patients involved by ischemic stroke and 83 control subjects contributed. Both groups were selected by simple sampling method. We tried to match the groups in terms of age, gender and socioeconomic condition during sampling. Those were assessed from the aspects of demographic data, risk factors of stroke, opium dependence, dosage and the methods of consumption, and the data was recorded in a designed checklist. The data were analyzed using chi-squared test, independent t-test, and multiple logistic regression models in SPSS software version 19. P
    Results
    A total of 83 patients (47% female and 53% male) with mean age of 68.55 ± 15.01 years and 83 control subjects (37.3% female and 62.7% male) with mean age of 67.94 ± 13.55 years (P = 0.782) were assessed; 39.8% of the case group and 20.5% of the control group consumed opium with no significant difference (P = 0.007). There was no difference in the amount and methods of opium consumption between the two groups. After the adjustment of the effects of underlying and confounding variables, opium was not determined as an associated factor with stroke (OR = 1.95, P = 0.096).
    Conclusions
    Opium was not identified as a risk factor of ischemic stroke. A more extended survey considering further confounding factors is recommended.
    Keywords: Stroke, Ischemia, Opium, Dependence
  • Farzad Jalilian, Behzad Karami Matin, Mohammad Ahmadpanah, Mari Ataee, Mehdi Mirzaei Alavijeh, Ahmad Ali Eslami *, Touraj Ahmadi Jouybari Page 8
    Background
    A major issue to consider in high risk behaviors such as substance abuse is personality factors.
    Objectives
    This study aimed to determine the role of personality factors (anxiety sensitivity, sensation seeking, hopelessness, and impulsivity) in substance use, psychotropic drug use, smoking, and alcohol drinking in a sample of male medical students in Iran.
    Patients and
    Methods
    In this cross-sectional study, conducted in Isfahan and Kermanshah Medical Universities in Iran, a total of 425 male medical students were randomly selected with the proportional to size from different faculties to participate voluntarily in the study. A self-report written questionnaire was applied to collect data. Then, the obtained data were analyzed by SPSS version 20 using logistic regression statistical tests at 95% significant level.
    Results
    Our findings showed that hopelessness (OR = 1.095, 95% CI: 1.033, 1.160) and sensation seeking (OR = 1.139, 95% CI: 1.065, 1.219) were the main influential predictors on smoking. Anxiety sensitivity (OR = 1.436, 95% CI: 1.114, 1.851) and impulsively (OR = 1.443, 95% CI: 1.153, 1.806) were the main influential predictors on drug abuse. In addition, anxiety sensitivity (OR = 1.460, 95% CI: 1.004, 2.124) and sensation seeking (OR = 1.756, 95% CI: 1.120, 2.753) were the main influential predictors on psychotropic drug abuse. Finally, sensation seeking (OR = 1.222, 95% CI: 1.121, 1.331) was the main influential predictor on alcohol drinking.
    Conclusions
    Our findings indicated that sensation seeking was the best predictor for alcohol drinking, cigarette smoking, and psychotropic drug abuse.
    Keywords: Alcohol Drinking, Smoking, Drug Abuse, Psychotropic Drugs, Universities
  • Alireza Mehrazmay, Mojtaba Satkin, Alireza Karambakhsh, Mahmood Salesi, Mozhgan Lotfi, Khodabakhsh Ahmadi * Page 9
    Background
    Military populations are at high risk for suicidal behavior. There are several well-known predictors for suicide and a few studies have evaluated the effect of substance abuse patterns on suicide in military environments.
    Objectives
    This study was designed to determine substance abuse related factors that predict suicidal attempts in soldiers by concerning confounding factors. The importance of determining these risk factors is that they allow us to identify high-risk people, who should receive intensive monitoring and attempts should be made to reduce modifiable predictors.
    Patients and
    Methods
    Through a cross sectional research, 3960 soldiers were selected by cluster sampling from army service garrisons in 12 regions of Iran during 2010. Data were gathered by demographic and military environment information, Texas Christian University (TCU) drug screen II and the Addiction Severity Index (ASI). The dependent variable was suicidal attempt during the military service course and the independent variables were demographic (age, education, job prior to service course and life situation), substance abuse related (the age at first substance abuse experience, alcohol abuse, tobacco abuse, ecstasy abuse, analgesics abuse, opium abuse, marijuana abuse, multi drug abuse and history of drug intoxication (subgroup analysis)), psychosocial (history of anxiety disorder, depression, obsessive compulsive disorder, personality disorder, child abuse, HIV risk behavior, physical fight) and military service-related factors (service place satisfaction, bad relationship with commanders, always having feelings of loneliness, combat situation, distance from home). Information was decoded in the SPSS 21 software and a backward logistic regression analysis was performed.
    Results
    The majority of soldiers with mean age of 21.8 (SD = 2.4) years were single (82.1%), employed (54.5%) and had a low level of education or were illiterate (71.1%). In total, 296 (7.5%) soldiers had suicidal attempts in their military service course. Predictors of suicidal attempt were education level of under diploma, age of under 18, being abused during childhood, having a history of human immunodeficiency virus (HIV) high risk behavior, anxiety disorder, depression disorder and service place dissatisfaction. By controlling known confounders, substance abuse-related predictors of suicidal attempt were first experience of substance abuse before the age of 15 (OR = 1.48, P = 0.023), abusing opium (OR = 3.92, P = 0.000), alcohol (OR = 1.39, P = 0.023) and multi substance abuse (OR = 1.37, P = 0.029).
    Conclusions
    By intensive monitoring of the situation of substance abuse among soldiers, commanders can reduce modifiable predictors of suicidal attempt.
    Keywords: Army, Soldiers, Behavior, Addictive, Suicide, Predictor, Risk Factors
  • Mehdi Noroozi, Alireza Noroozi, Ali Mirzazadeh, Ahmad Hajebi, Yadoallah Mehrabi, Sayed Saeed Hashemi, Hamid Sharifi, Seyed Ebrahim Ghoddousi, Korosh Etemad, Hamid Soori * Page 10
    Background
    The sharing of syringes by people who inject drugs (PWID) is an important factor for the transmission of HIV. Needle and syringe programs (NSP) are widely used to reduce any harm associated with drug injection, however since the impact of these programs have not been systematically studied our objective is to model the impact of NSPs on HIV incidences for PWID in Kermanshah, Iran.
    Objectives
    The aim of this study was to determine the effectiveness of NSP coverage in prevention of HIV incidence among PWIDs.
    Patients and
    Methods
    We used Wilson et al.’s mathematical model to predict the occurrence of HIV amongst PWID with sufficient and insufficient client-level coverage of NSPs. We parameterized and calibrated the model using behavioral and epidemiological data collected in an empirical study of 470 active PWID and recruited them through two Drop-In Centers (DIC) in Kermanshah, Iran from April to September, 2014. Other parameters such as risk of HIV transmission through injection with a shared injection, and effectiveness of syringe cleaning were obtained from the literature. We applied Monte Carlo simulation (10,000 runs) to capture the uncertainty (simulation interval – SI) in the model’s output.
    Results
    Given the output of the model, we found that among the PWID with sufficient coverage of NSPs the HIV rate is 1.02%, while those with insufficient coverage is increased to 4.04% (risk different = 3%, SI 95% 2.7 - 3.4%). By reducing the percentage of sharing from 18% (in patients with insufficient NSPs coverage) to 10%, the HIV incidence will be Dropped to 0.9% (SI 95%, 0.4 - 1.3%).
    Conclusions
    We found a large impact due to NSPs for reducing the occurance of HIV among active drug injectors who have been provided sufficient needles and syringes. The coverage of NSPs needs to be increased to observe such significant impact.
    Keywords: Mathematical Model, People Who Inject Drugs (PWID), Effectiveness
  • Mohammad Bagher Saberi Zafarghandi, Yalda Tabasi, Jafar Bolhari, Ali Baghbanian, Somayeh Yazdani, Mohammad Ali Adibfar, Mohsen Jadidi *, Mahboubeh Dadfar Page 11
    Background
    Drug abuse is the most problematic issue in many countries including Iran. Prevention, treatment and demand reduction programs of drug abuse have the highest priorities. In 2004, Iran’s ministry of health and medical education (MOME) integrated prevention and treatment substance use and human immunodeficiency virus infection/acquired immune deficiency syndrome (HIV/AIDS) programs in the rural primary health care (PHC) system.
    Objectives
    The aim of the present study was to evaluate the integration program of prevention and treatment of substance use and HIV/AIDS in the rural primary health care (PHC) system of Iran.
    Patients and
    Methods
    This was a cross sectional descriptive/qualitative study about supervision, assessment and monitoring by mental health experts team during year 2009. Data was collected mostly from an expert panel, which monitored the program accurately.
    Results
    The findings showed that the program was used in 380 health houses in 10 cities of Iran. The total number of inhabitants covered by the program were 5555258, and 8245 of them were substance abusers. The cases were registered and their data were reported by the managers. The function of health houses, health centers, and district health centers were assessed by considering the number of cases. The centers provided care services, interventions and harm reduction activities, and they referred some cases to specialists or other higher-level professional centers. Many educated experts including Behvarzes, multipurpose health workers, primary health personnel, educated general physicians (GPs) and family physicians (GFs) had worked actively in rural health centers. Furthermore, at district level, executive groups followed up cases were referred by (GFs).
    Conclusions
    Integrating program of prevention and treatment of substance use and HIV/AIDS in PHC system of Iran has positive outcomes. It is one of the most effective ways in this domain. It has a coherent structure, and a high potential in the introducing of PHC services to the community. The program has important impacts on the provision of health services and representation of mental health in rural areas. It seems that the program successes in the most of its goals, and can be continued and enhanced with some changes and reforms in the country.
    Keywords: Integration, Primary Health Care, Substance Abuse, Iran
  • Masoud Mozhdehi Fard, Mitra Hakim Shooshtari, Mohammad Reza Najarzadegan, Terme Khosravi, Reza Bidaki *, Maziar Moradi, Maryam Pourshams, Hamide Mohammadi Farsani, Zahra Ghiasi, Seyed Ali Mostafavi Page 12
    Background
    Childhood attention deficit hyperactivity disorder (ADHD) persists into adulthood in up to two thirds of affected patients. Usually, ADHD has co-morbidities with several psychiatric disorders, and its symptoms occur more frequently in suicide attempters and may thus be a reason for the completed act of suicide.
    Objectives
    The aim of the current study was to compare adult suicide attempters affected by ADHD with other suicide attempters without a history of suicide attempts that referred to the outpatient clinic.
    Patients and
    Methods
    This case control study was conducted at Loghman-Hakim hospital, Tehran, during a one year period. A total of 394 hospitalized patients in the poison control center that had attempted suicide were recruited. In the control group, 394 individuals without a history of suicide attempts were recruited from referrals to the outpatient clinic of Loghman-Hakim hospital, which provides services for almost all medical specialties. We used Conners’ adult ADHD rating scale, including the screening version form and subscale (CAARS-S: SV), the Wender Utah rating scale (WURS), and clinical interviews for diagnosis of ADHD. The hypothesis was tested using an independent samples t-test and ANOVA.
    Results
    The results of our study showed that a history of psychiatric disorders and a family history of ADHD and suicide were significantly higher (P > 0.01) in the case group than the control group. In addition, both children and adult ADHD among suicide attempters were significantly higher (P > 0.01) than the corresponding rates in the control group.
    Conclusions
    ADHD is a common co-morbidity among suicide attempters. Hence, early diagnosis and treatment with consideration of ADHD may reduce suicide attempt risk.
    Keywords: Attention Deficit Disorder with Hyperactivity, Suicide, Iran, Treatment, Prevention
  • Reza Bidaki, Zahra Rajabi, Mohsen Rezaeian, Masoud Sabouri Ghannad *, Mohammad Hossein Salehi Shahrbabaki Page 13
    Background
    Social acceptance in patients with HIV/AIDS is defined as the supports and aids offered by the community around them, which often leads to a better prognosis. If social acceptance is found significantly lower in HIV/AIDS-positive patients, proper planning can be designed to increase the knowledge, awareness and cultural level of society to promote patient acceptance.
    Objectives
    This research was designed to determine social acceptance in patients infected with HIV/AIDS, referred to the health center of Rafsanjan and the behavioral consultation center in Kerman, Iran, in 2013.
    Patients and
    Methods
    In this cross-sectional study, 130 HIV/AIDS-infected patients were enrolled. They filled in the Marlowe-Crowne social acceptance questionnaire and their answers were evaluated according to the questionnaire key. The scores were calculated with statistical t-test and analyzed by SPSS software version 16.
    Results
    Ninety (74.6%) patients were male and 33 (25.4%) were female. They were in the age range of 20-60 years old. Fifty four (41.5%) patients had moderate social acceptance and 76 (58.5%) had high social acceptance scores.
    Conclusions
    Among the variables including age, gender, education, occupation, residential area, marital status, family history of HIV/AIDS, family history of psychiatric disorders, and CD4 lymphocytes count, the relationship between gender, familial history of psychiatric disorders and CD4 lymphocytes count on one hand and the social acceptance on the other hand were significant (P value
    Keywords: HIV-AIDS, Social Acceptance, Consult Center
  • Heidarali Abedi, Mehri Nasiri Rizi, Ali Mohammadi Nasrollah, Arash Ghodoosi, Ali Navidian* Page 14
    Background
    Individuals’ experiences following addiction abstinence may have different meanings from the former addict’s perspective, demanding careful scrutiny to understand such experiences.
    Objectives
    This study aimed to explore and explain the meaning of the lived experiences of addicts after sobriety.
    Patients and
    Methods
    This descriptive phenomenological study aimed to describe the experiences of individuals who had stopped using drugs. The participants were 10 members of narcotics anonymous (NA) in Lenjan, Iran, who were recruited using the purposive sampling method. To gather the data, unstructured, in-depth interviews were carried out. The interviews were recorded on cassette tapes with the consent of the participants, and the collected data were analyzed using Colaizzi’s method.
    Results
    The results of this study were presented in the form of 48 codes and included the four main themes of detour, gateway, metamorphosis, and leadership. These represent the general structure of the individuals’ lives after recovery.
    Conclusions
    Our findings revealed that specific factors, such as recall of sustained suffering in the course of recovery, members’ contribution, being part of a community, participation in collective classes, feelings of equality and co-leveledness, observation of others’ success, and rethinking, played significant roles in addiction recovery.
    Keywords: Behavior, Addictive, Substance Withdrawal
  • Ali Farhoudian, Behrouz Dolatshahi *, Mozhgan Falahatdoost, Mahmoud Tavakoli, Mohammad Hassan Farhadi Page 15
    Background
    In the recent decade, Iran encountered the explosion of using methamphetamine and its consequences, including sexual high-risk behaviors.
    Objectives
    The aim of the present study was to investigate the effects of methamphetamine use on sexual high- risk behaviors in methamphetamine user males seeking treatment in public and private addiction treatment centers in Tehran, Iran.
    Patients and
    Methods
    A qualitative content analysis approach was conducted using semi-structured interviews strategy and focus group discussion. The main focus of the questions was “Can you explain sexual experiences related to methamphetamine dependency?” Then the narrative responses and the statements of 35 participants including methamphetamine users, their partners, and physicians, who focused on addiction treatment and research, were analyzed.
    Results
    Three main categories emerged from the analysis of interviews; each of these categories possessed a number of subcategories. These categories included “different attitudes towards sexual behaviors”, “compulsive sexual behaviors" and “health-related issues in sexual relationships.”
    Conclusions
    The methamphetamine use can predispose Iranian addicts to sexual high-risk behaviors. The methamphetamine users have multiple sexual partners; most of them do not use a condom, have sex with methamphetamine users, and have compulsive sexual behaviors.
    Keywords: Methamphetamine, Risk Behavior, Qualitative
  • Saeid Komasi, Mozhgan Saeidi *, Ali Zakiei, Mohammad Mehdi Amiri, Bahareh Soltani Page 16
    Background
    The use of metaphors rather than direct suggestions of treatment can help to weaken defense mechanisms against any functional changes and so cause an increase in the effectiveness of therapeutic interventions.
    Objectives
    This research was conducted with the aim of determining the effectiveness of individual metaphor therapy (IMT) in reducing the irrational beliefs and cognitive restructuring of drug addicts undergoing buprenorphine treatment.
    Patients and
    Methods
    Using a randomized controlled trial (RCT), 100 drug addicts who were referred to MMT/BMT centers in the city of Kermanshah, Iran, from July to September 2014 were selected through single-stage cluster sampling. After excluding 56 patients from the study due to their failure to meet the inclusion criteria, 44 people (37 at the end) were randomly enrolled into the experimental (n = 19) or control groups (n = 18). The SCID-I and the Jones’ Irrational Beliefs tests were used as a means of measurement. Ten sessions of IMT (one session per week) were used as the intervention for the experimental group. The controls received routine cognitive restructuring. Data analysis was conducted using a multivariate analysis of covariance (MANCOVA).
    Results
    After adjusting for age and gender, the findings of the study revealed that IMT was significantly effective in reducing the irrational beliefs of approval seeking (P = 0.02), high self-expectation (P = 0.01), frustration reactivity (P = 0.03), anxious over concern (P = 0.02), and perfectionism (P = 0.006).
    Conclusions
    Since IMT can repeatedly neutralize patients’ defenses without aggravating their anxiety, and as the therapy can help patients via the development of a new awareness or reformatting the patients’ condition, it is recommended that this kind of therapy be used more widely in cognitive restructuring among drug addicts.
    Keywords: Metaphor, Cognitive Therapy, Attitude, Drug Users, Buprenorphine
  • Yatan Pal Singh Balhara, Siddharth Sarkar *, Sagar Chandra Bera, Rishi Gupta, Nishtha Chawla, Rakesh Lal Page 17
    Background
    There is limited literature available on the diagnosis and treatment of dual disorders in non-western settings.
    Objectives
    The present study aims to describe the profile of patients diagnosed at a dual disorders clinic over a period of 12 years.
    Patients and
    Methods
    This retrospective study analyzed the case records of patients registered in the dual diagnosis clinic of the national drug dependence treatment centre (NDDTC) in Ghaziabad. Information relating to the demographics of the sample, substance use disorders, and psychiatric disorders were extracted from the case records. The association between the use of specific substances and psychiatric illnesses was assessed.
    Results
    The study included 492 patients, the majority of whom were male, married, and employed. Psychotic disorders were the largest category among the comorbid psychiatric disorders (38.7%), followed by depressive disorders (27.5%), and bipolar disorders (20.0%). Among the patients with primarily psychotic disorders, 40.8% were deemed to have substance-induced psychosis. Cannabis use had greater odds of being associated with psychotic disorders, opiates and benzodiazepines with depressive disorders, and alcohol with anxiety disorders.
    Conclusions
    The establishment of a dual diagnosis clinic offers an opportunity to gain further insights into the characteristics of patients diagnosed with dual disorders. It may also offer opportunities for training health-care personnel, evaluating specific treatment approaches, and providing comprehensive services customized to the patients’ needs.
    Keywords: Diagnosis, Dual (Psychiatry), Psychotic Disorders, Substance-Related Disorders, Cannabis, Mental Disorders
  • Natalia A. Villegas *, Shonaly M. Chodhury, Victoria B. Mitrani, Jessica Guerra Page 18
    Background
    Most women in substance abuse treatment are of childbearing age, and many of them have children who both are affected by and influence the mother’s substance abuse and treatment behaviors.
    Objectives
    This qualitative study (n = 13) was conducted in two drug treatment centers in southern Florida and explored the perspectives of mothers currently or recently in substance abuse treatment regarding their recovery motivators and challenges, as well as their attitudes and preferences regarding family involvement in their treatment.
    Patients and
    Methods
    We used a qualitative descriptive approach. In-depth interviews were conducted with the participants and centered on 3 major themes: (a) motivators for recovery, (b) challenges for recovery, and (c) attitudes and preferences for family involvement in recovery.
    Results
    Findings revealed that family plays an important role in the recovery of these mothers, and that mothers are willing to incorporate their families in their recovery process. Women expressed a positive attitude towards family therapy, and they believed that it could benefit their recovery, and their relationship with their children and families.
    Conclusions
    The findings of this study can contribute to the development of a family-based substance abuse treatment aftercare intervention that might benefit women in substance abuse treatment.
    Keywords: Family Therapy, Mothers, Mental Health, Substance Abuse, Women
  • Henri Chabrol, Stephanie Laconi *, Manon Delfour, Axelle Moreau Page 19
    Background
    Problematic Facebook use, also known as Facebook addiction, has recently been recognized as a cause of potential harm to adolescents and young adults. Some problematic Internet use risk factors have been linked to Facebook use. Yet few studies have explored the risk factors for problematic Facebook use in young people.
    Objectives
    The aim of this study was to evaluate the contribution of psychopathological variables, in particular borderline traits and interpersonal variables (i.e., parent and peer attachments and parental bonding styles), to the explanation of problematic Facebook use symptoms by taking gender into account and controlling for motives, one of the most important risk factors for problematic Facebook use.
    Patients and
    Methods
    The final sample consisted of 456 Facebook users (227 women) aged from 12 to 25 (M = 20.5; SD = 2.5). These participants completed online self-report questionnaires assessing problematic Facebook use, motives for Facebook use, depressive symptoms, social anxiety, sensation seeking, borderline personality traits, parental bonding and attachment, and peer attachment.
    Results
    Multiple regression analyses showed that motives and maternal overprotection were the main predictors of problematic Facebook use symptoms in both genders. Mediation analyses suggested that borderline personality traits and overprotection played different roles in the development of problematic Facebook use symptoms. In females, borderline traits were a mediator in the relation between maternal overprotection and problematic Facebook use symptoms. In males, maternal overprotection was a mediator in the relation between borderline traits and problematic Facebook use symptoms. To our knowledge, this is the first study exploring the contribution of parental bonding and borderline traits to problematic Facebook use.
    Keywords: Social Media, Internet, Borderline Personality Disorder, Gender
  • Brittany B. Dennis, Monica Bawor, James Paul, Carolyn Plater, Guillaume Pare, Andrew Worster, Michael Varenbut, Jeff Daiter, David C. Marsh, Dipika Desai, Lehana Thabane, Zainab Samaan * Page 20
    Background
    Current tools such as the Maudsley Addiction Profile (MAP) exist to evaluate different facets of addiction severity, however these instruments have neither been designed for nor validated within patients on methadone maintenance treatment (MMT).
    Objectives
    We aimed to provide a reliable tool to evaluate multiple domains of treatment response for patients on MMT. This tool can be applied easily with minimal time to patients, researchers and clinicians.
    Patients and
    Methods
    We modified the MAP to address health and social outcomes specific to the MMT patient population. Construction of the new tool was accomplished using expert opinion and MAP scores from participants recruited for the Genetics of Opioid Addiction (GENOA) study. This modified scale known as the GENOA Risk Evaluation Tool (GREAT) was then applied to 21 MMT patients in a generalizability study (G-Study) to assess reliability and consistency. We performed a criterion validation of the GREAT to assess the predictive validity of GREAT substance use domain scores against urine toxicology screening for illicit opioids using multi-variable logistic regression analysis (n = 117).
    Results
    Results showed excellent test-retest reliability for the GREAT (0.95) and its subscales (all ≥ 0.94). Results from the regression model showed the GREAT substance use score was a significant predictor for 3-month history of illicit opioid use (Odds Ratio [OR]: 1.16, 95% Confidence Interval 1.05, 1.29; P = 0.003).
    Conclusions
    A modified tool to assess methadone treatment response serves to identify patients at high-risk for relapse at a minimal cost, as well as evaluate the relevant physical and psycho-social domains affecting opioid-dependent patients. The GREAT will serve as a useful adjunct to regular clinical assessments, allowing clinicians and researchers to properly assess opioid addiction patient’s response to MMT.
    Keywords: Methadone, Opioid Dependence, Addiction, Risk Evaluation, Opioid Substitution Treatment
  • Mehrnaz Rezvanfard, Alireza Noroozi, Mehrshad Golesorkhi, Ensieh Ghassemian, Aiden Nasiri Eghbali, Azarakhsh Mokri, Hamed Ekhtiari * Page 21
    Background
    Increasing evidence indicates that opiate users and methadone maintenance patients (MMPs) are impaired in executive control tasks and response inhibition behavior compared to healthy individuals; however, the cognitive functional difference between opiate addicts and MMPs has not been clarified.
    Objectives
    This study employed Go/No-Go tasks to evaluate the response inhibition behavior in three groups: active opiate users, stable MMPs and healthy control subjects with negative urine analysis.
    Patients and
    Methods
    In this study, 45 opiate-dependents (including opium and heroin), 50 successful methadone maintenance patients (MMPs) and 50 normal controls were recruited. These three groups were matched in terms of age, gender and education level. Each subject conducted the six variants of Go/No-Go tasks in a sequential order, after being given the instructions to respond to stimulus displayed on the screen by pressing the space bar as quickly as possible (Go stimuli) and withholding responses to other stimuli (No-Go stimuli). We used Mann-Whitney nonparametric analysis to compare the performances of opiate users, MMPs and healthy controls on Go/No-Go task scores.
    Results
    In Go trials, opiate dependents and MMPs showed better performance than controls with lower omission errors, while in No-Go trials, opiate users and MMPs committed more errors and revealed poorer performance than the controls. No significant difference was found between opiate users and MMPs performance on Go or No-Go trials, and these groups were significantly faster than controls in response to targets on Go trials or non-targets on No-Go trials.
    Conclusions
    Opiate users and MMPs showed significant deficits on measures of response inhibition when compared to the normal participants, while MMPs did not differ from opiate users in their ability to inhibit their response to non-targets.
    Keywords: Inhibition (Psychology), Methadone, Opiate, Patients
  • Roghieh Nooripour, Mohammad Reza Abdi, Saeed Bakhshani, Mostafa Alikhani *, Simin Hosseinian, Taghi Pour Ebrahim Page 22
    Background
    Today the internet has become a part of our everyday life; communicating online has made it easy for people to begin and develop interpersonal relationships. Certain problems, however, appear to result directly from relationships online. One of these problems which has been prevalent among couples and families is extramarital internet relationships or internet infidelity. Study of this phenomenon in Iranian users’ needs a tool for evaluation.
    Objectives
    This study has been done to validate the internet infidelity questionnaire among internet users in Iran.
    Patients and
    Methods
    The internet infidelity questionnaire was translated and verified by experts and was conducted via the Internet on 481 Iranians (255 males) who were members at Iranian sites and chatrooms and were selected through sampling.
    Results
    Exploratory factor analysis was conducted on obtained data, resulting in a Persian internet infidelity questionnaire with 43 items as well as three main factors.
    Conclusions
    This internet infidelity questionnaire is a valid and reliable tool to assess the betrayed partner of internet infidelity. This questionnaire can justify 65.89 percent of common variance.
    Keywords: Internet, Iran, Questionnaires, Validity-Reliability
  • Seyed Reza Mousavi Gilani *, Alireza Dashipour Page 23
    Background
    Exercise is a way to improve self-esteem.
    Objectives
    The purpose of this study was to investigate the effects of eight weeks of aerobic exercise on the self-esteem of medical students at Zahedan University of Medical Sciences in Iran.
    Patients and
    Methods
    This study used a 58-item Coopersmith inventory to measure the self-esteem of 84 male students who participated in an exercise program as an intervention. Both dependent and independent t-tests, as well as a chi square test, were applied using SPSS software.
    Results
    The results showed that although the self-esteem average score was not significant before the intervention, it increased significantly in the experimental group. In the experimental group, the variation in the meanself-esteem score was 32.36–42.89 before and after the intervention.
    Conclusions
    Our findings revealed that aerobic exercise increases self-esteem. An improvement in educational, family, social, and general self-esteem scores was seen only in the experimental group.
    Keywords: Family, Physical Activity, Self Esteem
  • Ali Salami *, Ali Ghaddar, Eleonore Aboumrad, Wissam H. Joumaa Page 24
    Background
    The use of dietary supplements is very common in sport gyms worldwide. However, their use in exercisers in Lebanese gyms has never been investigated.
    Objectives
    The study aim was to evaluate the dietary intake of food macronutrients and to explore any side-effects associated with this kind of consumption.
    Patients and
    Methods
    Three hundred and sixty exercisers aged 20 - 50 years were randomly selected for participation in this cross-sectional study. The majority were men (60%) aged 20 - 30 years (78%).
    Results
    The intake of dietary supplements was observed in 38% of the study participants, with the highest prevalence in men (73%). It was also found that daily protein intake exceeded dietary needs in 92% of the participants, while daily fat intake was less than that required in 76% of them. It was noteworthy that 63% of supplement users in this study reported having experienced between one and several side-effects.
    Conclusions
    These results indicate a lack of awareness among people who exercise regularly on the benefits and side-effects of dietary supplements. There is an urgent need for the implementation of campaigns that target gym users in Lebanon to raise awareness in this regard.
    Keywords: Adverse Effects, Dietary Habits, Dietary Supplements, Lebanon
  • Seyed Ali Akbar Refahi *, Mohsen Hosseinbor, Zainab Poudineh, Mohammad Sharif Hosseinbor, Samira Masumian Page 25
    Background
    The use of addictive substances is one of the most important problems of human societies and one of the major challenges for the social, health, and political realms. Although the problem is not confined to specific age groups, young people at risk are among the main groups.
    Objectives
    This study examined the frequency of using alcohol and substances among students of Islamic Azad university in Zahedan in 2012.
    Patients and
    Methods
    This cross-sectional study included 1,014 students studying at the Islamic Azad university, Zahedan, using cluster sampling and distribution based on gender, college, and graduate level using the high-risk behaviors questionnaire. Demographic data were collected using a questionnaire.
    Results
    Smoking prevalence rates among female and male students were 6.80% and 39.1%, respectively. The prevalence of water pipe smoking in female students was 26.1%, and for male students, it was 56.7%. About 4.7% of female and 21.6% of male students reported using alcohol at least one or more times. The prevalence rates of drug use were 2.4% and 13.5% among female and male students, respectively.
    Conclusions
    The study results indicate a high prevalence of drug use among students. Thus, it is suggested that preventive and therapeutic interventions for university students are important and necessary.
    Keywords: Behavior, Addictive, Drugs, Smoking, Alcohol
  • Samaneh Fouladi *, Norodin Mir, Nour Mohammad Bakhshani, Mohammad Davoud Mohebi, Fariba Piri, Mehdi Sargazi Page 26
    Background
    Drug addiction is one of the most significant problems related to general health in the world, creating various mental problems in addicts and leading to social and family difficulties. Emotional factors also play a key role in treating addiction.
    Objectives
    The purpose of this study is to examine emotional self-awareness and impulse control in drug-dependent individuals with and without borderline personality characteristics undergoing methadone maintenance treatment (MMT).
    Patients and
    Methods
    This was a descriptive-correlational study. The population of the study included 361 drug-dependent individuals under Methadone Maintenance Treatment (MMT) who were selected randomly among referrals to substance abuse treatment clinics in Zahedan, Iran, in 2013. To obtain data, emotional self -awareness and impulse control were assessed using Bar-On Emotional Quotient Inventory (EQI) and Millon Clinical Multiaxial Inventory III (MCMI-III). Data were analyzed using SPSS software version 16.
    Results
    The findings indicated no significant differences between these two groups in terms of their emotional self-awareness (P ≥ 0.01). With regard to impulse control, the results revealed significant differences between these two groups (P ≤ 0.01).
    Conclusions
    It can be indicated that reinforcing components of emotional intelligence, especially emotional-awareness and impulse control, are effective methods to develop against substance use in among drug-dependent individuals.
    Keywords: Emotional Adjustment, Impulse-Control Disorders, Substance Abuse, Borderline Personality Disorder
  • Roya Noori *, Abbas Deylamizade Page 27
    In Western Asia, Afghan refugees constitute one of the main vulnerable populations with drug and HIV treatment needs. However, there is not considerable provision of drug and HIV services for this group. The study aimed to describe the provision of drug treatment and harm reduction services for Afghan refugees in Iran, the most populous Persian Gulf country. With the collaboration of the United Nations High Commissioner for Refugees in Tehran, Iran, a project was conducted by Rebirth Society in 2010 to provide free drug and HIV treatment and harm reduction services. Two drop-in-centers were allocated to the project. Six outreach peer members and four staff members were trained. Data were collected by a checklist and analyzed by SPSS version 18. Eighty-one Afghan refugees were admitted. All of them were drug users and needed HIV services. Drug treatments such as methadone maintenance treatment and therapeutic community services were provided. In addition, harm reduction programs such as condom education and distribution, HIV/AIDS education, voluntary counseling and testing, and needle and syringe programs were implemented. The project was an important step in the provision of drug and HIV services for Afghan refugees. Designing and providing long-term related services are suggested.
    Keywords: Drug, Harm Reduction, HIV, Persian Gulf, Refugees