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...on Women
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www.ProjectCork.org
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Summer 2009
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Adolescent depressive symptoms and smoking behavior: The gender-specific role of weight concern and dieting
Larsen JK; Otten R; Engels RCME. Journal of Psychosomatic Research 66(4): 305-308, 2009. (20 refs.)
Objective: Increased weight concern and dieting are associated with both depression and smoking among adolescents, particularly girls. This cross-sectional study examined the gender-specific role of weight concerns and dieting on the adolescent depression-smoking association. Methods: Participants were 2051 adolescents (1056 boys and 995 girls) from seven high schools in the Netherlands who filled out questionnaires on smoking, depression, and weight constructs and of whom weight and height were measured. Results: Logistic regression analyses showed that for girls, but not for boys, the depression-smoking association disappeared after controlling for weight concerns and dieting. Conclusion: Our findings indicate that weight concerns and dieting are important factors to consider in the depress ion-smoking initiation relation for girls, but not for boys. This suggests that smoking prevention programs for depressed girls might be enhanced by challenging the idea of smoking as a diet strategy and incorporating a focus on healthy weight regulation. However, before setting up a prevention trial, future prospective studies should first examine why and how weight concerns and dieting are important factors in the depression-smoking initiation relation among girls, also in conjunction with other established risk factors such as parental and peer smoking. Copyright 2009, Elsevier Science.
Are women at greater risk? An examination of alcohol-related consequences and gender
Sugarman DE; DeMartini KS; Carey KB. American Journal on Addictions 18(3): 194-197, 2009. (31 refs.)
Men typically drink more than women; however, women achieve higher BACs (blood alcohol concentration) than men at equivalent consumption levels. This study investigated the unique effect of gender on individual alcohol problems by controlling both consumption and intoxication in a sample of 1,331 undergraduate drinkers. Gender independently influenced the risk of experiencing seven of nine negative consequences: (a) being female increased risk for tolerance, blacking out, passing out, drinking after promising not to, and getting injured; (b) being male increased risk for damaging property and going to school drunk. Gender patterns should be explored in a wider set of alcohol-related problems. Copyright 2009, Taylor & Francis.
Caffeinated and alcoholic beverage intake in relation to ovulatory disorder infertility
Chavarro JE; Rich-Edwards JW; Rosner BA; Willett WC. Epidemiology 20(3): 374-381, 2009. (59 refs.)
Background: Many studies have examined whether caffeine, alcohol, or specific beverages containing these substances affect fertility in women. However, most of these studies have retrospectively collected information on alcohol and caffeine intake, making the results susceptible to biases. Methods: We followed 18,555 married women without a history of infertility for 8 years as they attempted to become (or became) pregnant. Diet was measured twice during this period and prospectively related to the incidence of ovulatory disorder infertility. Results: There were 438 incident report of ovulatory disorder infertility during follow-up. Intakes of alcohol and caffeine were unrelated to the risk of ovulatory disorder infertility. Comparing the highest to lowest categories of intake, the multivariate-adjusted relative risk, was 1.11 (95% confidence interval = 0.76-1.64; P for trend 0.78) for alcohol and 0.86 (0.61-1.20; 0.44) for total caffeine. However, intake of caffeinated soft drinks was positively related to ovulatory disorder infertility. Comparing the highest to lowest categories of caffeinated soft drink consumption, the RR was 1.47 (1.09-1.98; 0.01). Similar associations were observed for noncaffeinated, sugared, diet, and total soft drinks. Conclusions: Our findings do not support the hypothesis that alcohol and caffeine impair ovulation to the point of decreasing fertility. The association between soft drinks and ovulatory disorder infertility seems not to be attributable to their caffeine or sugar content, and deserves further investigation. Copyright 2009, Lippincott, Williams & Wilkins.
Chronic smoking prevents amelioration of endothelial function in the course of the menstrual cycle
Jochmann N; Mueller S; Kuhn C; Gericke C; Baumann G; Stangl K et al. Circulation Journal 73(3): 568-572, 2009. (28 refs.)
Background: Smoking is the most important modifiable cardiovascular risk factor in young women. The aim of this study was to investigate whether tobacco use influences physiological changes in endothelial function during the menstrual cycle. Methods and Results: Flow-mediated dilation (FMD) and nitro-mediated dilation (NMD) were assessed in healthy smoking and non-smoking women, by high-resolution ultrasound at 3 time points during the menstrual cycle: at menstruation, in the mid-follicular phase, and in the mid-luteal phase. A total of 25 women (12 nonsmokers, 13 smokers) completed the study protocol. FMD did not show differences between smoking and nonsmoking women at menstruation and the mid-follicular phase. At the mid-luteal phase, however, FMD was significantly reduced in smoking when compared with non-smoking women. NMD did not differ between smoking and non-smoking women, nor between the different cycle phases. Conclusions: In healthy women, smoking eliminates the physiological amelioration of endothelial function during the menstrual cycle. This study underlines the importance of an exact description of menstrual cycle phase and smoking status in studies investigating endothelial function in premenopausal women. Copyright 2009, Japanese Circulation Society.
Do drug treatment services predict reunification outcomes of mothers and their children in child welfare?
Grella CE; Needell B; Shi YF; Hser YI. Journal of Substance Abuse Treatment 36(3): 278-293, 2009. (67 refs.)
The effect of mothers' participation in substance abuse treatment on reunification with their children who are in out-of-home care is an important policy issue. This article examines the predictors of child reunification among mothers who participated in a statewide treatment outcome study. Data were integrated from multiple sources to determine the contributions of characteristics of mothers (n = 1, 115), their children (n = 2,299), and treatment programs (n = 43) on reunification outcomes. Hierarchical linear modeling was used to determine the fixed and random effects of mother, child, and program characteristics. Mothers with more employment and psychiatric problems were less likely to be reunified with their children; completion of 90 or more days in treatment approximately doubled their likelihood of reunification. Mothers who were treated in programs providing a "high" level of family-related or education/employment services were approximately twice as likely to reunify with their children as those who were treated in programs with "low" levels of these services. Copyright 2009, Elsevier Science.
Illicit drug use among women with children in the United States: 2002-2003
Simmons LA; Havens JR; Whiting JB; Holz JL; Bada H. Annals of Epidemiology 19(3): 187-193, 2009. (40 refs.)
PURPOSE: Given research that shows youth exposed to maternal addict ion have increased rates of cognitive, socioemotional, and behavioral problems, we examined the prevalence and correlates of past year illicit drug abuse or dependence among women with children younger than 18 years of age in the home to identify maternal risk factors. METHODS: Data were from the 2002 and 2003 National Survey on Drug Use and Health, a nationally representative sample of the U.S. civilian population. The current analysis utilized a subsample of women (N = 19,300) who reported having children Younger than 18 years in the home. Past year abuse or dependence on cocaine, heroin, marijuana, stimulants, and hallucinogens as well as nonmedical use of prescription medications were assessed. RESULTS: The prevalence of illicit drug abuse or dependence was 1.9%. Mothers reporting drug abuse or dependence had increased odds of being unmarried, controlling for other demographics. They also were more likely to report stress, poorer health status, and meet the criteria for serious mental illness (SMI). CONCLUSIONS; Prevention and intervention strategies should focus on developing and testing methods to screen for both risk factors associated with maternal drug abuse and actual substance abuse in primary and emergency care settings to reduce youth exposure and improve child developmental outcomes. Copyright 2009, Elsevier Science.
Maternal lactation characteristics after consumption of an alcoholic soup during the postpartum 'doing-the-month' ritual
Chien YC; Huang YJ; Hsu CS; Chao JCJ; Liu JF. Public Health Nutrition 12(3): 382-388, 2009. (53 refs.)
Objective: The present study examined whether ethanol exposure influences lactation parameters. Specifically, selected constituents in maternal blood and milk and die lactation performance of Chinese lactating mothers were evaluated after they had consumed chicken soup flavoured with sesame oil and rice wine (CSSR), a diet traditionally prescribed during the postpartum 'doing-the-month' ritual. Design: Twenty-three lactating mothers were examined. informed consent was obtained from each subject. Each subject was tested on two occasions separated by a week. The target alcohol dosage was 0.3 g/kg body weight. Milk and blood samples were collected prior to consumption of soup and at 120 and 150 min, respectively, after consumption. Levels of various constituents were measured. The time for ejection of the first milk droplet and total milk volume yielded were also measured. Results: Consumption of CSSR influenced TAG, insulin and lactate levels in maternal blood. Likewise, consumption of the Soup affected milk composition and its nutritional status, particularly total protein, TAG, fatty acid, P-hydroxybutyrate and lactate levels. CSSR intake significantly affected TAG and lactate levels in milk. The time for the first milk droplet to be ejected was significantly longer in the CSSR group, indicating that the milk-ejecting reflex is inhibited. However, blood prolactin level increased slightly after ethanol intake. Milk yields were reduced after ingestion of CSSR although the difference was not statistically significant. Conclusion: Consumption of CSSR affects not only the composition of maternal blood and milk, but also lactation performance. These findings suggest that an alcoholic diet should be avoided during lactation. Copyright 2009, Cambridge University Press.
Prevalence and correlates of drug/alcohol-facilitated and incapacitated sexual assault in a nationally representative sample of adolescent girls
McCauley JL; Conoscenti LM; Ruggiero KJ; Resnick HS; Saunders BE; Kilpatrick DG. Journal of Clinical Child and Adolescent Psychology 38(2): 295-300, 2009. (21 refs.)
Incapacitated/drug-alcohol facilitated sexual assault (IS/DAFS) is rapidly gaining recognition as a distinct form of assault with unique public health implications. This study reports the prevalence, case characteristics, and associated health risks of IS/DAFS using a large, nationally representative sample of 1,763 adolescent girls. Results indicate that 11.8% of girls experienced at least one form of sexual assault; 2.1% of the total sample experienced IS/DAFS. Thus IS/DAFS accounted for 18% of all reported sexual assaults, with a prevalence of 4.0% among girls 15 to 17 years of age and 0.7% among girls 12 to 14 years of age. Girls with a history of IS/DAFS were significantly more likely than girls with other sexual assault histories to report past-year substance abuse but not significantly more likely than girls with other sexual assault histories to report past-year depression or posttraumatic stress disorder. Copyright 2009, Lawrence Erlbaum Associates.
Prevalence of psychiatric and substance use disorders among single mothers nearing lifetime welfare eligibility limits
Cook JA; Mock LO; Jonikas JA; Burke-Miller JK; Carter TM; Taylor A et al. Archives of General Psychiatry 66(3): 249-258, 2009. (46 refs.)
Context: In the 1990s, US welfare reform legislation imposed a 5-year lifetime limit on financial support for low-income families with young children (younger than 18 years). With increasing numbers of single mothers and their children reaching the end of their welfare eligibility, there is concern about potentially high rates of untreated psychiatric and substance use disorders in this population. Objective: To determine the prevalence, correlates, and likelihood of treatment for mental and substance use disorders in a population of urban single mothers receiving Temporary Assistance for Needy Families (TANF). Design: In-person diagnostic assessments were conducted from November 1, 2003, to October 31, 2004. Setting: Cook County, Illinois. Participants: Female TANF recipients and residents of Cook County (N = 333) who were randomly sampled during the final 24 months of their eligibility for TANF. Main Outcome Measure: Prevalence rates of DSM-IV mental and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Results: Lifetime prevalence of Composite International Diagnostic Interview disorders was 61.0% (95% confidence interval [CI], 55.7%-66.3%); 12-month prevalence was 46.8% (41.5%-52.2%). Lifetime prevalence of mental disorders was 53.2% (95% CI, 47.8%-58.5%); 12-month prevalence was 44.1% (38.8%-49.5%). Lifetime prevalence of substance use disorders was 29.1% (95% CI, 23.9%-33.8%); 12-month prevalence was 9.0% (6.8%-12.0%). Lifetime prevalence of comorbid mental/substance use disorders was 21.3% (95% CI, 16.9%-25.7%); 12- month prevalence was 6.3% (3.7%-8.9%). Only 21.7% (95% CI, 14.8%-28.5%) of participants with 12- month mental disorders received treatment for mental disorders; 41.4% (22.3%-60.4%) of participants with 12- month substance abuse disorders received treatment for substance use disorders. Conclusions: Despite the high prevalence of psychiatric and substance use disorders in this population, many remain untreated. The consequences of terminating welfare assistance are worthy of further investigation, given the potential for adverse effects on both mothers and their young children. Copyright 2009, American Medical Association.
Psychopharmacologic management of opioid-dependent women during pregnancy
Martin PR; Arria AM; Fischer G; Kaltenbach K; Heil SH; Stine SM et al. American Journal on Addictions 18(2): 148-156, 2009. (62 refs.)
Illicit drug use during pregnancy presents complex clinical challenges, including reducing drug use and treating psychiatric disorders. Pharmacologic treatment of psychiatric disorders in a pregnant woman requires an evaluation of the balance between potential clinical benefit and the risk of potential neonatal consequences. This study describes psychiatric symptoms in 111 opioid-dependent pregnant women and their prescribed psychotropic medications. Hypomania, generalized anxiety disorder and depression were the most common disorders for which psychiatric symptoms were endorsed. Over half of women studied were prescribed some form of psychoactive medication during pregnancy. Pharmacologic vs. non-pharmacologic treatment approaches in this patient population are discussed. Copyright 2009, Taylor & Francis.
Simultaneous cannabis and tobacco use and cannabis-related outcomes in young women
Agrawal A; Lynskey MT; Madden PAF; Pergadia ML; Bucholz KK; Heath AC. Drug and Alcohol Dependence 101(1-2): 8-12, 2009. (33 refs.)
Compared to those who reported a lifetime co-occurrence of cannabis and tobacco use, individuals who report simultaneous use of cannabis and tobacco are more likely to also report higher rates of substance-related problems and psychopathology. In a sample of young women, we examine (a) co-occurring use, or whether regular cigarette smoking is associated with increased cannabis involvement and (b) simultaneous use, a special form of co-occurring use where cannabis and cigarettes are typically used on the same occasion to test whether those Who use cannabis and tobacco simultaneously are also more likely to report greater cannabis involvement and (c) the extent to which latent genetic and environmental factors contribute to simultaneous use in those with a history of co-occurring cannabis use and regular cigarette smoking. Women (N= 3427) who report regular cigarette smoking are 4.5-9.5 times more likely to report co-occurring cannabis use and other stages of cannabis involvement, including DSM-IVcannabis abuse and dependence. In those women who report co-occurring regular cigarette smoking and lifetime cannabis use (N= 1073), simultaneous use of cannabis and tobacco was associated with increased likelihood of negative cannabis-related outcomes. Simultaneous users were 1.6 times more likely to meet criteria for DSM-IV cannabis abuse, even after controlling for early covariates and for prior stages of cannabis involvement. Simultaneous use was not heritable, and twin similarity was attributable to shared environmental factors (31%). While our study does not determine causality between simultaneous tobacco-cannabis use and cannabis involvement, results indicate that simultaneous use is potentially a marker for more severe psychosocial consequences associated with cannabis use. Copyright 2009, Elsevier Science.
Transfer of methylamphetamine and amphetamine into breast milk following recreational use of methylamphetamine
Bartu A; Dusci LJ; Ilett KF. British Journal of Clinical Pharmacology 67(4): 455-459, 2009. (14 refs.)
What is already known aout this subject? The extent of drug transfer into milk during recreational intravenous use of methylamphetamine has not previously been studied. What this study adds. We have shown that methylamphetamine transfers into breast milk. center dot The amount a breastfed infant would receive varied over 2.5-fold range. A 48-h withholding period for breastfeeding is recommended following recreational use. To investigate the transfer of amphetamines into breast milk following their recreational use and estimate drug exposure for the breastfed infant. Two breastfeeding mothers who were occasional recreational users of intravenous amphetamines were studied. A urine sample was collected 4 h after dose, and milk samples were collected over 24 h. Drug in urine was qualitatively identified by gas chromatography-mass spectrometry and quantification in milk was by high-performance liquid chromatography. Absolute infant dose via milk was estimated. The urines contained predominantly methylamphetamine together with smaller amounts of amphetamine. In the 24 h after dose, average concentrations in milk were 111 mu g l(-1) and 281 mu g l(-1) for methylamphetamine and 4 mu g l(-1) and 15 mu g l(-1) for amphetamine in cases 1 and 2, respectively. Absolute infant doses for methylamphetamine plus amphetamine (as methylamphetamine equivalents) were 17.5 mu g kg(-1) day(-1) and 44.7 mu g kg(-1) day(-1), respectively, for cases 1 and 2. These limited data suggest that breastfeeding should be withheld for 48 h after recreational amphetamine use. Copyright 2009, Wiley-Blackwell.
Treatment outcomes and perceived benefits: A qualitative and quantitative assessment of a women's substance abuse treatment program
Lafave L; Desportes L; McBride C. Women & Therapy 32(1): 51-68, 2009. (33 refs.)
This study examines outcomes of a women's substance abuse treatment program based on empowerment, choice, and client/therapist collaboration. The program was assessed through qualitative and quantitative research methods. The article includes extensive quotes from six client interviews as well as data from pre-post surveys of 50 women in the treatment program. Results show that the women felt they benefited from the collaborative treatment approach. Benefits to the women included feeling more empowered and learning to take responsibility for their lives. The importance of taking a broad view of recovery that includes ongoing evaluation of positive changes in various areas of the clients' lives is discussed. Copyright 2009, Haworth Press.
Women's early recovery: Managing the dilemma of substance abuse and intimate partner relationships
Rivaux SL; Sohn S; Armour MP; Bell H. Journal of Drug Issues 38(4): 957-979, 2008. (40 refs.)
Numerous studies have shown that women's patterns of substance use are strongly impacted by social relationships. Using a hermeneutic phenomenological method, this study examined the interplay between intimate partner relationships and substance abuse recovery through in-depth interviews with 17 women in a treatment program. Six essential themes about the dilemmas posed by recovery and relationships emerged from analysis: (a) experiencing themselves as damaged goods, (b) paying the price for both recovery and relationship choices made; (c) trading parts of self for relationships and drugs; (d) waking from the nightmare and realizing the impact of abuse; (e) hoping, but not always quite believing, in the possibility of recovery; (f) asking themselves "who's in charge of my life?" This study expands on previous findings by examining critical similarities in the dynamics of interpersonal relationships and recovery for women and the meanings they assign to each. Copyright 2008, Journal of Drug Issues, Inc.
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