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Biomedical subjects

D S Lipton

Publications and source records attributed to D S Lipton.

At least 19 recordsLinked to original sources
PubMed2000

Developing a tobacco survey for deaf youth.

Formidable barriers hinder use of standard data collection methods among deaf youth. Culturally and linguistically sensitive data collection strategies are needed to identify the unmet health and programming needs of this population. Unfortunately, researchers often fail to describe the issues involved in developing such targeted methods. The authors describe development of a culturally appropriate data collection instrument for a study of tobacco-related knowledge, attitudes, and practices among deaf youth. The instrument uses interactive multimedia technology to administer a questionnaire translated into the primary languages used by the Deaf. The procedures taken to accommodate this technology to these languages and to Deaf culture are described. This process yielded useful insights with respect to data collection not only among the Deaf, but among other frequently overlooked and underserved populations as well.

Adolescent↗
PubMed1998

The diagnostic interview schedule for deaf patients on interactive video: a preliminary investigation.

OBJECTIVE: The authors investigated the feasibility of translating the National Institute of Mental Health Quick Diagnostic Interview Schedule-III, Revised, computer version, for deaf individuals. METHOD: The study involved translation of selected scales into American Sign Language, Signed English, and speech reading; review by an advisory panel and back translator; and collection and analysis of deaf individuals' reactions to translations. RESULTS: Focus groups responded favorably, translation problems were revealed, and solutions were suggested. CONCLUSIONS: The findings support the feasibility of translation of the Quick Diagnostic Interview Schedule-III, Revised, into American Sign Language, Signed English, and speech reading for deaf patients.

Adolescent↗
PubMed1998

Smack, crack, and score: two decades of NIDA-funded drugs and crime research at NDRI 1974-1994.

Since 1972, National Development and Research Institutes (NDRI) has been fortunate to have on its staff outstanding researchers involved in studying the relationship between drugs and criminality. This paper describes federally-funded research conducted by them. The drug-crime nexus has been an ongoing focus along with drug-user treatment evaluation and AIDS research. Over the two decades, NDRI has had about 20 major "drugs and crime" grants. Key research findings are presented from studies related to violent and nonviolent crime; prison-based treatment; drug use detection; and the use and distribution of heroin, crack, and methadone.

Crime↗
PubMed1996

The Interactive Video-Questionnaire: a new technology for interviewing deaf persons.

This paper traces the development of a new technology, the Interactive Video-Questionnaire, for interviewing Deaf persons by using manually signed questionnaires. After encountering numerous obstacles to conducting surveys with Deaf persons about substance abuse using the same methods typically used with hearing persons, the researchers, with a Small Business Innovative Research grant from the National Institute on Drug Abuse, piloted a survey method that uses videodisc and bar code readers to present survey questions signed on screen in American Sign Language and Signed English. Following consultations with Deaf participants, deficiencies of this method were identified and corrected. An interactive multimedia program was created in Phase II of this research effort that offered questions visually in American Sign Language, Signed English, or Speechreading. All questions were subtitled in written English, with Touchscreen entry and automatic data capture and storage. The potential exists for many important uses of the Interactive Video-Questionnaire.

Communication↗
PubMed1992

Retention of cocaine abusers in outpatient psychotherapy.

Retention in outpatient psychotherapy of 148 crack and cocaine abusers was examined. The clients were predominantly Black (63%) and Hispanic (21%), predominantly male (87%), and the majority (66%) had completed no more than 12 years of high school. Clients entered treatment in a low-cost treatment center in New York City between June 1987 and November 1988. Forty-two percent (62) of the subjects were seen for one or two research interviews only, and did not return to begin therapy. Of the 86 persons who came to at least one therapy session, 30% (26) dropped out before the third session, 28% (24) dropped out between the third and fifth sessions, and 42% (36) were retained for six or more sessions. Short-term and longer-term retentions were analyzed separately, using a battery including sociodemographic variables, treatment history, psychiatric symptomatology, number of arrests, and drug use variables. None of the variables considered was significantly related to short-term retention. There were large although not significant differences in longer term retention by therapist. Longer-term retention was associated significantly with being White (contrasted with being Black) and being young. Nonsignificant but large associations were found between longer-term retention and having few arrests, being Hispanic (contrasted with being Black), and having low SCL-90 scores. Results are compared with previous findings about retention in drug and alcohol treatment. It is suggested that future research on retention in treatment focus less on client variables and more on therapist and program variables.

Adult↗
PubMed1992

The validity of hair analysis for detecting cocaine and heroin use among addicts.

Radioimmunoassay of hair (RIAH) was compared with two criterion measures, confidential EMIT urinalysis and self-reporting of cocaine/heroin use, for a purposive sample of 134 persons in methadone treatment. Positive or negative RIAH was "confirmed" by urinalysis and/or self-report in 87 and 84% of the cases for cocaine and heroin (morphine), respectively. Corroborative evidence indicated that "excess" RIAH positives were attributable to the narrow window of detection for urinalysis (2 days), failure to admit drug use even to researchers, and/or inadvertent ingestion of small amounts of drug. A global self-report of cocaine use intensity was related to amount in the hair.

Adult↗
PubMed1991

Outcomes for cocaine abusers after once-a-week psychosocial therapy.

OBJECTIVE: The authors studied the efficacy of once-weekly psychotherapy, family therapy, or group therapy led by paraprofessionals among patients with cocaine use disorders. METHOD: Of subjects who sought outpatient treatment, 168 consented to participate in the study and were each randomly assigned to one of the three forms of therapy; 122 patients were interviewed 6-12 months later. Their pre- and posttreatment scores on the Addiction Severity Index were compared. RESULTS: Significant improvements were observed for the cohort as a whole, but virtually all of the improvement was restricted to the 23 subjects (19%) who were not using cocaine at follow-up. There was a strong relationship between abstinence from cocaine use and absence of addiction-related problems, especially psychiatric symptoms and family problems. CONCLUSIONS: The results of the study indicate that outpatient therapy once a week is ineffective for cocaine use disorder. The 19% abstinence rate probably represents spontaneous remission among patients with enough motivation to seek treatment, as the number of therapy sessions attended was not related to improvement. Either an intense level of outpatient contact or residential treatment followed by aftercare is probably needed, at least initially, while the patient is attempting to initiate and sustain abstinence.

Adult↗
PubMed1991

Cocaine, AIDS and i.v. drug use.

The papers in this volume cover a wide range of important topics. Yet many other equally important topics are not addressed. These include: (1) emerging trends in the epidemiology of HIV and drug use, such as the evidence that crack use may lead many of its practitioners to engage in high risk sex; (2) ways to deliver HIV prophylaxis to infected drug injectors, sexual partners, or perinatally infected children; and (3) the effectiveness of standard outreach in encouraging risk reduction. They do, however, provide important information about how to deal with both cocaine use and AIDS. They also raise many fruitful issues for additional research.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Changes in cocaine use after entry to methadone treatment.

A cohort sample of 93 addicts admitted to methadone maintenance in four clinics was followed-up for one year to determine change, and predictors of change, in cocaine use. Any use of cocaine in the preceding month decreased from 84% of subjects at admission to 66% at follow-up, and mean days of cocaine use per month for those still using decreased from 16 days to 9 days. Any drug injection in the preceding month decreased from 100% of subjects at admission to 39% at follow-up, among those remaining in the program. Continuance/cessation of cocaine use was not associated with program retention, but cocaine users were more likely to be administratively discharged. Reported symptoms of depression and speedballing at admission were significant predictors of continuance/cessation of cocaine use at follow-up. State-of-the-art cocaine abuse treatment, with attention to treatment of depression, would enhance the value of methadone maintenance for patients with dual heroin/cocaine addiction.

Adult↗
PubMed1991

Outcomes of an AIDS prevention program for methadone patients.

Methadone maintenance patients are at risk of contracting or transmitting HIV through intravenous drug use and/or unsafe sexual practices. An outcome evaluation of a voluntary AIDS prevention program for methadone patients in three clinics (two experimental, one control) is reported. The prevention program included three components: didactic AIDS education, HIV antibody counseling/testing, and facilitated peer support groups. Participation in AIDS education was associated with increased knowledge of AIDS risks and with improved attitudes toward condoms. Peer group participation was associated with improved attitudes toward the use of condoms and with increased use of condoms. Learning of HIV seronegativity was related to increased self-efficacy and decreased intravenous drug use risk behaviors. Rates of participation in the prevention program were disappointing, but the program seemed beneficial for those patients who did become involved.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Psychopathology among cocaine abusers entering treatment.

A number of different indicators of psychopathology were assessed in this study of 76 cocaine and crack abusers who entered outpatient treatment in New York City between June and December 1987. The majority (75%) had used cocaine for 4 years or more, and the majority (62%) spent over one thousand dollars a month on cocaine in the 6 months before entry into treatment. Forty-seven percent of the sample were found to be clinically depressed. Phobic disorders were the only other axis I diagnoses found in addition to depression, and all persons who were found to have phobic disorders also were diagnosed as having some form of depressive disorder. The four most common axis II diagnoses were antisocial personality (21%), passive-aggressive (21%), borderline (18%) and self-defeating (18%). Subjects were classified as falling into one of the following three categories of a newly developed "psychopathology classification": a) no diagnosed psychopathology except substance abuse or dependency; b) one or more axis II diagnoses, but no axis I diagnoses except for substance abuse or dependency; c) at least one axis I diagnosis in addition to drug disorders whether or not accompanied by an axis II diagnosis. Mean scores on subscales and total score on the SCL-90, as well as total score on the Beck Depression Inventory, were ordered by category of the classification scheme, with those having no diagnosed psychopathology except substance abuse having the lowest score and persons in the third category having the highest score.(ABSTRACT TRUNCATED AT 250 WORDS)

Cocaine↗
PubMed1990

Reactions of methadone patients to HIV antibody testing.

The emotional and behavioral responses of methadone patients to HIV antibody testing were examined by comparing 8 seropositives with 8 matched seronegatives. Seropositives displayed a wide range of immediate emotional reactions to learning their results, but no severe or damaging reactions; seronegatives were uniformly relieved. Almost all patients informed other persons of their serostatus with unremarkable consequences. Seropositives had higher anxiety than seronegatives at the 3-month follow-up, but behavioral outcomes were similar, tending towards reduced AIDS risk. The sample's program retention rate one year later was 94%.

AIDS Serodiagnosis↗
PubMed1990

Variables influencing condom use among intravenous drug users.

Correlates of condom use were identified using cross-sectional data from a convenience sample of 211 sexually active intravenous drug users enrolled in methadone maintenance in New York City. Sixty-eight percent did not use condoms at all in the previous month and only 11 percent used condoms every time. Nineteen percent were planning on conception, only 20 percent of whom had been tested for human immunodeficiency virus (HIV) antibody (all seronegative). Multiple logistic regression analysis indicated that condom use was independently associated with greater personal acceptance of condoms, greater partner receptivity to sexual protection, and recent entry to methadone treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Determinants of needle sharing among intravenous drug users.

Data from 110 IV-drug abusing persons in methadone maintenance were analyzed to determine the correlates of needle sharing. Sharing was directly related to peer group behavior, attitudes conducive to sharing, economic motivation to share, not owning injection equipment, and fatalism about developing AIDS. Sharers were aware of their AIDS risk. Indicated measures to reduce needle sharing would be positive peer support groups to help resist pressures to share, legal and free access to fresh injection equipment, education on the utility of risk reduction, and increased treatment options for IV cocaine users.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Contingency contracting with polydrug-abusing methadone patients.

The study assessed the effects of contingency contracting for medication take-home privileges on the polydrug use of methadone patients. Comparisons were made among 20 patients using cocaine, 13 using other illicit drugs, and seven exhibiting other noncompliant behavior. A within-subjects reversal design showed that there was no overall difference in the percentage of positive urines between the pre-contingency and contingency periods, nor between the pre- and post-contingency periods. During the first contingency month, however, one group of patients eliminated drug use, while the remaining had an increased percentage of positive urines. This increase may have been due to the heightened urinalysis regimen during the contingency period rather than to more actual drug use. During the first month, drug-related contracts not involving cocaine were more successful than those targeting cocaine, and non-drug-related contracts were more successful than drug-related ones. The study concluded that contracting had a favorable, though transient, effect primarily on non-cocaine-abusing methadone patients. Further research using stronger or multiple reinforcers is indicated.

Adult↗