Biomedical subjects

Leonard A Jason

Publications and source records attributed to Leonard A Jason.

At least 37 records · Page 2Linked to original sources

PubMed2005

Sex differences in social support and self-efficacy within a recovery community.

This study examined similarities and differences in social support and self-efficacy for abstinence between women and men recovering from substance addiction. The sample consisted of 87 residents of Oxford House (OH) self-run, community-based recovery homes. Analyses revealed similarities between women and men in terms of the composition and utilization of support networks and abstinence self-efficacy. Also, for both sexes, length of residency in OH was significantly related to decreased social support for alcohol and drug use and increased self-efficacy for abstinence. However, multiple-group SEM analyses demonstrated that social support for alcohol/drug use fully mediated the link between length of residency and abstinence self-efficacy for women, but not for men. Findings suggest that the process of gaining self-efficacy to remain abstinent is distinct for women and men, and that social support plays a different role in women's recovery than it does in men's.

Adult↗

PubMed2005

Preventive psychology in primary care settings.

This article will describe some of the more promising types of preventive interventions that exist in primary health care settings. It will present a rationale for practicing psychologists to consider issues of prevention when working in health care settings. Approaches to prevention and the integration of preventive measures into primary care will be presented, as well as examples of the implementation of innovative prevention programs. This article will conclude with examples and recommendations for primary care psychologists who wish to become more involved with prevention. EDITORS' STRATEGIC IMPLICATIONS: The authors provide useful information and suggestions both for individual psychologists interested in focusing on individual-level interventions, as well as larger-scale interventions that present more challenges to implement, but also provide greater benefits to community health and well-being. Health care professionals and administrators could discern why and how to involve psychologists in their prevention efforts.

Humans↗

PubMed2005

Chronic fatigue syndrome: the need for subtypes.

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS' characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.

Diagnosis, Differential↗

PubMed2005

Improving the diagnostic criteria and procedures for chronic fatigue syndrome.

Since the publication of the case definition for chronic fatigue syndrome (CFS) in 1988 the diagnostic criteria have been revised twice in the U.S. None of the case definitions were derived empirically. As a result, there is concern regarding the sensitivity, specificity, and reliability of the criteria. The goal of the present study was to identify methods for improving the diagnostic criteria for CFS. Three groups of 15 participants each were recruited: participants with (1) CFS, (2) major depressive disorder (MDD), and (3) healthy controls. Using statistical procedures, three methods for improving the diagnostic criteria were explored: identification of new diagnostic symptoms, the use of severity ratings for symptomatology, and the identification of standardized measures that differentiate cases of CFS from other conditions. Results of the present study suggest that these three methods hold promise for improving the sensitivity, specificity, and reliability of the diagnostic criteria for CFS.

Adult↗

PubMed2005

The relationships among coping styles and fatigue in an ethnically diverse sample.

The present study focused on coping strategies among African Americans, Latinos, and European Americans with chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF). The coping strategies examined were measured by using the COPE Scales, which assess Seeking Emotional Social Support, Positive Reinterpretation and Growth, Acceptance, Denial, Turning to Religion, Behavioral Disengagement, and Focusing on and Venting Emotions. In addition, the four coping strategies specifically designed for people with CFS, including maintaining activity, accommodating to the illness, focusing on symptoms, and information-seeking, were used in this study. It was hypothesized that African Americans and Latinos in comparison to European Americans would be more likely to use religious coping, behavioral disengagement, and denial. As predicted, African Americans were significantly more likely to turn to religion than European Americans, and Latinos and African Americans used denial significantly more often than European Americans. An additional finding was that focusing on symptoms was associated with greater fatigue and more physical disability among African Americans. Within the Latino sample, acceptance was related to greater fatigue and less physical disability, and greater optimism predicted less mental disability. Among European American participants, maintaining activity was related to less mental disability, whereas accommodating to the illness predicted more physical disability. These results indicate that coping varies among various ethnic groups with CFS and ICF; however, denial is consistently related to less adaptive outcomes. Therefore, healthcare professionals should find ways to reduce patient use of denial and promote alternative strategies for managing life events.

Adaptation, Psychological↗

PubMed2005

A collaborative action approach to researching substance abuse recovery.

Over the past 12 years, a university research team has been involved in a collaborative action research project with a community-based, self-run, residential substance abuse recovery program called Oxford House. Success of the project has been dependent on the development of trust, respect for the personal experiences of community members and group processes, commitment to serve the community, collaborative development of research and action agendas and techniques, efforts to validate findings with organization members, and accountability. In this article, we review this collaborative effort and examine the distinct opportunities and constraints in adopting this less conventional method of inquiry and action. We highlight a number of practical and theoretical issues that have been raised as we have strived to maintain a mutually beneficial alliance throughout the research endeavor.

Biomedical Research↗

PubMed2005

Disordered eating, trauma, and sense of community: examining women in substance abuse recovery homes.

Women with substance-related disorders are likely to suffer from disordered eating and past traumatic experience, issues that might inhibit the recovery process. The present study determined the prevalence of co-morbidity of disordered eating, trauma, and substance-related disorders among 60 women living in one of 15 mutual help substance abuse recovery homes that establish new social networks for residents. Psychological sense of community was also examined to determine whether residents were able to obtain support that may have previously been absent. Results indicated that women with co-existing disordered eating and substance-related disorders, as well as women who have experienced trauma benefit from democratic, independent-living environments. Implications for treatment and future research are discussed.

Adult↗

PubMed2005

Youth tobacco sales-to-minors and possession-use-purchase laws: a public health controversy.

Tobacco use among youth remains one of our nation's most significant public health problems, and yet available evidence from prevention and cessation person-centered approaches has been mixed. Given these disappointing outcomes, some have recommended more public health approaches, and these include tobacco sales-to-minors and possession-use-purchase laws. While community members and police officials have endorsed these types of public health initiatives, many within the public health community have been either guarded or even oppositional to such approaches. The primary reasons for this controversy are reviewed in this article. Outcome studies indicate that sales-to-minors laws can be an effective step toward the reduction of youth access to commercial sources of tobacco. However, even with these laws in place, many youth indicate that they continue to have easy access to tobacco, often by means of social sources. Advocates of these approaches have argued that more comprehensive public health interventions are needed, such as programs that combine youth access and possession-use-purchase laws. This article reviews the ongoing debate behind these types of public health efforts, and examines the evidence of such programs to reduce youth tobacco use.

Adolescent↗

PubMed2004

Heterogeneity among Latinas and Latinos entering substance abuse treatment: findings from a national database.

The current study examined differences in 30-day and lifetime substance use for a sample of Mexican American, Puerto Rican, and Cuban American men and women from the Drug Evaluation Network System, a national database on individuals seeking substance abuse treatment. There were significant gender and ethnic differences in recent and lifetime substance use after controlling for age, years of education, employment, medical, and psychological problems. Lifetime and 30-day substance use rates found in this study do not coincide with prevalence rates found in community samples of Latinas/os, indicating that the patterns of substance use may be different among individuals who seek substance abuse treatment than among those in the general population. The results of this study highlight the heterogeneity of Latinas/os who abuse substances.

Adult↗

PubMed2004

Assessing storefront tobacco advertising after the billboard ban.

This study examined storefront tobacco advertisements in 11 towns in Illinois from 1999 through 2001 to assess possible changes in these types of advertisements since the master tobacco settlement, which banned tobacco advertisements on billboards. Observers assessed the number of merchant- and industry-made tobacco storefront advertisements in Illinois stores and whether these advertisements were either brand- or price-focused. The relationship between the amount of tobacco advertisements and underage tobacco sales to minors was also explored. Findings indicated no significant relationships between tobacco advertisements and underage tobacco sales. However, industry price advertisements decreased over time because of tobacco price increases resulting from the master settlement, whereas industry brand advertisements increased over time, perhaps in an effort by the tobacco industry to retain sales of their products through brand recognition.

Advertising↗

PubMed2004

Factors influencing middle and high schools' active parental consent return rates.

The authors examined factors influencing the return rates for attempting to collect active parental consent forms from 21,123 students in the 7th through 10th grades in 41 middle and high schools. Overall return rates from middle schools were higher than from high schools. Schools that offered high levels of staff support for collecting consent forms had higher return rates. Procedures where the consent form was attached to a school form that parents had to complete and return to the school yielded the highest return rate. Implications for how researchers can obtain a high parent consent form return rate are discussed.

Adolescent↗

PubMed2004

Optimism, abstinence self-efficacy, and self-mastery: a comparative analysis of cognitive resources.

The relationship between optimism, abstinence self-efficacy, and self-mastery was examined by investigating levels of these cognitive resources among two samples of recovering substance abusers: Oxford House residents who attended twelve-step groups and twelve-step members who had never lived in an Oxford House. Participants 'levels of optimism were significantly and positively related to both abstinence self-efficacy and self-mastery scores, as abstinence self-efficacy was significantly and positively related to participants' number of days abstinent. Participants who reported having more than 180 days abstinent reported significantly higher levels of abstinence self-efficacy than participants who reported having less than 180 days abstinent. In addition, among participants who reported having less than 180 days abstinent, Oxford House residents reported significantly higher levels of abstinence self-efficacy than twelve-step members. Overall, findings suggest that cognitive resources facilitate substance abusers' recovery and that the Oxford House model might provide high levels of support in their ongoing abstinence.

Adult↗

PubMed2004

Maintenance of community change: enforcing youth access to tobacco laws.

Youth access to tobacco remains a significant problem for this nation. Methods have been developed to reduce youth access to commercial outlets and these involve enforcement efforts of monitoring and fining merchant offenders. In the present study, over a three year period of time, readiness to participate in these types of enforcement programs were assessed in 11 communities. Several years after the research study was completed, enforcement activities were re-assessed. Findings indicated that those communities that had made the largest changes in community readiness to enforce youth access laws during the three year intervention were the ones most likely to continue enforcement activities into the follow-up period. There is a need to better understand how youth access to tobacco community-based interventions can be maintained.

Adolescent↗

PubMed2003

Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution.

BACKGROUND: Chronic fatigue syndrome (CFS) is defined by symptoms and disability, has no confirmatory physical signs or characteristic laboratory abnormalities, and the etiology and pathophysiology remain unknown. Difficulties with accurate case ascertainment contribute to this ignorance. METHODS: Experienced investigators from around the world who are involved in CFS research met for a series of three day workshops in 2000, 2001 and 2002 intended to identify the problems in application of the current CFS case definition. The investigators were divided into focus groups and each group was charged with a topic. The investigators in each focus group relied on their own clinical and scientific knowledge, brainstorming within each group and with all investigators when focus group summaries were presented. Relevant literature was selected and reviewed independent of the workshops. The relevant literature was circulated via list-serves and resolved as being relevant by group consensus. Focus group reports were analyzed and compiled into the recommendations presented here. RESULTS: Ambiguities in the current CFS research definition that contribute to inconsistent case identification were identified. Recommendations for use of the definition, standardization of classification instruments and study design issues are presented that are intended to improve the precision of case ascertainment. The International CFS Study Group also identified ambiguities associated with exclusionary and comorbid conditions and reviewed the standardized, internationally applicable instruments used to measure symptoms, fatigue intensity and associated disability. CONCLUSION: This paper provides an approach to guide systematic, and hopefully reproducible, application of the current case definition, so that case ascertainment would be more uniform across sites. Ultimately, an operational CFS case definition will need to be based on empirical studies designed to delineate the possibly distinct biological pathways that result in chronic fatigue.

Cognition↗

PubMed2003

Is self-mastery always a helpful resource? Coping wiith paradoxical findings in relation to optimism and abstinence self-efficacy.

This study investigated the relationship between three personal resources (self-mastery, optimism, and abstinence self-efficacy) and ways of coping among recovering substance abusers (n = 52) residing in Oxford Houses. Although residents' scores on optimism and abstinence self-efficacy were significantly correlated in a positive direction, residents' self-mastery scores were significantly and negatively related to both optimism and abstinence self-efficacy scores. However, residents reported using significantly more emotion-focused than problem-focused coping even though there was a significant positive relationship between emotion-focused coping and self-mastery. These paradoxical findings might be due to communal living and 12-step philosophy that is antithetical to a sense of control, which may have facilitated residents' emotional regulation to stress. Furthermore, significant relationships between coping strategies and personal resources imply that active coping strategies are instrumental in recovering substance abusers' use of optimism and abstinence self-efficacy, whereas passive coping strategies are involved with self-mastery. In addition, African American residents reported using significantly more wishful thinking coping, suggesting ethnicity might be an important aspect of the coping process. Overall, findings suggest that optimism and abstinence self-efficacy are effective personal resources for recovering substance abusers in 12-step programs.

Adaptation, Psychological↗

PubMed2003

Variability in diagnostic criteria for chronic fatigue syndrome may result in substantial differences in patterns of symptoms and disability.

Chronic fatigue syndrome (CFS) is an illness that involves severe, prolonged exhaustion as well as neurologic, immunologic, and endocrine system pathology. Because the pathogenesis of CFS has yet to be determined, case definitions have relied on clinical observation in classifying signs and symptoms for diagnosis. The current investigation examined differences between CFS as defined by Fukuda and colleagues and a set of criteria that has been stipulated for myalgic encephalomyelitis (ME). Dependent measures included psychiatric comorbidity, symptom frequency, symptom severity, and functional impairment. The ME and Fukuda et al. (1994) CFS criteria were compared with a group having chronic fatigue due to psychiatric reasons. Significant differences occurred primarily with neurologic, neuropsychiatric, fatigue/weakness, and rheumatological symptoms. These findings suggest that it might be inappropriate to synthesize results from studies of this illness that use different definitions to select study populations.

Adult↗

PubMed2003

The relation of retail tobacco availability to initiation and continued smoking.

Used an ecological analysis employing multilevel random-effects regression analyses to model Level 1 (individual and social) and Level 2 (environmental) correlates of smoking initiation and continued smoking among 6th-, 7th-, and 8th-grade students. Data from 5,234 youth in 11 Midwestern communities were examined. Results indicate higher levels of retail tobacco availability (RTA) were associated with increased odds that a youth initiated smoking but not continued smoking. Among the Level 1 factors, youth who were older, male, had an adult tobacco user in the home, and had more peers who use tobacco had increased odds of initiating smoking. In contrast, only the presence of an adult tobacco user in the home and the number of peers who use tobacco were associated with increased odds that a youth continued smoking. Examining individual, social, and environmental factors simultaneously provides a clearer and more accurate model of these complex ecological influences.

Adolescent↗

PubMed2003

Chronic fatigue syndrome: symptom subtypes in a community based sample.

Most studies of Chronic Fatigue Syndrome (CFS) have been based on patients recruited from primary or tertiary care settings. Patients from such settings might not be typical of patients in the general population. The present investigation involved examining individuals with CFS from a community-based study. A random sample of 18,675 respondents in Chicago were first interviewed by telephone. A group of individuals with chronic fatigue accompanied by at least four Fukuda et al. (1994) symptoms associated with CFS were given medical and psychiatric examinations. From this sample, a physician review group diagnosed individuals with CFS. Those diagnosed with CFS were subclassified based on frequency of symptoms. Important differences emerged on measures of sociodemographics and disability. The implications of these findings and others are discussed.

Adult↗