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Biomedical subjects

N Heather

Publications and source records attributed to N Heather.

At least 19 recordsLinked to original sources
PubMed1992

Why alcoholism is not a disease.

OBJECTIVE: To expound the argument that alcoholism (or "problem drinking") is not best regarded as a disease. SUMMARY: Excessive drinking can cause physical disease and involve physical dependence without therefore being a disease itself. The "disease concept" of alcoholism is not needed to justify medical intervention or a caring approach to those who are dependent on alcohol. There is a specific and a general version of the disease concept of alcoholism. The specific disease concept, associated mainly with the Fellowship of Alcoholics Anonymous, is contradicted by empirical evidence and unhelpful for preventive and treatment responses to problem drinking, especially for the effort to detect and modify problem drinking at an early stage. The more general disease concept shares these disadvantages and is also ineffective in engendering sympathetic attitudes towards problem drinkers among the general public. It is more useful to view problem drinking as the result of the interaction between the individual's personality and the social context in which he or she has learned how to drink. CONCLUSION: For an effective and compassionate societal response to problem drinking, the disease model of alcoholism should be replaced by a social learning perspective.

Alcohol Drinking↗
PubMed1992

Drug use and HIV risk-taking behaviour among clients in methadone maintenance treatment.

Current drug use and HIV risk-taking behaviour of a sample of 95 methadone maintenance clients was investigated. Subjects had been on their current programme for an average of 70.9 weeks with a mean daily dose of methadone of 65.6 mg. Two-thirds had injected heroin, and 82% had injected a street drug in the month prior to interview. Over 20% of subjects had shared a needle in the month before interview, all with only one other person. Subjects who had injected cocaine in the month before interview had significantly higher levels of injecting risk-taking behaviour than those subjects who had injected but not used cocaine. Condom use among subjects was low, particularly in regular relationships. While knowledge concerning HIV was high among subjects, there was no relation between level of knowledge and actual behaviour. It is concluded that knowledge alone is not sufficient to ensure behaviour change.

Adolescent↗
PubMed1992

Development and validation of a multi-dimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index.

This article presents a new instrument with which to assess the effects of opiate treatment. The Opiate Treatment Index (OTI) is multi-dimensional in structure, with scales measuring six independently measured outcome domains: drug use; HIV risk-taking behaviour; social functioning; criminality; health; and psychological adjustment. Psychometric properties of the Index are excellent, suggesting that the OTI is a relatively quick, efficient means of obtaining reliable and valid data on opiate users undergoing treatment over a range of relevant outcome domains.

Adolescent↗
PubMed1992

Development of a short 'readiness to change' questionnaire for use in brief, opportunistic interventions among excessive drinkers.

Excessive drinkers (141) identified in medical settings who were not seeking help for an alcohol problem completed a questionnaire based on Prochaska and DiClemente's stages of change model. Principal components analysis revealed a clear factor structure corresponding to the 'precontemplation', 'contemplation' and 'action' stages of change. On this basis, a 12-item 'Readiness to change' questionnaire was developed with satisfactory psychometric properties. As predicted, scale scores on adjacent stages of change showed significantly higher inter-correlations than scores on non-adjacent stages. Concurrent validation by comparison with subjects' choices of cartoons depicting each of the stages of change and with screening questions regarding aspects of drinking behaviour was moderate to very good. The questionnaire provides a short and convenient measure of readiness to change which may be used in conjunction with brief, opportunistic interventions with excessive drinkers.

Adult↗
PubMed1992

Depressed affect as a predictor of increased desire for alcohol in current drinkers of alcohol.

Male drinkers (n = 45) were asked to rate their desire for a drink of alcohol when presented with the sight, smell and taste of their preferred alcoholic beverage and of a lemon cordial drink. The subjects' level of depressed affect on that day and their average daily consumption of alcohol over the last 30 days were measured prior to exposure to these cues. Both level of depressed affect and log of mean daily alcohol consumption predicted increased desire for alcohol when alcohol cues were present, accounting for 40% of the variance in desire. When presented with the lemon cordial cues only 14% of the variance in desire for alcohol was explained by these variables. Also, Spearman's rank order correlations were calculated between heavy drinkers' (n = 19) ratings of self-efficacy to resist drinking and desire for alcohol in the presence of the alcohol cues. There were significant negative correlations between desire for alcohol and self-efficacy ratings on the 'urges and temptations' and 'positive social situations' subscales of the Situational Confidence Questionnaire-39. Several alternative accounts of these findings are discussed.

Adolescent↗
PubMed1991

Problem drinking.

Explore the source record for details and available documents.

Alcoholism↗
PubMed1991

Importance of substance cues in relapse among heroin users: comparison of two methods of investigation.

Ninety-three heroin users in treatment rated the importance to their last relapse to heroin use of the 13 categories and subcategories of reasons for relapse identified by Marlatt and Gordon (1985). These subject ratings were compared with the consensual categorizations of two independent judges who coded subjects' descriptions of the same relapse episodes. The results showed that, when judges categorized subjects' open-ended responses to questions about their last relapse, temptations or urges in the presence of substance cues were accorded no importance as a reason for relapse, and these categorizations were similar in this respect to previously reported findings. In contrast, when subjects themselves directly quantified the importance of the various relapse categories in precipitating their last relapse, substance-related temptations or urges obtained the highest mean rating of all categories.

Adaptation, Psychological↗
PubMed1991

Issue of statistical power in comparative evaluations of minimal and intensive controlled drinking interventions.

An analysis of recent studies of minimal and intensive cognitive-behavioural treatments for problem drinking was undertaken to decide to whether a lack of statistical power explains the failure of the majority of studies to find a difference in outcome between these two types of treatment. Although the sample sizes have typically been small (n = 12-21), the analysis suggests that low statistical power is unlikely to be the explanation for the majority of null findings. It seems more likely that the difference in outcome between one positive study and the majority of null results reflects some combination of differences in the type of clients who were treated, the therapists' experience, and the type of intensive therapy that was provided. The low power of these studies demonstrates the desirability of researchers calculating the sample size required to an effect before commencing an outcome study. If they continue to undertake studies with small sample sizes, then they should refrain from inferring that the failure to reject a null hypothesis means that there is no difference between treatments.

Alcohol Drinking↗
PubMed1991

The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users.

The initiation and maintenance of substantial behaviour change is required to reduce the spread of HIV infection among the intravenous drug-using population. In order to ascertain the efficacy of interventions aimed at reducing HIV-related risk-taking behaviour among this population, valid and reliable (yet preferably short) instruments for measuring such behaviour are required. The HIV risk-taking behaviour scale (HRBS) is a brief 11-item interviewer-administered scale which examines the behaviour of intravenous drug users in relation to both injecting and sexual behaviour. This paper describes the construction of the scale, in addition to data evaluating its reliability and validity. Initial analyses indicate that the scale has satisfactory psychometric properties.

Adolescent↗
PubMed1991

Estimating drug consumption in opioid users: reliability and validity of a 'recent use' episodes method.

The efficient and accurate measurement of recent drug use is an essential component of treatment and research among opioid users. Urinalysis results alone will not give sufficient information to either the clinician or researcher, due to limitations in detection and an inability to distinguish extent of use. The present paper describes a 'recent use episodes method', adapted from the measurement of alcohol consumption, for obtaining self-reported drug use in eleven different drug categories. Reliability and validity data indicate that the method provides a quick means by which accurate information may be obtained on the overall recent drug use of opioid users.

Adult↗
PubMed1991

Calculating standard drink units: international comparisons.

Simple calculation rules are providing for converting alcohol consumption data among four standard units currently used by researchers and educators in the USA, Canada, the UK, and Australia. A plea is made for the adoption of a common method for reporting alcohol consumption in research, using metric fluid volume units.

Alcoholic Beverages↗
PubMed1991

The Situational Confidence Questionnaire (Heroin).

This paper describes the derivation of a 22-item Situational Confidence Questionnaire for heroin users [SCQ (Heroin)]. Results revealed the SCQ (Heroin) to be an internally consistent scale with an acceptable level of test-retest reliability. Construct and discriminant validation were demonstrated through moderately significant correlations of all subscales with the short form of the Beck Depression Inventory. Factor analysis revealed a three-factor structure which could be labeled: coping with or enhancing arousal states, casual or occasional usage, and coping with negative emotions.

Adaptation, Psychological↗
PubMed1990

Assisted natural recovery from alcohol problems: effects of a self-help manual with and without supplementary telephone contact.

One hundred and seven problem drinkers responding to a newspaper advertisement were randomly assigned to groups receiving: (1) a general advice and information booklet; (2) a behaviourally-based self-help manual; (3) in addition to the manual, an opportunity to make progress reports to a telephone answering service; and (4) in addition to the manual, an opportunity to make telephoned progress reports to an interviewer. Eighty-seven (81.3%) respondents were successfully followed-up and collateral information was available for 54 (61.1%) of these. Results showed a higher proportion drinking above recommended limits at six months follow-up in the control group (78%) than in the groups receiving the manual (53%). There were no significant differences due to presence or type of telephone contact and poor use was made of the opportunity for telephone contact. Findings justify the widespread promotion of self-help materials as a means of assisting the natural recovery process among problem drinkers.

Adolescent↗
PubMed1990

Problem drinking as a form of learned behaviour: a final rejoinder to Gorman and Edwards.

This article continues, and hopefully concludes, a dispute in this journal over the value of the learning paradigm of problem drinking, as outlined by Heather & Robertson. It is first reasserted that the idea that the problem drinking paradigm is nothing more than a bid by psychologists to take over the alcohol studies field is neither a useful nor serious proposition. Secondly, it is denied that our claim is that psychology has already succeeded in substituting a new paradigm for an old one, but conceded that the term 'general theory' may be more appropriate in some ways than 'paradigm'. Thirdly, the criticism that the general learning theory is as tautologous as the disease theory it aspires to replace is again rejected. Finally, the merits of a general theory of problem drinking, as opposed to a diversity of explanatory models, are expounded.

Alcohol Drinking↗