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Biomedical subjects

R K Brooner

Publications and source records attributed to R K Brooner.

At least 37 records · Page 2Linked to original sources
PubMed1995

Validity of intravenous drug abusers' self-reported changes in HIV high-risk drug use behaviors.

The HIV-1 high-risk drug use behavior of intravenous drug abusers was assessed both retrospectively (for 6 months) and prospectively (for 6 months) via structured interview and urinalysis testing. Subjects were 281 intravenous drug abusers, 146 enrolled in outpatient methadone treatment (Treatment group) and 135 not in treatment (Community group). The Treatment group reported fewer drug injections and less needle sharing and had fewer positive urinalyses for opiates and cocaine than did the Community group. Reported drug injection and needle sharing declined over time, and an increasing proportion of subjects reported abstinence from these behaviors. In contrast to the behavioral reports of subjects, positive urinalyses indicating opiate and/or cocaine use did not decline over time. Almost half (45.8%) of the reported increase in injection abstinence from intake to month six was disconfirmed by urinalysis. In contrast to this large discrepancy regarding reported behavior change, there was good agreement between reported injection abstinence and urinalysis results at single points in time. These data indicate that the validity of the reported HIV-1 risk behavior change of drug abusers may be less than that of reported risk behavior occurrence. The data raise important questions about the validity of reported reductions in high-risk drug use behaviors, and indicate the importance of using biological indicators of HIV-1 risk behavior (such as urinalysis) whenever possible.

Adult↗
PubMed1994

Condom use rates for specific sexual behaviors among opioid abusers entering treatment.

A structured interview was used to determine the details of high risk sexual behaviors, including number of sexual partners, frequency of condom use, and involvement in commercial sexual activity in 165 opioid abusers (mean age 34 years, 36% minority, 47% female) entering out-patient methadone substitution therapy. The median number of sexual partners in the sample was one, and 95% were sexually active in the past year. Most patients (84%) denied any commercial sexual activity and reported rates of monogamy and sexual abstinence (81%), and rates of condom use (15%), that were comparable with reports from general population surveys. However, intravenous drug abusers (IVDAs) remain at higher risk for exposure to HIV-1 because they are likelier to have sexual contact with other IVDAs and former IVDAs. Continuing efforts are needed to improve the safe sex practices of IVDAs, but it may be a significant challenge to reduce their high risk sexual behavior considerably below that of the general population. Concomitant drug abuse treatment may help in efforts to accomplish sexual behavior change.

Adult↗
PubMed1994

Psychiatric distress in antisocial drug abusers: relation to other personality disorders.

Antisocial drug abusers with other personality diagnoses have been found to differ from those with the antisocial diagnosis only on a measure of normal personality dimensions, the former group reporting greater proneness to emotional distress and instability. The present study examined the relationship between personality comorbidity among antisocial drug abusers and a standardized measure of current psychiatric distress level. Patients included 167 opioid drug abusers admitted to a community outpatient drug abuse treatment program. The results indicated that the presence of additional personality diagnoses among antisocial drug abusers was associated with high levels of distress compared with those with the antisocial diagnosis only and with those with no personality diagnosis.

Adult↗
PubMed1994

Contingent methadone take-home doses reinforce adjunct therapy attendance of methadone maintenance patients.

Two studies utilized within-subjects designs to determine whether take-home methadone doses can reinforce adjunct therapy attendance of drug abuse patients. These studies varied the reinforcement density and the schedule of methadone take-home doses. In Study 1, patients (n = 10) either could or could not receive a take-home following each therapy session. Study 2 patients (n = 15) could either earn take-homes following each therapy session attended (i.e., 2 take-homes per week) or could earn one take-home dose following each attendance to two consecutive sessions attended. In both studies experimental conditions alternated during three-week blocks of time. Across studies, any reinforcement by take-home doses produced more attendance at therapy sessions than that observed in the no reinforcement condition. Take-home incentive effects were strongest when each of the two weekly therapy sessions was reinforced by a methadone take-home dose. Increased attendance was not associated with reduced drug use, due perhaps to high rates of pre-study drug use and limited therapy duration. Contemporary opioid abusers present with multiple problems that methadone was never intended to treat. The present studies illustrate a method by which methadone treatment can improve the likelihood of delivering other services that may prove effective in treating some of these problems.

Adult↗
PubMed1993

Antisocial personality disorder and HIV infection among intravenous drug abusers.

OBJECTIVE: Antisocial personality disorder in drug abusers has been associated with poor treatment outcome. The authors examined the relationship between diagnosis of antisocial personality and HIV infection. METHOD: Subjects were 272 intravenous drug abusers, 140 (52%) of whom were in methadone treatment. Subjects were given an HIV risk behavior interview before diagnostic interviewing and HIV testing. RESULTS: Using the DSM-III-R definition, the authors found that 119 (44%) of the subjects met criteria for antisocial personality. Significantly more of the subjects with antisocial personality (18% [N = 21] than of the subjects without antisocial personality (8% [N = 12]) had HIV infection. The diagnosis of antisocial personality disorder was associated with a significantly higher odds ratio of infection independent of ethnicity, gender, and treatment status. CONCLUSIONS: Antisocial personality is a risk factor for HIV infection among intravenous drug abusers.

Adult↗
PubMed1993

Antisocial personality disorder among drug abusers. Relations to other personality diagnoses and the five-factor model of personality.

Antisocial personality disorder among drug abusers has been associated with poor drug abuse treatment outcome and greater human immunodeficiency virus infection risk compared with drug abusers without the disorder. Despite this, less is known about the personality trait dimensions of antisocial drug abusers, or about the prevalence of axis II comorbidity among this group. Similarly, little is known about the personality trait dimensions of antisocial drug abusers compared with those with axis II diagnoses other than antisocial or those with no personality diagnosis. The present study compared the personality traits of 203 outpatient opioid drug abusers categorized into either a pure antisocial group (i.e., antisocial diagnosis only), mixed antisocial group (i.e., antisocial plus another axis II diagnosis), other axis II group (i.e., axis II diagnosis other than antisocial), or a non-axis II group. Psychiatric diagnoses were made using a structured interview and personality traits of the four groups were compared using a self-report measure of the five-factor model of personality. As predicted, the mixed group was significantly more prone to neuroticism compared with the pure group, with higher scores on the vulnerability to stress and hostility facets. The mixed group also had a greater score on the neuroticism domain compared with the non-axis II group, with higher scores on five of the six facets. Significant differences were also found on agreeableness. The mixed group had lower scores on this domain (i.e., had higher interpersonal antagonism) compared with the non-axis II group. Somewhat surprisingly, the agreeableness score for the pure group was not significantly different from those of the remaining three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Antisocial behavior of intravenous drug abusers: implications for diagnosis of antisocial personality disorder.

OBJECTIVE: A pattern of chronic adult antisocial behavior is not sufficient for the DSM-III-R diagnosis of antisocial personality disorder unless the early-onset criteria are satisfied, even if the adult criteria are met. The utility of the early-onset requirement for the diagnosis was examined in intravenous drug abusers, a population known to have high rates of irresponsible, aggressive, and criminal behavior. METHOD: The subjects were 237 drug abusers who had volunteered for an outpatient study of psychopathology and HIV risk behavior and infection. They completed a structured psychiatric interview as part of their participation in that study. The adult antisocial behavior of the group that met both the early-onset and the adult criteria for antisocial personality disorder, the group that met only the adult criteria, and the group that met neither the early-onset nor the adult criteria was then compared. RESULTS: Antisocial personality disorder (meeting the early-onset and adult criteria) was diagnosed in 44% of the sample; an additional 24% met only the adult criteria. The group with the diagnosis of antisocial personality disorder reported a more pervasive and more serious pattern of adult antisocial behavior than did the other groups, although antisocial behavior was commonplace in all three groups. CONCLUSIONS: Early onset of multiple antisocial behaviors identified a subset of drug abusers with important differences in the extent and severity of their adult antisocial behavior. The antisocial behavior of the group that met only the adult criteria suggests the possibility of a late-onset and less severe form of antisocial personality disorder.

Age Factors↗
PubMed1992

HIV risk behavior in drug users: increased blood "booting" during cocaine injection.

The practice of "booting" or "kicking," in which blood is drawn into the syringe and then injected, was assessed as a possible behavioral mechanism contributing to cocaine's association with increased human immunodeficiency virus (HIV) infection. Intravenous drug users (IVDUs) (N = 68) demonstrated (with an empty, needleless syringe) their usual style of injection of cocaine, heroin, and speedball, in random order. The experimenter recorded the injection procedures and the syringe volumes at each step. Total blood volumes and number of pumps of the syringe were each greater during simulated cocaine and speedball use than during heroin use (p less than .05); means for both cocaine and speedball were 2- to 3-fold greater than for heroin. Subjects also described the booting behavior of their needle-sharing partners; the percentage having partners who booted blood was significantly greater during cocaine use than during heroin use (p less than .05). These findings indicate that cocaine use is associated with a behavioral style of injection (increased blood booting) that is more likely to contaminate the injection equipment with blood. Thus, the practice of booting may warrant special attention in AIDS prevention interventions and risk assessments.

Adult↗
PubMed1991

Clustering of multiple substance use and psychiatric diagnoses in opiate addicts.

Using a standardized psychiatric interview, the prevalence of and interrelationships among various substance use diagnoses and non-substance use psychiatric diagnoses were examined in a population of opiate addicts (n = 66) enrolled in methadone maintenance treatment. Multiple substance use disorders were found in these patients, and more substance use disorders were found in those patients with, versus without, a non-substance use psychiatric diagnosis. Certain substance use disorders were found to cluster. These results suggest that opiate addicts should be evaluated for multiple substance use disorders as well as for non-substance use disorders, and that certain subpopulations may be at increased risk for multiple substance use disorders.

Adult↗
PubMed1990

Intravenous drug abusers with antisocial personality disorder: increased HIV risk behavior.

Intravenous drug abuse is strongly associated with HIV transmission and with having a diagnosis of Antisocial Personality Disorder (ASPD). While the co-occurrence of intravenous drug abuse and ASPD is related to poor drug abuse treatment outcome, little is known about the contribution of ASPD to the intravenous drug abusers (IVDAs) level of HIV risk. The present study related the diagnosis of ASPD with specific drug use behaviors associated with high risk of HIV transmission. Subjects (N = 100) were intravenous drug abusers who volunteered for an HIV risk assessment study. Subjects with ASPD reported significantly higher rates of injection-equipment sharing and shared with significantly more people than IVDAs without ASPD.

Adult↗
PubMed1990

Dimensions of alcoholism: a multivariate analysis.

The present study multivariately interrelated demographic and psychometric variables that have been extensively researched in the alcoholism literature. These variables included the essential-reactive continuum, degree of familial alcoholism, subjective distress, antisocial personality features and gender. Data were collected for 76 inpatients (56 male and 20 female) meeting DSM-III criteria for alcohol abuse/dependence. The mean age of the sample was 38.9 years and ranged in age from 18 to 69 years. Three factors with eigenvalues greater than 1 were extracted. Factor 1 was labeled Neuroticism, and measures of depression, anxiety, neuroticism and female gender had the highest loadings. Number of first-degree relatives with alcoholism, essential (early onset and greater severity) alcoholism and greater antisocial propensity had the highest loadings on Factor 2, labeled "Essential-Familial." The Extroversion scale of the Eysenck Personality Inventory and number of second-degree relatives with alcoholism loaded most highly on Factor 3, labeled "Extroversion." Theoretical and clinical implications associated with these dimensions of alcoholism and variously proposed alcoholic subtypes are discussed.

Adult↗
PubMed1984

Assessment of body elimination attitude.

Constructed a 26-item Likert format Body Elimination Attitude Scale with good internal consistency and temporal stability (N = 60). Factor analysis yielded seven factors labeled Fecal Smell, Personal Hygiene, Sight, Dirty Hair, Animal Feces, Mucous-like Discharge, and Sound. Both the prominence of items that pertained to defecation and the positive association of the Scale with a measure of obsessive personality-anal character were viewed as consistent with psychoanalytic theory. Correlations with psychometric instruments revealed greater body elimination disgust to be associated with psychopathology. Youth, lesser education, having fewer children, being female, and lesser income also were associated with greater disgust.

Adolescent↗