No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Boş Zaman Aktivitelerinin Madde Bağımlılığı Sürecindeki Rolüne İlişkin Nitel Bir Çalışma
... Nevertheless, to perform interventions only for the patients and not their families does not ensure a holistic approach and may decrease the success of treatment (Albayrak & Balcı, 2014). In the studies carried out in this field, leisure time activities with the relatives of the family were important in terms of treatment and increased the well-being of caregivers because they developed positive interactions in the family (Albayrak & Balcı, 2014;Ertüzün et al., 2016). Therefore, there is a need for holistic treatment approaches in which the families are also supported in the treatment system. ...
ain Points
• There is a need for treatment systems in which families are also supported in the fight against addiction in Turkey.
• Caregivers of individuals with substance use disorder had higher emotional burden. The process
experienced by them is too difficult due to the changes in their lives.
• Development of intervention programs not only for the patient, but also for the caregivers of the
patient in the treatment process of substance abuse can also positively affect the luxury rates and
the treatment process of the illness.
• Since addiction is a chronic disorder, economic problems caused by substance abuse in families with
low income had more destructive role on the well-being and functionality of this families.
... ). Tedavi ve tedavi sonrası süreçlerde bireylerin yaşadığı durumların ortaya konulması (Danışmaz Sevin ve Erbay, 2019;Ertüzün, Koçak Uyaroğlu, Demirel ve Kocak, 2016;Erükçü Akbaş ve Mutlu, 2016;Macit, 2020); bağımlılık ile ilişkili çeşitli risk faktörlerine ilişkin görüşlerin incelenmesi(Özmen ve Kubanç, 2013; Yalman, 2019;Yaman, 2014) gibi konular da nitel ve karma desenli çalışmaların araştırma alanlarını kapsamaktadır. Bunlara ek olarak, damgalama gibi olgular kapsamında bağımlılığa ilişkin yorumların yapılması (Aker, Dündar ve Pekşen, 2007; Havaçeliği Atlam ve Coşkunol, 2019) bağımlılığa ilişkin psikolojik yaklaşımların açıklanması (Canbolat ve Ergin, 2019; Yöntem, 2019) gibi konuları açıklığa kavuşturmayı amaçlayan çalışmalar da ele alındığında; nitel ve karma desenli çalışmalarda çok disiplinli bir yaklaşıma doğru yol alındığı göze çarpmaktadır. ...
... It is also associated with lower life satisfaction (Farmer & Sundberg, 1986), and bored individuals have difficulties in finding meaning in life when compared to those who are not bored (Van Tilburg & Igou, 2011). It is among the results of the research that boredom predicts suicide attempts of individuals and even causes death due to their risky behaviours (Ben-zeev, Young & Depp, 2012;Ertüzün, Uyaroğlu, Demirel & Kocak, 2016). On the other hand, according to Yaman andPeker (2012), boredom is among the causes of cyber-bullying. ...
This study examined the role of basic needs, loneliness and life satisfaction on boredom among university studentsand differences between the average of students' boredom scores by gender. Research was designed in a correlational survey model. The sample group consisted of 613 (393 female, 220 male) university students who studied in the second semester of the 2017-2018 academic year of Mugla Sıtkı Kocman University. Multiple Linear Regression Analysis and independent samples t-test was used for data analyses. According to the findings, it was determined that the need for power and fun, life satisfaction and loneliness significantly predicts boredom while the need for survival, love & belonging and freedom didn't predict boredom. Finally, male's boredom averages were found significantly higher than those of female's. The results gave researchers, practitioners and theorists a new perspective on boredom. It was seen that basic needs, loneliness and life satisfaction played an important role in boredom. Therefore, efforts should be made to meet the basic needs of university students, especially entertainment and power needs, to increase their life satisfaction and to reduce their loneliness in intervention studies to prevent boredom. In this regard, suggestions have been made for practitioners and researchers. Bu araştırmada, üniversite öğrencilerinde temel ihtiyaçlar, yalnızlık ve yaşam doyumunun can sıkıntısı üzerindeki yordayıcı rolleri incelenmiştir. Ayrıca, cinsiyete göre öğrencilerin can sıkıntısı düzeyleri arasındaki farklar araştırılmıştır. Araştırma, ilişkisel tarama deseninde tasarlanmıştır. Örneklem grubu Muğla Sıtkı Koçman Üniversitesi'nin 2017-2018 Eğitim-Öğretim yılının ikinci döneminde öğrenim gören 613 (393 kadın, 220 erkek) üniversite öğrencisinden oluşmaktadır. Temel ihtiyaçlar, yalnızlık ve yaşam doyumunun can sıkıntısını yordayıp yordamadığı çoklu doğrusal regresyon analiziyle, öğrencilerin can sıkıntısı düzeylerinin cinsiyete göre farklılaşıp farklılaşmadığı t-testi yöntemiyle test edilmiştir. Çalışmadan elde edilen bulgulara göre, eğlence ile güç ihtiyacı, yaşam doyumu ve yalnızlığın can sıkıntısını anlamlı bir şekilde yordadığı, hayatta kalma, sevgi ve ait olma ve özgürlük ihtiyacının ise can sıkıntısını yordamadığı saptanmıştır. Son olarak, erkeklerin can sıkıntısı düzeylerinin, kadınlarınkinden anlamlı bir şekilde yüksek olduğu bulunmuştur. Sonuçlar, araştırmacılara, uygulayıclara ve teorisyenlere can sıkıntısı hakkında yeni bir bakış açısı kazandırmıştır. Temel ihtiyaçların, yalnızlığın ve yaşam doyumunun can sıkıntısı Makale Geçmişi: Geliş
... Participants stated that educational activities (e.g., workshops, presentations, material preparation, and modules) and social activities (e.g., athletic activities, projects, visits to relative organizations, and institutional cooperation) were carried out in their schools in line with the addiction prevention program. In their study, Ertüzün, Koçak Uyaroğlu, Demirel, and Koçak (2016) cite the importance of spare-time activities for one receiving treatment for addiction both during and after the treatment process for substance addiction. In a separate study, Özgen (2016) found that students participating in sports used technology at a normal level, recommending that students participate in athletic activities in order to avoid technology addiction. ...
... Studies show that drug use is directly affected by how individuals make use of their free time. In a quasi-experimental study with a control group that observed a 12-year change of participants in Iceland, it was stated that planned leisure activities had a positive effect on young people and they decreased number of bad habits (Ertüzün et al., 2016). ...
Hızlı kentleşme ile birlikte değişen yaşam koşulları, kent kullanıcılarını ve aynı zamanda çocukların oyun alanlarını da olumsuz etkilemektedir. Günümüzde artan yapı yoğunluğu, trafik ve kentlerdeki göç alımı ile kentlerde değişen insan profiline bağlı olarak azalan güven duygusu, okul çağındaki çocukların sokak ve çevreyle olan bağlantısını koparmıştır. Ayrıca kentlerde açık ve yeşil alanların azalması nedeniyle çocukların oyun alanları kısıtlanırken, eğitim alanları içerisinde bulunan okul bahçeleri de bu açığı kapatmak amacıyla daha fazla önem kazanmıştır. Çocukların ve gençlerin çevre bilinci kazanma noktasında da önemli aktörlerden biri olan okul bahçelerinin ekolojik bazı göstergelere göre düzenlenmesi son derece önemlidir. Bu göstergelerden en önemlileri; yeşil alan oranları, kullanılan bitkilerin doğallık değerleri ve alanlardaki bitki örtüsü çeşitliliğidir. Çalışmanın amacı Kilis kent merkezinde bulunan okul bahçelerinin söz konusu bu göstergelere göre değerlendirilmesidir. Çalışmada Kilis kent merkezinde yer alan 8 anaokulunun, 36 ilköğretim okulunun ve 14 lisenin açık ve yeşil alanları değerlendirilmiştir. Çalışma alanında yeşil alan oranı ve kişi başına düşen yeşil alan miktarının en az olduğu eğitim kurumları ilköğretimler; en fazla olduğu kurumlar ise liseler olarak belirlenmiştir. Tüm okullardaki ortalama doğallık değeri % 40’ın üzerinde olup; okul bahçelerindeki bitki örtüsü çeşitliliğinin yeterli olmadığı sonucuna varılmıştır.
... Participants stated that educational activities (e.g., workshops, presentations, material preparation, and modules) and social activities (e.g., athletic activities, projects, visits to relative organizations, and institutional cooperation) were carried out in their schools in line with the addiction prevention program. In their study, Ertüzün, Koçak Uyaroğlu, Demirel, and Koçak (2016) cite the importance of spare-time activities for one receiving treatment for addiction both during and after the treatment process for substance addiction. In a separate study, Özgen (2016) found that students participating in sports used technology at a normal level, recommending that students participate in athletic activities in order to avoid technology addiction. ...
Bu çalışma, madde kullanımının bireylerin günlük yaşam döngülerine, sosyal ilişkilerine ve mesleki performanslarına olan etkilerini incelemeyi amaçlamıştır. Çalışma, madde kullanımının günlük yaşamdaki yeri, kullanım öncesi ve sonrası bireylerde yaşanan değişimleri ve bireylerin ideal yaşam algılarında meydana gelen değişiklikleri ortaya çıkarmayı hedeflemektedir. Nitel araştırma yöntemiyle 17 katılımcıyla yarı yapılandırılmış mülakatlar kullanılarak veriler elde edilmiştir. Katılımcılarla yapılan görüşmelerde, madde kullanımının günlük yaşam ve rutinlere etkisi, sosyal ve mesleki yaşamdaki rolü, zaman ve mekân boyutları, fiziksel ve duygusal duruma etkisi ve ideal yaşam tasavvuru şeklinde beş ana tema ortaya çıkmıştır. Bu temaların analiziyle ortaya çıkan araştırmanın sonuçlarına göre; madde kullanımının bireylerin kişisel özgünlüklerini ve toplumdaki işlevlerini ciddi şekilde kısıtladığını, madde kullanımı öncesi ve sonrasındaki duygusal geçişlerin bireyin psikolojik ve sosyal hayatında derin olumsuz etkilere neden olduğu, sosyal ve mesleki rollerinde performans düşüklüğü yaşattığı, kullanım sonrası işten ayrılmaların arttığı ve sosyal ilişkilerin zayıfladığı görülmektedir. Ayrıca sağlık durumu ve kişisel bakım ihmal edilmekte, bu durum günlük yaşamlarını, sosyal ve aile ilişkilerini derinden etkilemektedir. Genel olarak, madde kullanımının bireylerin günlük yaşam rutinlerinin merkezinde olduğu ve bunun sonucunda aile, arkadaş ve sosyal faaliyetlere katılımın azaldığı görülmektedir. Bu bağlamda, sosyal destek sistemlerinin etkinliklerinin gözden geçirilmesi ve bireylerin günlük yaşam rutinlerine uyum sağlayacak şekilde müdahalelerin tasarlanması gerekmektedir.
Bu çalışmanın amacı, ilaç tedavisi gören madde bağımlılarının tedaviyi reddetme süreçlerinde etkili olan faktörleri incelemektir. Bu faktörler arasında ilaçsız tedavi yöntemleri, işlevsellik, kişisel inançlar, duyumlar ve alternatif tedavi seçenekleri yer almaktadır. Araştırma, madde bağımlılarının medikal tedaviyi reddetme kararlarını etkileyen bu unsurları ortaya çıkarmayı hedeflemektedir. Madde bağımlıları ile yapılan araştırma için nitel araştırma yöntemi kullanılmış olup yarı yapılandırılmış form kullanılarak 13 katılımcı ile derinlemesine görüşmeler yapılmıştır. Yapılan görüşmelerden elde edilen veriler ışığında İlaç Reddini Etkileyen Faktörler, İlaçsız Tedavi Süreci ve İşlevsellik, İlaç Tedavisine Dair İnançlar, Duyumlar ve Etkisi ve İlaca Alternatif Tedavi Yolların Denenmesi ve Etkisi olmak üzere 4 tema ortaya çıkmıştır. Katılımcıların ilaçlı tedaviyi reddetmesinde ilaç sektörüne dair olumsuz tutum, ilaçların yan etkileri ve ilacın madde bağımlılığı tedavisinde sürece dahil olan faktörler yer almaktadır. Aynı zamanda, ilaç kullanmadan yapılan tedavilerin etkinliğinin artırılması, katılımcıların bu tür tedavilere yönelik motivasyonlarını güçlendirmede kritik bir öneme sahip olduğu belirlenmiştir. İlaçlı tedaviye dair inanç ve duyumların olumsuz yönde olması ilaçlı tedaviye karşı olumsuz yargının beslenmesine yol açmakta ve katılımcıların ilaçsız tedavi arayışına neden olan önemli faktörler arasında yer almaktadır. İlaçsız tedavide ilaca alternatif yolların denenmesi ve etkisi ilaçlı tedavinin sürdürülebilirliğinin anlamlı şekilde azalmasına neden olmaktadır. Medikal tedavinin reddi konusunda literatürdeki sınırlılık madde bağımlılığı tedavisinin geliştirilmesi ve iyileştirilmesi bağlamında anlamlı bir boşluğu vurgulamaktadır. Bu bağlamda, araştırma madde bağımlılığı tedavisinde etkili yöntemlerin geliştirilmesi ve mevcut yöntemlerin iyileştirilmesi adına büyük önem taşımaktadır.
Bu çalışma ile bağımlı bireylerle çalışan profesyonellerin gözlemlerinden yola çıkarak gençlerde madde kullanımının oluşumu ve tedavi süreçlerinde aile etkisinin etiyolojini ortaya çıkarabilmek ve bağımlılık öyküsü içerisinde aile deneyimlerini daha yakından inceleyebilmek amaçlanmıştır. Araştırma, nitel araştırma yöntemine ve fenomenolojik desene uygun olarak yürütülmüştür. Birbirinden farklı kurumlarda görev yapan, farklı mesleklere sahip ve madde bağımlısı bireylerle çalışan 15 kişiyle derinlemesine mülakat gerçekleştirilmiştir. Elde edilen veriler sonucunda; bağımlılığa evrilen aşamadan bağımlılık sonrası aşamalara kadarki her bir süreç içerisinde aile faktörünün farklı etki ve deneyimlere sahip olduğu tespit edilmiştir. Bağımlılık öncesi süreçte krizler, problemler, iletişimsizlikler, travmatik yaşam deneyimleri sıklıkla karşılaşılan aile özellikleri olurken; bağımlılık sürecinde madde kullanımından geç haberdar olma, şok-panik-öfke-gizleme gibi davranışsal tepkiler verme ve eş bağımlılık geliştirme gibi aile deneyimleri öne çıkmaktadır. Bağımlılığın tedavisi aşamasında ise sürecin başarılı olabilmesi için aile katılımı ve desteği en önemli unsurlardan biridir. Tedavi aşamasında hızlı ve kolay çözüm yolları talep eden veya var olan tedavinin aksaması durumunda hızlı şekilde motivasyon kaybı yaşayabilen aile deneyimleri tespit edilmiştir. Yine annelerin babalardan daha uzun süre ve daha aktif şekilde tedavi sürecine katıldıkları aileler çoğunluktadır. Sonuç olarak aile faktörü bağımlılığın her aşamasında kendi özel şartları içerisinde değerlendirilmeli ve tedavi sürecine dahil edilmelidir. Tedavi süreçleri sadece bağımlı bireylerle sınırlandırılmamalı, sosyal çevrenin ve özellikle ailelerin de tedaviye uyumu desteklenmelidir.
Abstract
Substance addiction is the continuation of substance intake and inability to stop it, despite the physical,
mental or social problems that arise in the process of taking the substance (Arıkan & Doğan, 1999:53,
akt; Daşbaş, Polat, & Kesen, 2013). Substance use is a broad term used for addictive substances like
alcohol, cigarette, caffeine, but in this research it will indicate drug use. Recently, substance use has increased especially among adolescents in Turkey. Therefore, the therapy and rehabilitation services should
be increased and become diversified in relation to this augmentation. Since addiction is a relapsing
situation, recovery of it requires multidimensional interventions during and after the treatment. It
should be noted that recovery of substance addiction necessitates physical treatment as well as psycho-social interventions. In this regard, this research aims to investigate the methods used in the treatment and
rehabilitation process of substance addiction through the existing literature.Keywords: substance addiction, therapy and rehabilitation models, psycho-social interventions
Günümüzde sıkılma algısının serbest zamanı değerlendirme ile ilişkili olduğu düşünülmektedir. Sıkılma algısını daha iyi anlamak için sıkılma algısı ile ilişkili konuları da anlamak önemlidir. Alan yazın incelendiğinde, serbest zaman engelleri ile sıkılma algısının negatif ilişkili olduğu ve bu durumun serbest zaman katılımını olumsuz yönde etkilediği görülmektedir. Serbest zamanla ilişkili olan diğer konular ise televizyon ve bilgisayar karşısında geçirilen zaman, sigara, alkol ve madde bağımlılığı konularıdır. Sıkılma algısı arttıkça bahsedilen değişkenlerinde arttığı alan yazında çalışılan konular arasındadır. Sıkılma algısının, egzersiz bağımlılığın manidar bir yordayıcısı olup olmadığı bu araştırmanın amacını oluşturmakta, bununla birlikte bazı demografik değişkenlere göre sıkılma algısı ve egzersiz bağımlılığı puanlarının farklılaşıp farklılaşmadığı tespit edilmeye çalışılmaktadır. Bu çalışma nicel bir çalışma olup ilişkisel ve nedensel model bağlamında gerçekleştirilmiştir. Araştırmanın örneklemini Antalya ilindeki farklı spor klüplerine üye olan 120 kadın (Ortyaş=30.81 ± 9.98) ve 98 erkek (Ortyaş= 30.69± 9.33) olmak üzere toplam 218 kişi oluşturmaktadır. Çalışmada veri toplama aracı olarak; Iso-Ahola ve Weissinger (1990) tarafından geliştirilmiş olup Türkçe geçerlik-güvenirliği Kara vd. (2014) tarafından yapılan "serbest zamanda sıkılma algısı" ölçeği ile Hausenblas ve Downs (2003) tarafından geliştirilen, Türkçe geçerlik ve güvenirliği ise Gürbüz ve Aşçı tarafından (2006) yapılan "Egzersiz Bağımlılığı Ölçeği" kullanılmıştır. Araştırma verilerinin analizi için ise pearson momentler çarpım korelasyonu ve ilişkisiz örneklemler için iki faktörlü anova kullanılmıştır. Sıkılma algısı ve egzersiz bağımlılığı alt boyutları arasındaki ilişkiye bakıldığında; sıkılma algısının alt boyutu olan doyum ve egzersiz bağımlılığının alt boyutu olan geri çekilme etkileri arasında manidar negatif bir ilişkinin olduğu görülmektedir. Elde edilen bulgular cinsiyet ve yaşın sıkılma algısı ve egzersiz bağımlılığı üzerinde etkisinin olmadığı bununla birlikte bu iki değişken arasındaki ilişkinin yalnızca doyum ve geri çekilme arasında olduğu görülmüştür.
Drug addicts, being excluded from society, constitute their own sub-culture with its own distinctive way of
dealing with specific problems, clothes, music, languages, and beliefs. The aim of this study is to examine
Turkish rap songs that contain expressions related to alcohol and drug addiction, which are thought to
encourage the drug subculture, and to view drug subculture as a way of expression using the qualitative
research method. Songs reflecting drug subculture on YouTube have been selected using the purposive
sampling method until data saturation is reached. The two researchers listened to 50 songs that reflect drug
subculture in the content or meaning of the rap songs between February 20 and March 20, 2018. Music is
said to influence youths’ emotions, behaviors, and communication styles, with rap music being problematic.
As a result of the analysis, under the main theme of expressions related to alcohol and substance use,
four sub-themes have been formed: expressions demeaning women (n = 18, 13.1%), desperate-pessimistic
expressions (n = 37, 27.0%), expressions supporting violence and crime (n = 36, 26.3%), and slang and
taboo expressions (n = 46, 33.6%). The songs included in the study have been concluded to reflect and
contain a great number of expressions on drug subculture.
Kendilerine özgü sorunlarla baş etme tarzları, giyinişleri, müzikleri, dilleri, inançları ile toplumdan
dışlanan madde bağımlıları, kendilerine ait madde alt kültürünü oluşturmaktadırlar. Bu araştırmanın
amacı, madde alt kültürünün dile gelmiş hâli olarak görülen rap müziğinden hareketle madde alt kültürünü
özendirdiği düşünülen, alkol ve madde bağımlılığına ilişkin ifadeleri içeren Türkçe rap şarkıların nitel
araştırma yöntemiyle incelenmesidir. Türkçe rap şarkılar amaçlı örnekleme yöntemiyle Youtube internet
sitesinden seçilmiştir. İzlenme oranı yüksek olan Türkçe rap şarkılar, veriler doygunluğa ulaşıncaya kadar
sırayla dinlenmiştir. Bu şekilde ulaşılan 50 şarkı, 20.02.2018-20.03.2018 tarihleri arasında iki araştırmacı
tarafından dinlenerek yazıya aktarılmıştır. Müziğin gençlerin duygularını, davranışlarını ve iletişim
biçimlerini etkilediği ve rap müziğin problem müzik türlerinden olduğu belirtilmektedir. Yapılan analiz
sonucunda “Alkol ve madde kullanım ifadeleri” ana teması altında dört alt tema oluşturulmuştur: (1)
kadınları aşağılayıcı ifadeler (n =18, %13,1); (2) umutsuz-karamsar ifadeler (n =37, %27,0); (3) şiddet ve
suç ifadeleri (n =36, %26,3); (4) argo ve küfür ifadeleri (n =46, %33,6). Araştırmaya dâhil olan şarkıların
madde alt kültürüne ait çok fazla ifade içerdiği ve madde alt kültürünü özendirdiği sonucuna varılmıştır.
ABSTRACT
Apart from industrial exposure, volatile agent exposure occurs to a significant extent by abusing these substances with the aim of excitement. In recent years, inhalants addiction has rapidly spread among children and adolescents. Indeed children and adolescents’ use of substance may vary. Inhalants dependence is generally seen at average 14-15 years of age in the patients. When psychological reasons affecting volatile substance dependence are examined, it can be said that factors such as not knowing how to cope with stress in general, desire to get rid of negative and bad emotions, pleasure from matter, pleasure, wanting to belong to a group and feeling strong.
When social factors are taken into consideration, it is first and foremost that access to volatile substances is easy and cheap, acceptance within the family, peer influence, positive perspective on the substance in the social environment and encouraging visuals in the social media
Reducing adolescent substance use is important in South Africa, a developing nation with increasing adolescent substance use, lack of leisure/recreation opportunities, and high rates of adolescent discretionary time. Previous research suggests leisure boredom and adolescent substance use co-occur in this setting. Using longitudinal data from 2,580 South African adolescents as they progressed from the 8th to 11th grade, the current study disentangles the associations of trait and state leisure boredom with substance use, and examines how ability to restructure boring situations moderates those associations. On average, individuals with higher trait boredom used more substances, and on occasions when state boredom was high, the prototypical adolescent used more substances. Although restructuring did not moderate these associations, greater ability was associated with lower substance use independent of leisure boredom. Findings illustrated the importance of considering how trait and state aspects of leisure may contribute to adolescents’ risk behavior and addressed through preventive intervention.
There has been very little research investigating leisure boredom and risk behaviour among adolescents in South Africa. Using a qualitative approach, this study investigated adolescents’ perceptions of leisure boredom and risk behaviour during free time. The sample comprised three groups of adolescent participants: a community group, a school group and a group who had dropped out of school. Participants documented their free time experiences by taking photographs that were later discussed in focus groups. The findings showed that the participants were bored in their free time mainly because they had nothing to do. The low socio-economic environment where they lived contributed to occupational deprivation and imbalance in their free time, maintaining or ‘trapping’ the adolescents within the situation and contributing to feelings of boredom. The participants spent much of their free time ‘hanging out’ on street corners or in backyards, which allowed them to socialise, but inevitably led to boredom. Participants felt that boredom was part of life, although some perceived it to be ‘dangerous’ because it often led to risky behaviour. In conclusion, the study showed that for the participants, leisure is an occupational concern due to the occupational deprivation and imbalance occurring within their free time. Occupational therapists should consider how leisure boredom influences adolescent health, wellbeing and development, and plan interventions accordingly.
Investigated the effect of need for cognition on boredom proneness scores among 214 undergraduates using the short form of the Need for Cognition Scale and the Boredom Proneness Scale. Results showed that individuals low in need for cognition possessed greater boredom proneness scores. Individuals who were less likely to engage in and enjoy effortful cognitive activities were more prone to experience the negative affect of boredom when compared to high need-for-cognition persons. It appears that individuals who are more inclined to provide their own stimulation are more apt to escape negative experiences of boredom. Males were also found to be more prone to boredom. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Background
There is a need for novel approaches to the treatment of stimulant abuse and dependence. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse, with direct effects on decreased use and craving. In addition, exercise has the potential to improve other health domains that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight gain, quality of life, and anhedonia, since it has been shown to improve many of these domains in a number of other clinical disorders. Furthermore, neurobiological evidence provides plausible mechanisms by which exercise could positively affect treatment outcomes. The current manuscript presents the rationale, design considerations, and study design of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) CTN-0037 Stimulant Reduction Intervention using Dosed Exercise (STRIDE) study.
Methods/Design
STRIDE is a multisite randomized clinical trial that compares exercise to health education as potential treatments for stimulant abuse or dependence. This study will evaluate individuals diagnosed with stimulant abuse or dependence who are receiving treatment in a residential setting. Three hundred and thirty eligible and interested participants who provide informed consent will be randomized to one of two treatment arms: Vigorous Intensity High Dose Exercise Augmentation (DEI) or Health Education Intervention Augmentation (HEI). Both groups will receive TAU (i.e., usual care). The treatment arms are structured such that the quantity of visits is similar to allow for equivalent contact between groups. In both arms, participants will begin with supervised sessions 3 times per week during the 12-week acute phase of the study. Supervised sessions will be conducted as one-on-one (i.e., individual) sessions, although other participants may be exercising at the same time. Following the 12-week acute phase, participants will begin a 6-month continuation phase during which time they will attend one weekly supervised DEI or HEI session.
Clinical Trials Registry
ClinicalTrials.gov, NCT01141608
http://clinicaltrials.gov/ct2/show/NCT01141608?term=Stimulant+Reduction+Intervention+using+Dosed+Exercise&rank=1
To examine 12-year changes in alcohol use and cigarette smoking in response to community-based prevention activities among Icelandic adolescents.
This study used a quasi-experimental, non-randomized control group design to compare outcomes in 4 Icelandic communities (n=3117) that participated in community-based substance use prevention activities designed to increase levels of parental monitoring and adolescent engagement in healthy leisure-time activities and a matched group of 7 comparison communities (n=1,907). Annual, nationwide, population-based cross-sectional surveys of the prevalence of adolescent substance use were conducted among cohorts of Icelandic adolescents, aged 14-15 years (N=5,024), in all communities from 1997 to 2009.
Parental monitoring and adolescent participation in organized sports increased in communities that adopted the intervention program compared to communities that did not, whereas unmonitored idle hours and attendance at unsupervised parties decreased. Over time, alcohol use (OR=0.89, 95% CI 0.82, 0.98, p=0.012) and being intoxicated during the last 30 days (OR=0.86, 95% CI 0.78, 0.96, p=0.004) decreased more in the intervention than control communities.
Community-based prevention designed to strengthen parental monitoring and participation in organized sports may confer some protection against adolescent substance use.
We investigated prospectively whether physical activity level in adolescence predicts use of alcohol and illicit drugs in early adulthood. We studied 4,240 individual twins (1,870 twin pairs). We classified those who consistently reported frequent leisure physical activity at ages 16, 17 and 181/2 as persistent exercisers, those exercising less than three times monthly as persistently inactive, and all others as occasional exercisers. To control for familial confounds, within-family analyses compared activity-substance use associations in co-twins discordant for baseline physical activity. Individual-based analyses showed no clear association between baseline physical activity and subsequent weekly alcohol consumption. However, weekly alcohol intoxication (OR = 1.9, p = .002) and problems due to alcohol use (OR = 2.0, p < .001) were more common among persistently inactive participants. After excluding those reporting weekly intoxication at baseline, the risk for alcohol intoxication remained elevated among women occasionally (OR = 2.4, p = .017) or persistently (OR = 5.8, p < .001) inactive at baseline, but this association was not replicated within discordant twin pairs. Individual-based analyses showed that drug use in adulthood was more common among those persistently physically inactive in adolescence (OR = 3.7, p < .001) in comparison to those persistently active. This finding was replicated within discordant twin pairs. Among those with no drug experience during adolescence, persistent inactivity (OR = 1.9, p = .007) increased risk for drug use. We conclude that persistent physical inactivity in adolescence may increase the risk of later problems due to excess alcohol use. Sedentary lifestyle predicts illicit drug use even when controlling for familial factors.
This trial assessed whether behavioral treatment improves outcome during a 26-week outpatient opioid detoxification. Thirty-nine opioid-dependent adults were assigned randomly to a buprenorphine dose-taper combined with either behavioral or standard treatment. Behavioral treatment included (a) a voucher incentive program for providing opioid-free urine samples and engaging in verifiable therapeutic activities and (b) the community reinforcement approach, a multicomponent behavioral treatment. Standard treatment included lifestyle counseling. Fifty-three percent of the patients receiving behavioral treatment completed treatment, versus 20% receiving standard treatment. The percentage of patients achieving 4, 8, 12, and 16 weeks of continuous opioid abstinence were 68, 47, 26, and 11 for the behavioral group and 55, 15, 5, and 0 for the standard group, respectively. Behavioral treatment improved outcomes during outpatient detoxification.
A two-stage model of peer influence was proposed. The model served as a framework for examining individual and relationship-specific differences in susceptibility to influence. The two stages are (1) the acquisition of a peer context and (2) conforming to the behavior of a peer. Data from a four-wave longitudinal study were used to assess (1) the initial selection of cigarette- and alcohol-using peers and (2) influence from peers. Relationship factors and variables identified as risk factors for substance use were hypothesized to increase susceptibility to peer influence. The results indicated that adolescents who did not value school achievement or spending time with parents were more apt than others to choose friends who smoked cigarettes more than they did. Adolescents who chose friends who drank more than they did not differ from other adolescents on any of the risk factors. Thus, low-risk adolescents were as likely to acquire a friend context where drinking was likely to occur as were adolescents who had more risk factors. When the second stage was examined, only high peer acceptance and high friendship quality resulted in adolescents being more apt to conform to their friend's substance-use behaviors.
Previous research has shown that between 80 and 90 percent of adult smokers report having started smoking before 18 years of age. Several studies have revealed that multiple social factors influence the likelihood of smoking during adolescence, the period during which the onset of smoking usually occurs. To better understand the social mechanisms that influence adolescent smoking, we analyzed the relationship and relative importance of a broad spectrum of social variables in adolescent smoking in Iceland, a Nordic country with high per-capita income.
We used cross-sectional data from 7,430 14- to 16 year-old students (approximately 81% of all Icelanders in these age cohorts) in the 2006 Youth in Iceland study. The Youth in Iceland studies are designed to investigate the role of several cognitive, behavioral, and social factors in the lives of adolescents, and the data collected are used to inform the design, implementation, and evaluation of substance use prevention programs that are being developed by Icelandic social scientists, policy makers, and practitioners.
Our analysis revealed that friends' smoking behavior and attitude toward smoking were strongly associated with adolescent smoking and other tobacco use, as well as alcohol consumption during the previous 30 days. Main protective factors were parent's perceived attitude toward smoking, the quantity of time spent with parents, absence of serious verbal conflict between parents and adolescents, and participation in physical activity. Family structure was related to adolescent smoking to a small extent, but other background factors were not.
We conclude that multiple social factors are related to adolescent smoking. Parents and other primary preventive agents need to be informed about the complicated nature of the adolescent social world in order to maximize their impact.
This study examined the relationship between sport participation on the one hand and smoking and the use of alcohol and drugs on the other among Icelandic youth 12- to 15 years of age. Two indicators of sport participation were employed; one measured its extent in formally organized sports clubs, while the other measured the extent to which the subjects were involved in sports regardless of whether they trained informally or with a formally organized sports club. Two random samples of 12- to 15-year-olds from the urban areas of southwest Iceland, comprising 456 and 358 subjects, were analyzed to determine if there was a negative correlation between sport participation and the measures of deviant behavior in question. However, 3 of the 12 relationships tested were not significant at the .05 level. The findings do not change significantly when gender, social class, and age are controlled. It is concluded that the findings give cross-cultural support to previous research results indicating a negative relatio...
Because of the proximity of Persian Iran to Afghanistan, the main opium producer in the world, drug use especially opium use has a long history in Iran. Opium and its residues are the traditional drugs while heroin, heroin Kerack, norgesic, temgesic, and methamphetamine use and injection have emerged more recently. In recent decades, heroin smoking and injection have presented challenges to the Persian health policy makers to accept and develop the internationally-approved programs of drug use treatment and harm reduction. The current paper summarizes the overall picture of main drugs used and the history of establishing the nationwide movement of drug use treatment and harm reduction programs after the 1979 revolution until the end of 2014. The paper concludes that Persian Iran has a well-developed healthcare system in the provision of drug use treatment and harm reduction programs in the south-west of Asia especially the Persian Gulf region. These therapeutic and harm reduction-related programs are required to be strengthened by opium supply reduction and eradicating drug production in Afghanistan. The provision of prevention programs, drug education via mass-media, employment and inexpensive leisure activities are required in Iran. In addition, conducting household surveys of the prevalence of drug use and evaluating the clinical effectiveness and treatment outcomes of the provided drug treatment and harm reduction programs are required. National and regional collaborations are rigorously suggested to manage supply reduction along the borders and implement demand reduction inside the borders.
Copyright © 2015 Elsevier B.V. All rights reserved.
The impact of personality on leisure behaviour and experience has been ignored in psychological research. Where personality research on leisure has been reported it is usually highly simplistic using outmoded trait approaches. It is argued that personality constructs have a role in leisure theory if they are conceptualized as the person variable in the interactionism model, that is, used in conjunction with information about the social situation to predict and explain behaviour. As well as identifying several existing personality constructs that are relevant to understanding leisure behaviour, it is suggested that theorists and researchers could benefit from developing «leisure-specific» personality constructs that reflect significant individual differences in response to free time and leisure situations. As an illustration, the author's Self-As-Entertainment personality construct is outlined and data reported providing a preliminary assessment of its reliability and validity.
This article considers the relation of family factors to adolescent substance use, with a focus on the specific pathways by which family factors have their effects. We review findings on four types of variables (family substance use, parental support and monitoring, parent-child conflict, and family life events) and discuss theoretical models of how family risk and protective factors are related to adolescents' outcomes. The evidence favors a transactional model in which family factors have largely mediated effects on adolescent substance use through relations to adolescents' self-control, life events, and peer affiliations; interactions between variables are also prominent. We discuss the implications of mediated effects for theoretical models of human development and consider how the transactional approach opens avenues for preventive intervention.
Examined the relationship between substance abuse, leisure boredom, and leisure participation in 39 adolescent substance abusers (SAs) and 81 non-SAs (aged 15–18 yrs). SAs had a tendency to participate more frequently in leisure activities in general, and physical recreation activities in particular. Nonetheless, SAs were significantly more bored with leisure than non-SAs. Results are interpreted as evidence that SAs have a personality predisposition toward sensation seeking and a low tolerance for constant experience. If leisure activities fail to satisfy their need for optimal arousal, leisure boredom results and drugs may be used as an alternative. Findings also suggest that an experiential approach in treating adolescent SAs may be better than traditional cognitive and didactic approaches. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Since it began in the mid-1990s, the debate surrounding the normalisation of adolescent recreational drug use has attracted considerable attention and has tended to polarise opinion within the field. In this article two of the main protagonists in the debate come together to discuss its legacy. Focusing on the twin themes of continuity and change the authors begin by considering the relevance of early developments in the sociology of drug use, noting that this earlier work anticipated much that has recently been written on the subject, including the emphasis on hedonism and consumption in leisure lifestyles. From here they go on to critically reflect on the role that structure and agency have played in the normalisation debate, suggesting that the original thesis underplayed the role of structural influences in favour of a rational action model of adolescent drug use. In their more recent work, both authors have come to emphasise how drug use is shaped by an interplay between social structure and human agency. While some areas of disagreement remain, they agree that normalisation is best understood as a contingent process negotiated by distinct social groups operating in bounded situations.
Contingency management (CM) procedures, that provide incentives for specific behaviors, are efficacious in treating substance use disorders. Typically, CM interventions reinforce submission of urine specimens negative for the targeted drug(s) of abuse, but other behaviors can be reinforced as well, such as compliance with non-drug-related activities. This article describes 1,059 activities chosen by 46 subjects participating in one of two CM studies. The most frequently chosen activities were related to recreational activities (going to movies, library, or church) and sobriety (attending Alcoholics Anonymous meetings, completing worksheets). Over 95% of subjects participated in at least one of these types of activities, and together they accounted for over 70% of the activities selected. Over half the subjects participated in at least one activity related to employment, health, family, and personal improvement, such as applying for a job, attending a medical appointment, taking their child to an event, or creating weekly to-do lists. A detailed description of activity selection and verification procedures may assist in developing consistent approaches across treatment settings, and future research may evaluate further the efficacy of this contingency management approach in treating substance abusers.
To determine whether parent social influences are associated with health-risk behaviors more than peer social influences among young minority adolescents.
We conducted a cross-sectional survey of seventh-grade students in a public urban magnet middle school using a survey instrument adapted from the Centers for Disease Control and Prevention Youth Risk Behavior Survey. The sample consisted of all seventh-grade students in the school, and the survey was part of a needs assessment for a school-based health education program. We measured four health-risk behaviors: use of (a) tobacco, (b) alcohol, (c) onset of sexual activity, and (d) marijuana use; and five social influences: (a) parent disapproval of health-risk behaviors, (b) parent modeling of health-risk behaviors, (c) parent monitoring of health-risks, (d) peer disapproval of health risks, and (e) peer modeling of health-risk behaviors. The analyses included measures of the prevalence of health-risk behaviors, bivariate analyses to evaluate relationships between health-risk behaviors and social influences, and regressions analyses to determine the independent associations of the social influences with the four health-risk behaviors.
Twenty percent of respondents reported using tobacco, over 50% used alcohol in the past year, 13.3% were sexually active, and 12% reported marijuana use. Parent influences were associated with differences in alcohol use, whereas peer influences were associated with differences in all measured health-risk behaviors: tobacco and alcohol use, sexual activity, and marijuana use. Regression analyses demonstrated that peer social influences were the only measures independently associated with abstinence from tobacco (p < .05), alcohol (p < .01), sexual activity (p < .05), and marijuana use (p < .05). In all analyses, peers emerged as the most consistent social influence on health-risk behavior.
This study suggests peers and peer group behavior may be better predictors of adolescent health-risk behaviors than parental social influences among young adolescents.
Mentally ill persons represent a population that is potentially vulnerable to receiving a poorer quality of medical care. This study examines the relationship between mental disorders and the likelihood of receiving recommended nutrition and exercise counseling.
Cross-sectional study combining chart-review data and administrative database records.
One hundred forty-seven Veterans Affairs (VA) medical centers nationwide.
The sample included 90,240 patients with obesity and/or hypertension who had >/=3 medical outpatient visits in the previous year.
The outcomes of interest were chart-documented receipt of nutrition counseling and receipt of exercise counseling in the past 2 years. This chart information was merged with VA inpatient and outpatient administrative databases, which were used to identify persons with diagnosed mental disorders. Most patients received nutrition counseling (90.4%), exercise counseling (88.5%), and counseling for both (85.7%) in the past 2 years. The rates of counseling differed significantly but modestly by mental health status. The lowest rates were found among patients dually diagnosed with comorbid psychiatric and substance use disorders; however, the magnitude of the disparities was small, ranging from 2% to 4% across outcomes. These results were unchanged after controlling for demographics, health status, and facility characteristics using multivariable generalized estimating equation modeling.
Among patients engaged in active medical treatment, rates of nutrition and exercise counseling were high at VA medical centers, and the diagnosis of mental illness was not a substantial barrier to such counseling. More work is needed to determine whether these findings generalize to non-VA settings and to understand the potential role that integrated systems such as the VA can play in reducing disparities for vulnerable populations.
Cognitive-behavioral therapy (CBT) approaches to intervention for adolescent substance use disorders has been limited and formal controlled clinical efficacy trials have been rare. Moreover, the early literature on the efficacy of CBT for adolescent substance abuse has been characterized by significant methodological limitations. Recent innovations in the treatment of adolescent substance abuse and the recent completion of several randomized clinical trials has brightened the picture with respect to establishing the empirical support for CBT. The aim of this review is to integrate the findings from controlled trials of CBT for adolescent substance abuse.
Studies representing randomized clinical trials were reviewed using criteria provided by Lonigan et al. and Nathan & Gorman as a guide.
Despite some prominent differences in design and methodology, the studies reviewed provide consistent empirical evidence that group and individual CBT are associated with significant and clinically meaningful reductions in adolescent substance use. The evidence for the efficacy of group therapy is particularly important, countering the assertion that aggregating problem youths into group treatment settings is associated with iatrogenic effects. The findings from the randomized trials reviewed represent significant developments in treatment outcome research and lay the foundation for validating CBT for adolescent substance use disorders. Future research directions include improving short- and long-term outcomes, enhancing treatment motivation and engagement, and identifying mechanisms and processes associated with positive change, especially for youths with comorbid conditions.
This systematic review examined the hypothesis that school institutional factors influence young people's use of drugs. We aimed to (1) identify the effect of school-level changes on drug use and (2) explore the possible mechanisms by which school-level influences on individual drug use might occur.
Systematic review. Experimental/quasi-experimental studies of "whole-school" drug prevention interventions and longitudinal observational studies on the association between school-level and individual-level school-related exposures and drug use were included. Experimental studies were included because they are the most reliable available source of evidence about causation. Observational studies of school-level and individual-level school-related exposures were included with the aim of providing evidence about a wider range of possible school-level effects and how school-level influences might be mediated by individual-level factors.
Experimental studies suggested that changes to the school social environment that increase student participation, improve relationships and promote a positive school ethos may be associated with reduced drug use. School-level and individual-level observational studies consistently reported that disengagement and poor teacher-student relationships were associated with drug use and other risky health behaviors.
There is evidence of school effects on young people's drug use. Interventions that promote a positive school ethos and reduce student disaffection may be an effective complement to drug prevention interventions addressing individual knowledge, skills, and peer norms. Such approaches should now be piloted in a wider range of settings. Further research is also needed to explore mechanisms by which schools may influence young people's drug use.
Exercise has been proposed as an adjunct intervention for substance use disorders due to its many benefits in terms of mental and physical health. This study investigated the association between completion of exercise-related activities and substance use disorders treatment outcome in a sample of 187 participants undergoing intensive outpatient treatment with contingency management. The sample was divided into two groups based upon whether or not an individual completed an exercise-related activity. Individuals who engaged in exercise-related activities (n=45) were found to achieve longer durations of abstinence during treatment than individuals who did not complete an exercise-related activity (n=142). Overall, these findings suggest that exercise may be of benefit to individuals undergoing substance use disorders treatment. Methods for implementing an exercise intervention within substance use disorders treatment are discussed.
Üniversite öğrencilerinde sigara-alkol kullanımı ve aile sorunları ile ilişkisi
- S K Akfert
- E Çakıcı
- M Çakıcı
Akfert SK, Çakıcı E, Çakıcı M. (2009). Üniversite
öğrencilerinde sigara-alkol kullanımı ve aile sorunları
ile ilişkisi. Anatolian Journal of Psychiatry, 10, 40-47.
Madde bağımlılığı: aile ile ilgili olası risk faktörleri, algılanan ebeveyn kabul-reddi ve çocuk yetiştirme stilleri
- S Bircan
- G Erden
Bircan S, Erden G. (2011). Madde bağımlılığı: aile ile ilgili
olası risk faktörleri, algılanan ebeveyn kabul-reddi ve
çocuk yetiştirme stilleri. Çocuk ve Gençlik Ruh Sağlığı
Dergisi, 18(3), 211-222.
Farklı sosyoekonomik çevreden iki ilköğretim okulunda öğrenim gören öğrencilerin sigara kullanma durumları ve etkileyen faktörlerin belirlenmesi. Fırat Sağlık Hizmetleri Dergisi
- D Çuhadar
- A Bahar
Çuhadar D, Bahar A. (2007). Farklı sosyoekonomik
çevreden iki ilköğretim okulunda öğrenim gören
öğrencilerin sigara kullanma durumları ve etkileyen
faktörlerin belirlenmesi. Fırat Sağlık Hizmetleri Dergisi,
2(5), 132-145.
Gözden geçirme: beşi kıtada genç sorunları. Çocuk ve Gençlik Ruh Sağlığı Dergisi
- A Ekşi
Ekşi A. (2003). Gözden geçirme: beşi kıtada genç
sorunları. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 10(2),
78-87.
Exercise, stress resistance, and central serotonergic systems. Exercise and sport sciences reviews
- B N Greenwood
- M Fleshner
Greenwood BN, Fleshner M. (2011). Exercise, stress
resistance, and central serotonergic systems. Exercise
and sport sciences reviews, 39(3), 140.
Young people in Iceland
- A L Kristjansson
- I D Sigfusdottir
- J Sigfusson
Kristjansson AL, Sigfusdottir ID, Sigfusson J. (2006)
Young people in Iceland. Science and Culture. Reykjavik,
Iceland: The Icelandic Ministry of Education.
Uyuşturucu Başta Olmak Üzere Madde Bağımlılığı Ve Kaçakçılığı Sorunlarının Araştırılarak Alınması Gereken Önlemlerin Belirlenmesi Amacıyla Kurulan Meclis Araştırması Komisyonu Raporu
- Kurulu Meclis Araştırma
Meclis Araştırma Kurulu. (2008). Uyuşturucu
Başta Olmak Üzere Madde Bağımlılığı Ve Kaçakçılığı
Sorunlarının
Araştırılarak
Alınması
Gereken
Önlemlerin Belirlenmesi Amacıyla Kurulan Meclis
Araştırması Komisyonu Raporu. Ankara
Physical activity and prevalence and incidence of mental disorders in adolescents and young adults
- A Ströhle
- M Höfler
- H Pfister
- A G Müller
- J Hoyer
- H U Wittchen
- Ve Diğ
Ströhle A, Höfler M, Pfister H, Müller AG, Hoyer J,
Wittchen HU, ve diğ. Physical activity and prevalence
and incidence of mental disorders in adolescents and
young adults. Psychol Med. 37(11), 1657-66.
Alcohol misuse in South African male adolescents: A qualitative investigation. International quarterly of community health education
- A Yıldırım
- H Şimşek
Yıldırım A, Şimşek H. (2006). Sosyal Bilimlerde
Nitel Araştırma Yöntemleri. (6. baskı) Ankara: Seçkin
Yayıncılık
44. Ziervogel CF, Ahmed N, Flisher AJ, Robertson
BA. (1997). Alcohol misuse in South African male
adolescents: A qualitative investigation. International
quarterly of community health education,17(1), 25-41.