Open Access
Substance use disorder and lifetime suicidal behaviour: a scoping review
(Elsevier, 2024) Leza González, Leire; Haro Escribano, Begoña; López-Goñi, José Javier; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Suicidal behaviours are prevalent in substance use disorder (SUD) patients. These behaviours have a negative impact on the psychopathological profile of these patients. However, few studies have evaluated suicide as a continuum (i.e. starting with ideation, followed by attempts and ending with death) and its evolution during treatment. The aim of this scoping review was to explore what is known about suicidal behaviour in individuals undergoing clinical treatment for SUD. Methods: The PsycINFO, Web of Science (Core Collection and MEDLINE), Scopus, and Cochrane Library databases were searched. After screening the records based on eligibility and exclusion criteria, 30 studies were ultimately selected for inclusion. Results: Most of the studies were conducted in the USA and Europe. Only three studies evaluated suicidal behaviour with a specific instrument. The prevalence of suicidal ideation (SI) in people being treated for SUD ranged from 20 % to 62.2 %, and the prevalence of suicide attempts (SA) ranged from 15.8 % to 52.1 %. Only one study reported death by suicide. Conclusions: Despite the high prevalence of suicidal behaviours and their harmful consequences, the assessment of this phenomenon is scarce and heterogeneous. There is a need to assess suicidal behaviour with standardized criteria in order to develop tailored SUD treatment.
Open Access
Gender differences in patients with substance use disorder and physical/sexual abuse: a preliminary study
(Colegio Oficial de la Psicología de Madrid (COPM), 2023) Haro Escribano, Begoña; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; López-Goñi, José Javier; Ciencias de la Salud; Osasun Zientziak
Objetivo: Explorar las diferencias de género en distintas variables (sociodemográficas, gravedad del consumo, sintomatología psicopatológica, inadaptación a la vida cotidiana, características del trauma y sintomatología de estrés postraumático) en pacientes que acuden a tratamiento por trastorno por consumo de sustancias (TCS) y han sufrido abuso físico y/o sexual. Método: La muestra estuvo compuesta por 26 mujeres y 31 hombres que habían sufrido abuso físico y/o sexual y buscaban tratamiento para TCS. Resultados: Las mujeres habían sido víctimas de abuso sexual en un porcentaje significativamente mayor que los hombres. Además presentaban una frecuencia significativamente mayor de revictimización a otro evento traumático y una presencia significativamente mayor de síntomas de evitación que los hombres. Conclusiones: El estudio confirma la existencia de un perfil más grave en las mujeres que en los hombres con TCS que han sufrido abuso físico y/o sexual a lo largo de la vida. En consecuencia, se debe promover la atención informada sobre el trauma con perspectiva de género en los programas de tratamiento del TCS. Dada la naturaleza preliminar de este estudio, se necesita más investigación en este campo.
Open Access
Prevalence and differential profile of patients with substance use disorder who have suffered physical and/or sexual abuse
(SAGE, 2021) Haro Escribano, Begoña; López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Ciencias de la Salud; Osasun Zientziak
Patients with substance use disorder (SUD) who undergo treatment present a high prevalence of lifetime physical and/or sexual abuse. Studies about this phenomenon and the specific needs of patients with a history of abuse must be carried out to tailor treatment programmes. The first goal of this paper was to determine the prevalence of physical and/or sexual abuse among patients with SUD, and the second goal was to analyse the specific characteristics of these patients. A sample of 418 subjects was assessed to achieve the first goal, and 104 subjects (52 with and 52 without a history of physical and/or sexual abuse) were examined to reach the second goal. All patients sought treatment for SUD in two Spanish clinical centres. The results showed that 15.5% of the sample had a history of physical and/or sexual abuse (42.3% of women and 9.9% of men). Patients with a history of abuse presented a higher need for SUD treatment in family and psychiatric areas and more psychopathological symptoms than patients without a history of abuse. According to this more serious profile, a patient-centred intervention considering the history of abuse is recommended. This will allow the specific needs of these patients to be met, thus improving SUD treatment success.
Open Access
Psychosocial and personality characteristics of juvenile offenders in a detention centre regarding recidivism risk
(Colegio Oficial de Psicólogos de Madrid, 2020) Cacho Fernández, Raúl; Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Ciencias de la Salud; Osasun Zientziak
En este estudio se analizan las características psicosociales de una muestra de menores infractores en un centro de internamiento en función del riesgo de reincidencia. Se evaluó una muestra de 102 menores infractores (92 varones y 10 mujeres) que cumplían una medida judicial en el único centro de internamiento de Navarra (España). Se recogió información sobre las características sociodemográficas, psicosociales y el riesgo de reincidencia a través del Inventario para la Gestión y la Intervención con Jóvenes (IGI-J), así como sobre las características de personalidad a través del Inventario Clínico de Adolescentes de Millon (MACI). Los resultados mostraron que el riesgo de reincidencia era alto para el 21.6% de la muestra, moderado para el 31.4% y bajo para el 47.1%. Se encontraron diferencias estadísticamente significativas entre los grupos en numerosas características psicosociales y de personalidad. Además, las principales variables relacionadas con los diferentes niveles de riesgo de reincidencia fueron la presencia/ausencia de una historia de conductas violentas, el rendimiento escolar, las habilidades para la solución de problemas y la sumisión como características de personalidad. Estas cuatro variables clasificaban correctamente al 80.4% de la muestra. Con arreglo a los resultados encontrados, estas variables se deben tener en cuenta en el desarrollo de programas de intervención eficaces en los centros de internamiento con menores infractores con el objetivo de disminuir la tasa de reincidencia.
Open Access
Impact of a trauma intervention on reducing dropout from substance use disorder treatment
(American Psychological Association, 2021) López-Goñi, José Javier; Haro Escribano, Begoña; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Ciencias de la Salud; Osasun Zientziak
Objective: To evaluate the effectiveness (in terms of retention) of an intervention aimed at treating the consequences of lifetime physical and/or sexual abuse among patients who are also seeking substance use disorder treatment (SUD-T) in a clinical centre. Method: A parallel, randomized, controlled clinical trial using an experimental design (with one treatment group and one control group) with repeated measures (pretreatment, posttreatment and 6-month follow-up) was carried out. The sample consisted of 57 patients in SUD-T who had experienced lifetime physical and/or sexual abuse. All patients received a cognitive-behavioural SUD-T. In addition, the treatment group (n = 29) received physical and/or sexual abuse treatment (PSA-T). Results: The treatment group presented a lower SUD-T dropout rate (37.9%; n = 11) than the control group (50.0%; n = 14), but this difference was not statistically significant (χ2 = 0.8; p = .359; Phi = .122). The main variable related to SUD-T success (therapeutic discharge after completing the 40 outpatient sessions or 12 inpatients months and maintained abstinence) was the completion of PSA-T. Conclusions: The completion of this trauma-centred treatment improved the retention rate of SUD-T in patients with histories of physical and/or sexual abuse. This is a promising result because of the high SUD-T dropout rate shown by patients with victimization.
Open Access
Prescription drug abuse among female survivors of intimate partner violence: a call for research
(Springer, 2023) Haro Escribano, Begoña; Cuesta-García, Andrea; Miguel-Alvaro, Alejandro; Fernández-Montalvo, Javier; Crespo, María; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Substance abuse, including the misuse of prescription drugs, has increased in the last two decades around the world (McCabe, et al., 2007; National Institute on Drug Abuse [NIDA], 2023; World Health Organisation [WHO], 2020). Global sources estimated that 5.5% of people aged 15-64 years worldwide had used an illicit drug and that 0.7% of the adult population suffered from drug use disorders. A proportion of disorders is associated with the non-medical use of prescription drugs such as synthetic opioid analgesics, anxiolytics, hypnotics or psychostimulants (NIDA, 2023; WHO, 2020). Furthermore, prescription drug abuse (PDA) might be higher in specific populations such as women with substance use disorder (SUD; Peteet, 2020), especially among those who had attempted suicide (Icick, 2017). Some of the factors that have been related with PDA are histories of abuse and the lessened stigma associated with the use of prescription drugs compared to the use of illegal drugs (Fleary et al., 2013). For example, survivors of violence have presented a greater vulnerability to substance abuse (Khantzian, 1997), than has serious medical consequences (Benyamin et al., 2008). Intimate partner violence (IPV) is a global public health problem associated with several physical and mental health consequences in women such as depression, anxiety, or substance abuse (Campbell, 2002). Among these consequences, Bailey et al. (2019) indicated that women abused substances to manage their emotions. This relationship has been mostly supported by the self-medication hypothesis, which holds that people with an addiction problem seek to cope with emotional distress through substance use (Khantzian, 1997). Although the relationship between IPV and substance use has been established among women (Ahmadabadi et al., 2019; Golding, 1999), few studies have examined the specific relationship between IPV and PDA. In recent years, an increase in PDA among Spanish women who had suffered IPV has been observed (Ministerio de Igualdad, 2020). The most prevalent prescribed drugs were both anxiolytic and antidepressant drugs, with higher rates of use among IPV survivors than among the general population (Crespo et al., 2017). In other countries, studies found that almost half of participants were taking pain and/or psychotropic medications to cope with IPV impact (Wuest et al., 2007). On the other hand, victimization histories were more extensive among women who used sedative-hypnotics and opiates compared to women who did not (Kubiak et al., 2006). As IPV may be a predisposing factor for the development of PDA (Kubiak et al., 2006), the main goals of this review were to provide a summary of recent research on the relationship between IPV and PDA, identify gaps in knowledge and propose specific avenues for future research.