Since 1997, the use of methamphetamine as a drug of abuse has been widespread in the United States. While several forms of amphetamine are useful in some areas of medicine, methamphetamine as an abused substance is associated with severe and multifaceted consequences. Problems associated with the abuse of amphetamine and its derivatives such as methamphetamine have been well documented. As the manufacture and use of methamphetamine across the United States has increased, the impact of methamphetamine abuse has been felt beyond individual users; families as well as communities can be seriously affected. An increase in child neglect and violence as well as a lack of resources for health care, social services, and law enforcement because of methamphetamine abuse have been reported by many communities. This study examines the historical spread of methamphetamine misuse in the United States and the resulting individual, social, and environmental consequences. A public health perspective on family, community, and social aspects is offered, and ideas for future research and policy changes are explored.
Aims: This exploratory study is the first to examine previously identified variables of increased vulnerability to victimization, the prevalence of aggression in a cohort of patients with first-episode psychosis and the potential impact of impairments in facial affect recognition (FAR) on victimization.Methods: Sixty-nine male participants completed assessments of IQ, substance use, psychopathy, childhood trauma, aggressive behaviour and psychopathology. Participants were asked about violent victimization in the past year and charges for violent offences. FAR was assessed using the Animated Full Facial Comprehension Test.Results: The victimized group (n = 25) had significantly higher psychopathy traits (P = .042) and lower recognition of sadness (P < .01) compared to the non-victimized group (n = 44). Participants who reported charges for violent offences (n = 15) had significantly higher scores on measures of physical abuse in childhood (P < .01), substance use (P < .05 for cannabis, P < .001 for cocaine and amphetamine use), psychopathy traits (P < .01), psychopathology (P = .031) and lifetime aggressive behaviour (P < .01). The logistic regression models using FAR sadness and Psychopathic Personality Inventory-Revised (PPI-R) total score as predictors for victimization (χ 2 [2] = 13.81, P = .001; Nagelkerke R 2 = .30) and using physical abuse in childhood, PPI-R total score, and psychopathology as predictors for violent offences (χ 2 [3] = 14.89, P = .002; Nagelkerke R 2 = .36) were significant.
Conclusions: These findings highlight the value of considering victimization in psychotic illness from a social information processing perspective in addition to known clinical and lifestyle factors. Based on these results, future studies could explore the use of affect recognition training early in the course of the illness as a possible intervention to reduce victimization. K E Y W O R D S aggression, facial affect recognition, first-episode psychosis, psychopathy, victimization, violence
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