Objective Physical pain is considered a potential predictor of relapse in alcohol dependent individuals after treatment. The aim of this study was to evaluate whether reductions in pain level during the follow-up period after treatment were associated with lower relapse risk. Method A sample of 366 participants were recruited from alcohol treatment centers in Warsaw, Poland. At baseline information was obtained about pain level, demographics, childhood abuse, impulsivity, depressive symptoms, severity of alcohol and sleep problems. After finishing the alcohol treatment program patients were followed for 12 months and alcohol drinking (relapse) as well as pain severity were evaluated. Results In the followed group, 29.5% of patients confirmed that they drank any alcohol during last four weeks. Comparing follow-up to baseline pain 48.6% of subjects reported an increased severity of pain, 28.8% - the same level of pain, 22.6% - decreased level of pain. There was a significant association between the decrease in level of pain and the lower risk of relapse. Other factors associated with relapse during four weeks prior to the follow up were: baseline severity of depressive symptoms, low baseline social support and number of drinking days during 4 weeks prior to entering treatment. In multivariate analysis a decrease in pain level was associated with a lower likelihood of relapse (OR=0.159; 95%CI:0.04–0.62; p=0.008) even when controlled for other factors associated with relapse. Conclusions Decreases in pain level following treatment for alcohol dependence are associated with, and may contribute to, a lower risk of alcohol relapse.

No abstract

ABSTRACT. Objective: Chronic pain and problematic alcohol use commonly co-exist, as the use of alcohol is commonly considered a useful pain self-management strategy. The purpose of this study was to characterize pain and pain-related problems in a group of primary alcohol-dependent individuals entering treatment facilities. Method: A sample of 366 (73.5% men and 26.5% women) alcohol-dependent (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria) subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, social functioning, sexual and physical abuse during childhood, and severity of alcohol and sleep problems as well as level of impulsivity and general psychopathology. The study group was divided into a "mild or no pain" group and a "moderate or greater pain" group. Results: Among the study group, 34.4% of individuals reported moderate or greater physical pain during the last 4 weeks. The statistical analysis revealed that the experience of physical pain was significantly associated with lower level of education, unemployment, experience of sexual abuse before 18 years of age, and severity of alcohol dependence as well as other potential predictors of relapse (impulsivity, sleep problems, general psychopathology). When entered into logistic regression analysis with other dependent variables, the level of general psychopathology, severity of sleep problems, age, and education were all significantly associated with pain severity. Conclusions: Physical pain is a prevalent and potentially impairing experience in adults seeking treatment for alcohol dependence.

IntroductionThe sexual self-schema is a part of a broader concept of the self that is believed to be crucial for intrapersonal and interpersonal sexual relationships.AimTo develop and perform psychometric validation of the Polish version of the Sexual Self-Schema Scale for Women (SSSS-W-PL).Methods561 women 18 to 55 years old were included in the final analysis. Linguistic validation was performed in 4 steps in line with the MAPI Institute guidelines. Convergent validity was calculated using the Pearson r product-moment coefficient between different measures of sexuality (attitudes and experience, behavior, arousal, romantic relationship) and SSSS-W-PL total and factor scores. To test discriminant validity, we applied hierarchical regression analyses predicting the number of lifetime sexual partners, self-rating as a sexual person (1 item, “I feel sexually attractive”; on a 5-point Likert scale), and arousability, with independent variables being extraversion (Ten-Item Personality Inventory), self-esteem (Rosenberg Self-Esteem Scale), and the SSSS-W-PL (total and factor scores).Main Outcomes MeasuresSexual self-schema was measured by the SSSS-W-PL, whereas arousability was measured by the arousal/excitement scale of the Changes in Sexual Functioning Questionnaire.ResultsThe mean age of the study population was 29.0 ± 7.6 years. The final scale consisted of 24 adjectives grouped within 4 factors: romantic, passionate, direct, and embarrassed. The 4-factor model accounted for 39% of the variance. The Cronbach α was 0.74 for the SSSS-W-PL total score and 0.61 to 0.84 for individual factors. Test-retest reliability of the scale after 2- to 8-week intervals was 0.87 (95% CI = 0.82–0.86, P < .001). The increment variances were statistically significant and ranged from 3.8% to 11.6%.ConclusionThe analysis showed good psychometric properties and internal validity of the SSSS-W-PL. The SSSS-W-PL might be helpful in consulting and/or providing sexual therapy to gynecologic cancer survivors or women with a history of childhood sexual abuse.Nowosielski K, Jankowski KS, Kowalczyk R, et al. Sexual Self-Schema Scale for Women—Validation and Psychometric Properties of the Polish Version. Sex Med 2018;6:131–142.

After accounting for potentially confounding variables (demographics, severity of depression, anxiety symptoms) in MANCOVA models, patients with AUD presented deficits in identification and description of their own emotional states, as well as lower emotion regulation skills when compared to HCs. No between-group differences were observed in self-reported recognition of other people's emotions, social skills, and a behavioral measure of mental states recognition. Specific rather than general emotion-processing deficits in participants with AUD were identified, suggesting problems with processing of intrapersonal emotional signals.

The serotonin system is hypothesized to contribute to predisposition and course of alcohol dependence. However, the potential association between the T102C polymorphism (rs6313) in the type 2A serotonin receptor (HTR2A) gene and treatment outcomes in alcohol dependence has not been investigated. The aim of the study was to assess the contribution of this genetic polymorphism as a predictor of relapse in relation to other previously identified predictors. A sample of 254 alcohol dependent subjects, were recruited in alcohol treatment centers in Warsaw, Poland and prospectively assessed at baseline and follow-up after 12 months. At baseline, information about demographics, psychopathological symptoms and alcohol problems was obtained. The stop-signal task was performed and blood samples for genetic analysis of HTR2A T102C (rs6313) were collected. Relapse was defined as any drinking during the follow-up period. The statistical analysis showed that the CC genotype was significantly associated with increased relapse. Other significant factors were baseline depressive symptoms, number of drinking days during the 3 months prior to the baseline assessment, severity of alcohol-related problems, and a lifetime history of impulsive suicide attempts. Logistic regression analysis with and without the genetic factor revealed that adding the genetic factor increased the R square value by about 4%, with the CC genotype in the T102C polymorphism being the strongest predictor of relapse (OR=2.32). The significant influence on relapse of the CC genotype, which is associated with fewer 5-HT2A receptors in the central nervous system, suggests the possibility that this genetic polymorphism could influence response to serotonergic medications.

Although these results are limited by the small sample and are exploratory, they highlight a novel approach to sample selection in a population that is difficult to access and study. Future research should include larger samples and other relevant polymorphisms to advance this field of study.

Despite the fact that the group of sexual offenders remains a population which is still difficult to study, the results of current research are considered novel and interesting. Surprisingly, the very old descriptions applying to paraphilia, which is considered to be one of the reasons of sexual offences, appear to be accurate, especially in the context of similarities between impulsivity and pathologic sexual behaviors. Notably, the nomenclature concerning impulsivity enables a specific and reasonable description of behaviors associated with sexual offences. Moreover, the results of research studies show that it is the lack of inhibition, not pathologic arousal, which is the most important factor in the pathogenesis of forbidden sexual behaviors. In addition, it has been shown that behavioral manifestations of impulsivity (substance abuse, suicide attempts) appear commonly in sexual offenders. Mutual relationships between alcohol drinking, suicide attempts, history of child sexual abuse and sexual offences, both in symptomatologic and etiologic aspect, raise a suggestion that all these phenomena may share a common background of poor inhibitory control.