Two studies were conducted to investigate the use of cognitive/attentional distraction (via commercially available video games) to control conditioned nausea in pediatric cancer patients receiving chemotherapy. The first study compared the nausea severity in children who played video games during chemotherapy-related procedures with that of control-group children who did not play video games. The second study used a combined ABAB withdrawal and repeated measures analysis of variance design that incorporated baseline and intervention assessments within a single session. In both studies, video game-playing resulted in significantly less nausea. The introduction and withdrawal of the opportunity to play video games produced significant changes (reduction and exacerbation, respectively) in nausea. Although video games also reduced self-reported anxiety, the effects were weaker than those for nausea. Pulse rate and systolic/diastolic blood pressure were not consistently affected.Hypnosis and related relaxation induction procedures have been shown to relieve the distress associated with painful medical treatment (cf. Turk, Meichenbaum, & Genest, 1983). Although the mechanisms underlying the effectiveness of these techniques are not clearly understood, it has been suggested that cognitive/attentional distraction may be involved (McCaul & Malott, 1984). The hypothesis is that cognitive-behavioral techniques block pain by consuming some degree of the attentional capacity that would otherwise be devoted to pain perception.Our understanding of the use of distraction in behavioral symptom control comes largely from laboratory research in which healthy volunteers were required to engage in repetitive cognitive tasks (e.g., repeating a word list) while immersing an arm in ice water (Farthing, Venturino, & Brown, 1984;Spanos, McNeil, Gwynn, & Stam, 1984). Subjects in these studies generally reported less pain when they were involved in the distracting task.Clinical research on distraction has been more limited. Pickett and Clum (1982) found that cognitive distraction (therapist-guided imagery of pleasant scenes) resulted in reductions in patients' ratings of their worst pain since surgery. In two separate studies, ulig (1979a, 1979b) found that distraction via video game-playing relieved discomfort in adult dental patients during amalgam restoration. A recent individual-analysis case study involving 3 pediatric cancer patients (Kolko & Rickard-This research was funded by a grant to William H. Redd from the American Cancer Society and by gifts from the Society of Memorial Sloan-Kettering Cancer Center and the Rudin Foundation. The authors wish to thank Matthew Seegull for his consultation in designing the video game intervention and the patients for their cooperation.
This study examined the characteristics of gay men attending circuit parties and their drug use. In particular, the role of methylenediomethamphetamine (MDMA, "ecstasy") was considered in relation to other drug use and sexual behavior. A one-page survey was distributed to 173 men attending a circuit party. Respondents were generally gay men, Caucasian, employed, and well-educated. Twenty-five percent self-identified as HIV-positive. Eighty-six percent reported using at least one substance on the day of the party; polydrug use was frequent. The most common substances were MDMA, ketamine, and methamphetamine. MDMA use was highly associated with ketamine, methamphetamine, and cocaine use. MDMA use was also associated with significantly more receptive anal intercourse. Circuit parties are settings of increased drug use and associated high-risk sexual behavior. A better understanding of these issues is needed to develop interventions aimed at reducing drug use and sexual risk taking among gay men who attend circuit parties.
We tested the hypothesis that there is a mediational pathway from parental alcohol use during the participants' adolescence to the participants' psychological symptoms in young adulthood. This pathway includes the participants' alcohol use and their psychological symptoms, both during adolescence. The participants are inner city African American and Puerto Rican early adolescents followed until young adulthood. They reported their own and their parents' behavior. Structural equation modeling showed that parental alcohol use was related to early adolescent alcohol use, which was associated with late adolescent alcohol use. Late adolescent alcohol use was related to psychological symptoms in late adolescence, which predicted young adult psychological symptoms. Males reported more alcohol use and more psychological symptoms than females in late adolescence and more psychological symptoms in young adulthood. Findings suggest that parents' and adolescents' alcohol use should be a focus in interventions designed to prevent or treat psychological symptoms in late adolescence and young adulthood. KeywordsParent and adolescent alcohol use; adolescent and young adult psychological symptoms
This study compares the views on spirituality of dually diagnosed patients (diagnosed with both substance abuse and general psychiatric disorders) and medical students in order to investigate their respective orientations toward spirituality and their views of the importance of spirituality in the treatment of addiction. We administered a modified version of Feagin's "Orientation to Life and God Scale" to assess religious and spiritual orientation in both the patients and students. A second series of items was developed and administered in order to compare the patients' and students' perceptions of the relative importance of a religious and spiritual orientation in substance abuse treatment. A third series of items was also given to compare the nature of religious and health-related services on the inpatient unit that patients and students most wanted to see improved. We found that the medical students responsible for treating substance abuse are significantly less religiously and spirituality oriented than the patients they treat, and that the students do not indicate that spirituality is an important component in the care of these patients. It may be clinically relevant to train medical students in the potential importance of spirituality in addiction treatment so that they can incorporate spirituality into the treatment of addictions.
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