Post-bariatric surgery patients are overrepresented in substance abuse treatment, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The severity of the substance use disorder (SUD; i.e., warranting inpatient treatment) and related consequences necessitate a better understanding of the variables associated with post-RYGB SUDs. This investigation assessed factors associated with post-RYGB substance misuse. Post-RYGB patients (N = 141; at least 24 months postsurgery) completed an online survey assessing variables hypothesized to contribute to post-RYGB SUDs. Fourteen percent of participants met criteria for postoperative substance misuse. Those with a lower percent total weight loss (%TWL) were more likely to endorse substance misuse. Family history of substance misuse was strongly associated with postoperative substance misuse. Eating-related variables including presurgical food addiction and postsurgical nocturnal eating, subjective hunger, and environmental responsiveness to food cues were also associated with a probable postoperative SUD. These findings have clinical utility in that family history of substance misuse can be easily assessed, and at-risk patients can be advised accordingly. In addition, those who endorse post-RYGB substance misuse appear to have stronger cognitive and behavioral responses to food, providing some support for the theory of behavioral substitution (or "addiction transfer").

Training in the Fairy Tale model of trauma-informed treatment was provided to clinical and direct care staff working with 53 youth in a residential treatment facility. Compared to the year prior to training, in the year of the training the average improvement in presenting problems was increased by 34%, time to discharge was reduced by 39%, and rate of discharge to lower level of care was doubled. The inclusion of numerous interventions, along with limitations in implementation and evaluation, make it difficult to precisely identify the cause(s) of the improvement.Numerous treatment approaches have been tried with youth so severely troubled that they have been placed in residential treatment. These approaches generally involve at least several of the following: providing a safe, stable environment; mobilizing peer influence; arranging reinforcers This project was supported by grants from the OSHEI Foundation and the Fierle Family Foundation.

No abstract

Research is warranted to develop more culturally sensitive interventions to target those ethnic minorities at elevated risk. Further study of binge eating among Arab-Americans is particularly important, as the prevalence of this condition was higher among this group over any other.

Traumatic incident reduction (TIR) is a trauma resolution method that appears to be well tolerated and has yielded relatively rapid benefit in two adult treatment studies. This article reports on two open trials using TIR with 33 urban at-risk youth and 31 unaccompanied refugee minors. In both studies, participants consistently responded positively. In the second study, nearly all participants who began treatment with posttraumatic stress disorder ended without it, with an average of at least one significant trauma memory being treated per session. TIR's apparent efficiency and effectiveness in these preliminary studies indicates its promise in child and adolescent treatment.