- Email: [email protected]
0284 SUBJECTIVE EXPERIENCE OF SUBSTANCE USE IN EARLY PSYCHOSIS
S102
Schizophrenia Research 86 (2006)
severity scores than people who did not (mean = 5.95, SD = 3.66 vs. mean = 2.50, SD = 1.76, respectively; p = 0.037), whilst no significant difference was found in scores between those who have used cannabis frequently for long periods and those who have not. The majority of this population used cannabis frequently over long periods of time, although heavy use is not associated with symptomatology. However, experiencing UEs is significantly associated with positive symptoms. This suggests that a more negative response to the effects of cannabis might be found in people more susceptible to development of psychotic symptoms. That a considerable proportion stopped using cannabis in response to UEs could reflect their insight into the detrimental effects of cannabis on their mental state. The follow-up of this group will ascertain whether the presence of UEs with cannabis use proves to be a predictor of future transition to psychosis. 0277 IMPACT OF LOCUS OF CONTROL ON CANNABIS ABSTINENCE M. Neumann *, S. Ruhrmann, F. Schultze-Lutter, J. Klosterk¨otter. Department of Psychiatry and Psychotherapy at the University of Cologne, Cologne, Germany Presenting author contact: [email protected] Introduction: In recent years, evidence of a direct link between cannabis use and increased risk of mental health problems has accumulated. Therefore, a 5-session group program for patients seeking help for mental problems with cannabis misuse or abuse has lately been established in an Early Recognition Centre. It is focused on increasing patients’motivation to at least reduce cannabis use, using psycho-education, techniques of motivational interviewing (MI) and the SORCC-model (Stimuli, Organismic variables, Reactions, Contingency and Consequences) as a conceptual framework. As clients’ personal characteristics, e.g. internal attribution, self-efficacy and self-esteem, are regarded as key elements that co-determine positive change, the purpose of the present study was to investigate the impact of the locus of control on the efficiency of the program. Method: Locus of control was assessed with the ‘Fragebogen zu Kompetenz- und Kontroll¨uberzeugungen’ (FKK) [questionnaire on competence and control believes] and cannabis use was assessed with the Composite International Diagnostic Interview, CIDI, in a sample of 14 outpatients participating in the group program. Results: First analysis revealed a significant correlation between abstinence and internality (r = 0.650; p = 0.05) and a significant correlation between abstinence and high self-efficacy (r = 0.641; p = 0.05). Comparing participants staying abstinent or at least reducing cannabis consumption to every other day or less (n = 10), with participants still consuming cannabis daily (n = 4), significantly greater expression of externality was found in the latter (MannWhitney test, p = 0.839). Conclusions: Associations between positive change, i.e. abstinence or significant reduction, and internal locus of control and high selfefficacy were shown. This highlights the importance to implement elements to increase internal attribution and self-efficacy into such psychoeducational programs in order to produce long-term behaviour change.
Abstracts 0284 SUBJECTIVE EXPERIENCE OF SUBSTANCE USE IN EARLY PSYCHOSIS H.J. Carr1 *, L. Howie2 , E. Macdonald3 , D. Albiston1 . 1 ORYGEN Youth Health, Parkville, Australia, 2 La Trobe University, Bundoora, Australia, 3 Centre for Mental Health Research, Australian National University, Canberra, Australia Presenting author contact: [email protected] Substance use is highly prevalent in early psychosis with the potential negative impact on the course of psychotic illness well documented. Literature examining early psychosis and comorbid substance use has predominately focused on the measurement of prevalence rates and identification of salient correlates and predictors of use. However a number of studies have demonstrated the importance of examining the subjective experience of substance use in schizophrenia and indicated its importance in the development of targeted interventions (Addington & Duchak, 1997). In particular it has been suggested that what an individual believes about their substance use may act as a strong determinant of their future substance use behaviour, such as encouraging continued use or prompting abstinence (Laudet, Magura, Vogel & Knight, 2004). This phenomenological study explored the subjective experience of substance use on the lives of young people with early psychosis. Qualitative data were generated through in depth interviews and analysed using the phenomenological method to construct a description of the participants’ collective experience. The findings revealed a pattern of transition from social recreational substance use to regular and habitual use characterised by fluctuations in mood, increasing difficulty with occupational functioning, sedentary activity, changes in social networks and family conflict. Whilst substance use allowed participants to experience new thoughts, feelings and behaviours that changed their self-perception the experience also resulted in a struggle to redefine their identity. Participants continued substance use despite an awareness of its negative consequences, suggesting that motivational enhancement and educational strategies alone may not be sufficient to facilitate cessation of substance use. This research identified possible targets for primary prevention and highlighted the need for close monitoring of depressive symptoms and risk assessment. The findings also provide preliminary evidence to support to the provision of coping skills training and psychosocial interventions that facilitate adaptation, integration and recovery. 0417 PRELIMINARY PROFILES OF INDIVIDUALS WITH A FIRST EPISODE OF METHAMPHETAMINE PSYCHOSIS T. Buchanan1 *, T. Lecomte1 , K. Meuser3 , A. Thornton2 , D. Lang1 , G.W. MacEwan1 , W.G. Honer1 , R. Williams1 , A. Ringrose1 , E. Durgan1 , K. Schultz1 . 1 University of British Columbia, Vancouver, B.C., Canada, 2 Simon Fraser University, Burnaby, B.C., Canada, 3 Dartmouth Medical College, Hanover, NH, United States Presenting author contact: [email protected] Introduction: Methamphetamine psychosis (MAP) is a problem of epidemic proportions in Western North America, with many young people suffering from the co-occurring disorder. Since widespread MA use and one of its most devastating side-effects – acute psychosis – is a fairly recent phenomenon, little is known regarding the profiles of individuals with this co-occurring disorder. These preliminary results are part of a larger longitudinal study of individuals with MA psychosis and is a first step to identifying profiles of these individuals.
Schizophrenia Research 86 (2006)
severity scores than people who did not (mean = 5.95, SD = 3.66 vs. mean = 2.50, SD = 1.76, respectively; p = 0.037), whilst no significant difference was found in scores between those who have used cannabis frequently for long periods and those who have not. The majority of this population used cannabis frequently over long periods of time, although heavy use is not associated with symptomatology. However, experiencing UEs is significantly associated with positive symptoms. This suggests that a more negative response to the effects of cannabis might be found in people more susceptible to development of psychotic symptoms. That a considerable proportion stopped using cannabis in response to UEs could reflect their insight into the detrimental effects of cannabis on their mental state. The follow-up of this group will ascertain whether the presence of UEs with cannabis use proves to be a predictor of future transition to psychosis. 0277 IMPACT OF LOCUS OF CONTROL ON CANNABIS ABSTINENCE M. Neumann *, S. Ruhrmann, F. Schultze-Lutter, J. Klosterk¨otter. Department of Psychiatry and Psychotherapy at the University of Cologne, Cologne, Germany Presenting author contact: [email protected] Introduction: In recent years, evidence of a direct link between cannabis use and increased risk of mental health problems has accumulated. Therefore, a 5-session group program for patients seeking help for mental problems with cannabis misuse or abuse has lately been established in an Early Recognition Centre. It is focused on increasing patients’motivation to at least reduce cannabis use, using psycho-education, techniques of motivational interviewing (MI) and the SORCC-model (Stimuli, Organismic variables, Reactions, Contingency and Consequences) as a conceptual framework. As clients’ personal characteristics, e.g. internal attribution, self-efficacy and self-esteem, are regarded as key elements that co-determine positive change, the purpose of the present study was to investigate the impact of the locus of control on the efficiency of the program. Method: Locus of control was assessed with the ‘Fragebogen zu Kompetenz- und Kontroll¨uberzeugungen’ (FKK) [questionnaire on competence and control believes] and cannabis use was assessed with the Composite International Diagnostic Interview, CIDI, in a sample of 14 outpatients participating in the group program. Results: First analysis revealed a significant correlation between abstinence and internality (r = 0.650; p = 0.05) and a significant correlation between abstinence and high self-efficacy (r = 0.641; p = 0.05). Comparing participants staying abstinent or at least reducing cannabis consumption to every other day or less (n = 10), with participants still consuming cannabis daily (n = 4), significantly greater expression of externality was found in the latter (MannWhitney test, p = 0.839). Conclusions: Associations between positive change, i.e. abstinence or significant reduction, and internal locus of control and high selfefficacy were shown. This highlights the importance to implement elements to increase internal attribution and self-efficacy into such psychoeducational programs in order to produce long-term behaviour change.
Abstracts 0284 SUBJECTIVE EXPERIENCE OF SUBSTANCE USE IN EARLY PSYCHOSIS H.J. Carr1 *, L. Howie2 , E. Macdonald3 , D. Albiston1 . 1 ORYGEN Youth Health, Parkville, Australia, 2 La Trobe University, Bundoora, Australia, 3 Centre for Mental Health Research, Australian National University, Canberra, Australia Presenting author contact: [email protected] Substance use is highly prevalent in early psychosis with the potential negative impact on the course of psychotic illness well documented. Literature examining early psychosis and comorbid substance use has predominately focused on the measurement of prevalence rates and identification of salient correlates and predictors of use. However a number of studies have demonstrated the importance of examining the subjective experience of substance use in schizophrenia and indicated its importance in the development of targeted interventions (Addington & Duchak, 1997). In particular it has been suggested that what an individual believes about their substance use may act as a strong determinant of their future substance use behaviour, such as encouraging continued use or prompting abstinence (Laudet, Magura, Vogel & Knight, 2004). This phenomenological study explored the subjective experience of substance use on the lives of young people with early psychosis. Qualitative data were generated through in depth interviews and analysed using the phenomenological method to construct a description of the participants’ collective experience. The findings revealed a pattern of transition from social recreational substance use to regular and habitual use characterised by fluctuations in mood, increasing difficulty with occupational functioning, sedentary activity, changes in social networks and family conflict. Whilst substance use allowed participants to experience new thoughts, feelings and behaviours that changed their self-perception the experience also resulted in a struggle to redefine their identity. Participants continued substance use despite an awareness of its negative consequences, suggesting that motivational enhancement and educational strategies alone may not be sufficient to facilitate cessation of substance use. This research identified possible targets for primary prevention and highlighted the need for close monitoring of depressive symptoms and risk assessment. The findings also provide preliminary evidence to support to the provision of coping skills training and psychosocial interventions that facilitate adaptation, integration and recovery. 0417 PRELIMINARY PROFILES OF INDIVIDUALS WITH A FIRST EPISODE OF METHAMPHETAMINE PSYCHOSIS T. Buchanan1 *, T. Lecomte1 , K. Meuser3 , A. Thornton2 , D. Lang1 , G.W. MacEwan1 , W.G. Honer1 , R. Williams1 , A. Ringrose1 , E. Durgan1 , K. Schultz1 . 1 University of British Columbia, Vancouver, B.C., Canada, 2 Simon Fraser University, Burnaby, B.C., Canada, 3 Dartmouth Medical College, Hanover, NH, United States Presenting author contact: [email protected] Introduction: Methamphetamine psychosis (MAP) is a problem of epidemic proportions in Western North America, with many young people suffering from the co-occurring disorder. Since widespread MA use and one of its most devastating side-effects – acute psychosis – is a fairly recent phenomenon, little is known regarding the profiles of individuals with this co-occurring disorder. These preliminary results are part of a larger longitudinal study of individuals with MA psychosis and is a first step to identifying profiles of these individuals.