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  • 1.
    Schückher, Fides
    Örebro University, School of Medical Sciences.
    Alcohol use disorder in socially stable women receiving outpatient treatment: Individual characteristics of importance for onset age and treatment outcome2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Socially stable women with alcohol use disorder (AUD) are seldom studied separately and are often marginalized in treatment of substance abuse. The overall aim of this thesis was to examine variables of importance in relation to age at onset of AUD and treatment outcome.

    Study I, which included 338 men and women being treated for AUD, showed that women had a significantly later onset and shorter duration in excessive alcohol use as well as less weekly pure alcohol intake than men. Participants with earlier onset of excessive alcohol use reported significantly more psychiatric symptoms and more immature personality traits than those with later onset. 

    Study II-IV included 75 women with AUD receiving outpatient treatment. Of the participants, 68% reported a history of childhood maltreatment. Emotional abuse and their mother’s alcohol and/or substance problems were independent predictors of earlier age at onset of AUD. In Study III treatment outcome was measured as a change in alcohol consumption. A more positive change, especially with regard to abstinence, was found in women who did not report childhood abuse. Study IV showed that, at 12month follow up, most of the participants had reached their end-oftreatment goal either abstinence or low-risk drinking. However, those with a goal of abstinence at the end of treatment showed significantly less risk drinking than those with low-risk drinking as a goal. The most important predictor of abstinence at the 12-month follow up was having abstinence as an end –of –treatment goal. 

    These results indicate the importance of identifying and addressing childhood trauma in treating socially stable women with AUD. Focusing on motivational changes during treatment may also be of importance, especially in patients with relapses, as abstinence still is the most stable treatment option.

    List of papers
    1. The Importance of Age at Onset of Excessive Alcohol Use with Regard to Psychiatric Symptoms and Personality Characteristics
    Open this publication in new window or tab >>The Importance of Age at Onset of Excessive Alcohol Use with Regard to Psychiatric Symptoms and Personality Characteristics
    Show others...
    2017 (English)In: Alcoholism Treatment Quarterly, ISSN 0734-7324, E-ISSN 1544-4538, Vol. 35, no 4, p. 328-343Article in journal (Refereed) Published
    Abstract [en]

    Psychiatric symptoms and personality characteristics were studied in men (n=252) and women (n=86) as they commenced treatment for excessive alcohol use. The Addiction Severity Index, Symptom Check List, and Temperament and Character Inventory were used. ANOVA with early/late onset and gender as covariates showed significantly lower scores for psychiatric symptoms and more mature personality characteristics in the late-onset group compared to early onset. Men described more depression and anxiety, and women higher persistence. Results indicate the importance of considering age at onset of excessive alcohol use when patients enter treatment because different treatment approaches may be required.

    Place, publisher, year, edition, pages
    Taylor & Francis Group, 2017
    Keywords
    alcohol onset, gender, personality, psychiatric symptoms
    National Category
    Substance Abuse
    Identifiers
    urn:nbn:se:oru:diva-61355 (URN)10.1080/07347324.2017.1350540 (DOI)000411473600003 ()2-s2.0-85026532744 (Scopus ID)
    Note

    Funding Agency:

    University Health Care Research Center, Region Örebro County, Sweden 

    Available from: 2017-10-09 Created: 2017-10-09 Last updated: 2020-12-01Bibliographically approved
    2. The Impact of Childhood Maltreatment on Age of Onset of Alcohol Use Disorder in Women
    Open this publication in new window or tab >>The Impact of Childhood Maltreatment on Age of Onset of Alcohol Use Disorder in Women
    2018 (English)In: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 24, no 6, p. 278-285Article in journal (Refereed) Published
    Abstract [en]

    It is unclear whether exposure to childhood maltreatment is associated with the age of onset of alcohol use disorder (AUD). A group of socially stable women with AUD seeking treatment (n = 75) were interviewed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview. They also filled out the Childhood Trauma Questionnaire-short form. Emotional abuse, sexual abuse and multiple childhood traumas were found to be associated with earlier onset of AUD. Multivariable linear regression analysis showed that independent predictors for an earlier onset of AUD were exposure to emotional abuse (beta = -7.44, SE = 2.83, adjusted p = 0.010) and mother's alcohol/substance problems (beta = -7.87, SE = 3.45, adjusted p = 0.026). These variables explained 18.9% of the variance of age of onset of AUD. These findings highlight a need for increased clinical attention to AUD subgroups who have experienced childhood maltreatment, especially emotional abuse, as well as a need for including support in the patient's own parental role in the treatment.

    Place, publisher, year, edition, pages
    S. Karger, 2018
    Keywords
    Age of onset, Alcohol use disorder, Childhood maltreatment, Mother’s alcohol/substance problems
    National Category
    Psychiatry
    Research subject
    Psychiatry
    Identifiers
    urn:nbn:se:oru:diva-72004 (URN)10.1159/000494766 (DOI)000456650200002 ()30448841 (PubMedID)2-s2.0-85057010272 (Scopus ID)
    Note

    Funding Agency:

    University Health Care Research Center, Region Örebro County, Sweden

    Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2021-11-22Bibliographically approved
    3. History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
    Open this publication in new window or tab >>History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
    2019 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 19, no 1, article id 159Article in journal (Refereed) Published
    Abstract [en]

    Background: To examine the relationship between treatment outcome, as measured according to change in alcohol consumption, and a history of childhood abuse (emotional, physical, sexual) in socially stable women undergoing treatment for alcohol use disorder (AUD).

    Methods: Participants were assessed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview at the beginning of treatment (n = 75), end of treatment (n = 59) and 12 month follow-up after treatment (n = 57). Self-report data on alcohol consumption were obtained at all three time-points using the Alcohol Habits Inventory-Revised 2. Self-report data on childhood maltreatment were obtained at the beginning of treatment using the Childhood Trauma Questionnaire-short form. Study outcomes were changes in alcohol consumption (grams of pure alcohol per week), risk-drinking and reported abstinence.

    Results: Of the 75 women enrolled, 38 (50.7%) reported a history of childhood abuse and the rest did not. Both groups showed a significant improvement in all three outcomes at the end of treatment and at 12-month follow-up. At the end of treatment, a significant inter-group difference was found for reported abstinence (non-abused group, 39.3% vs abused, 12.9%; p < 0.05). At 12-month follow-up, significant inter-group differences were observed for all treatment outcomes, with superior outcomes being found for the non-abused group, including a higher proportion of women with reported abstinence (55.6% vs 13.3%; p < 0.01).

    Conclusion: The present findings suggest that an evaluation of a possible history of childhood abuse is warranted in all women seeking treatment for AUD, irrespective of social stability. In terms of clinical practice, the results suggest that additional interventions may be warranted in this population.

    Place, publisher, year, edition, pages
    BMC, 2019
    Keywords
    Adult women, Alcohol use disorder, Childhood abuse, Treatment outcome
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:oru:diva-79099 (URN)10.1186/s12905-019-0857-4 (DOI)000502718200002 ()31830964 (PubMedID)2-s2.0-85076488310 (Scopus ID)
    Note

    Funding Agency:

    University Health Care Research Center, Region Örebro County, Sweden

    Available from: 2020-01-15 Created: 2020-01-15 Last updated: 2023-08-28Bibliographically approved
    4. Predictors for abstinence at 12-month follow up in socially stable women seeking treatment for alcohol use disorder
    Open this publication in new window or tab >>Predictors for abstinence at 12-month follow up in socially stable women seeking treatment for alcohol use disorder
    (English)Manuscript (preprint) (Other academic)
    National Category
    General Practice
    Identifiers
    urn:nbn:se:oru:diva-86674 (URN)
    Available from: 2020-10-20 Created: 2020-10-20 Last updated: 2020-12-01Bibliographically approved
    Download full text (pdf)
    Alcohol use disorder in socially stable women receiving outpatient treatment: Individual characteristics of importance for onset age and treatment outcome
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  • 2.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences.
    Berglund, Kristina
    University of Gothenburg, Department of Psychology, Gothenburg, Sweden .
    Engström, Ingemar
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Sellin, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Predictors for abstinence at 12-month follow up in socially stable women seeking treatment for alcohol use disorderManuscript (preprint) (Other academic)
  • 3.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Berglund, Kristina
    Psychology, Göteborgs universitet, Göteborg, Sweden.
    Engström, Ingemar
    Örebro University, School of Medical Sciences.
    Sellin, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Predictors for Abstinence in Socially Stable Women Receiving Treatment for Alcohol Use Disorder2022In: Alcoholism Treatment Quarterly, ISSN 0734-7324, E-ISSN 1544-4538, Vol. 40, no 2, p. 244-257Article in journal (Refereed)
    Abstract [en]

    There is a knowledge gap about predictors of treatment outcomes in alcohol use disorder (AUD) in socially stable women. This study examined factors that may predict abstinence 12 months after the end of treatment for AUD in socially stable women. Fifty-seven women with AUD participated in 12-month follow-up. Information about sociodemographic, alcohol-related, psychiatric symptoms, psychological functioning, and participants' treatment goals and ability to change alcohol habits were gathered from structured interviews and self-report instruments. Predictors for abstinence at the 12-month follow up were calculated by univariable and multivariable logistic regression models. Significant predictors for abstinence were having no history of childhood abuse (OR: 8.13; 95%CI: 2.22-29.75; p < .01) and a goal of abstinence at the end of treatment (OR: 15.17; 95%CI: 3.45-66.69; p < .001). Most participants (>60%) achieved their goals of abstinence or low-risk drinking. The results highlight the significance of identifying patients with experiences of childhood abuse, since such experiences may adversely affect the outcome of AUD treatment. Our findings also emphasize the importance of patients' own goals of abstinence, since it resulted in the most stable outcome. Treatment could, therefore, also focus on motivating individuals to aim for abstinence.

  • 4.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences.
    Björk, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Berglund, Kristina
    University of Gothenburg, Göteborg, Sweden.
    Berggren, UB
    University of Gothenburg, Göteborg, Sweden.
    Balldin, JB
    University of Gothenburg, Göteborg, Sweden.
    Engström, Ingemar
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Fahlke, CF
    University of Gothenburg, Göteborg, Sweden.
    Individuals with onset of excessive drinking in late adulthood: Do they differ from the early onset group in psychiatric symptoms and personality characteristics?2016Conference paper (Refereed)
  • 5.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences.
    Björk, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Berglund, Kristina
    University of Gothenburg.
    Berggren, Ulf
    University of Gothenburg.
    Balldin, Jan
    University of Gothenburg.
    Engström, Ingemar
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Fahlke, Claudia
    University of Gothenburg.
    Differences in psychiatric symptoms and personality characteristics appear to be more pronounced between early and late onset of excessive drinking than between genders2016Conference paper (Refereed)
  • 6.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    Sellin Jönsson, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
    Engström, Ingemar
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    Berglund, Kristina
    Department of Psychology,University of Gothenburg, Göteborg, Sweden.
    History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder2019In: BMC Women's Health, E-ISSN 1472-6874, Vol. 19, no 1, article id 159Article in journal (Refereed)
    Abstract [en]

    Background: To examine the relationship between treatment outcome, as measured according to change in alcohol consumption, and a history of childhood abuse (emotional, physical, sexual) in socially stable women undergoing treatment for alcohol use disorder (AUD).

    Methods: Participants were assessed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview at the beginning of treatment (n = 75), end of treatment (n = 59) and 12 month follow-up after treatment (n = 57). Self-report data on alcohol consumption were obtained at all three time-points using the Alcohol Habits Inventory-Revised 2. Self-report data on childhood maltreatment were obtained at the beginning of treatment using the Childhood Trauma Questionnaire-short form. Study outcomes were changes in alcohol consumption (grams of pure alcohol per week), risk-drinking and reported abstinence.

    Results: Of the 75 women enrolled, 38 (50.7%) reported a history of childhood abuse and the rest did not. Both groups showed a significant improvement in all three outcomes at the end of treatment and at 12-month follow-up. At the end of treatment, a significant inter-group difference was found for reported abstinence (non-abused group, 39.3% vs abused, 12.9%; p < 0.05). At 12-month follow-up, significant inter-group differences were observed for all treatment outcomes, with superior outcomes being found for the non-abused group, including a higher proportion of women with reported abstinence (55.6% vs 13.3%; p < 0.01).

    Conclusion: The present findings suggest that an evaluation of a possible history of childhood abuse is warranted in all women seeking treatment for AUD, irrespective of social stability. In terms of clinical practice, the results suggest that additional interventions may be warranted in this population.

  • 7.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Sellin, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Berglund, Kristina
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Berggren, Ulf
    Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.
    Balldin, Jan
    Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
    Engström, Ingemar
    Örebro University, School of Medical Sciences.
    Fahlke, Claudia
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    The Importance of Age at Onset of Excessive Alcohol Use with Regard to Psychiatric Symptoms and Personality Characteristics2017In: Alcoholism Treatment Quarterly, ISSN 0734-7324, E-ISSN 1544-4538, Vol. 35, no 4, p. 328-343Article in journal (Refereed)
    Abstract [en]

    Psychiatric symptoms and personality characteristics were studied in men (n=252) and women (n=86) as they commenced treatment for excessive alcohol use. The Addiction Severity Index, Symptom Check List, and Temperament and Character Inventory were used. ANOVA with early/late onset and gender as covariates showed significantly lower scores for psychiatric symptoms and more mature personality characteristics in the late-onset group compared to early onset. Men described more depression and anxiety, and women higher persistence. Results indicate the importance of considering age at onset of excessive alcohol use when patients enter treatment because different treatment approaches may be required.

  • 8.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    Sellin, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
    Fahlke, Claudia
    Department of Psychology, University of Gothenburg, Göteborg, Sweden.
    Engström, Ingemar
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    The Impact of Childhood Maltreatment on Age of Onset of Alcohol Use Disorder in Women2018In: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 24, no 6, p. 278-285Article in journal (Refereed)
    Abstract [en]

    It is unclear whether exposure to childhood maltreatment is associated with the age of onset of alcohol use disorder (AUD). A group of socially stable women with AUD seeking treatment (n = 75) were interviewed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview. They also filled out the Childhood Trauma Questionnaire-short form. Emotional abuse, sexual abuse and multiple childhood traumas were found to be associated with earlier onset of AUD. Multivariable linear regression analysis showed that independent predictors for an earlier onset of AUD were exposure to emotional abuse (beta = -7.44, SE = 2.83, adjusted p = 0.010) and mother's alcohol/substance problems (beta = -7.87, SE = 3.45, adjusted p = 0.026). These variables explained 18.9% of the variance of age of onset of AUD. These findings highlight a need for increased clinical attention to AUD subgroups who have experienced childhood maltreatment, especially emotional abuse, as well as a need for including support in the patient's own parental role in the treatment.

  • 9.
    Schückher, Fides
    et al.
    Örebro University, School of Medical Sciences.
    Sellin, Tabita
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Fahlke, Claudia
    Engström, Ingemar
    Örebro University, School of Medical Sciences.
    The Impact of Childhood Maltreatment on Onset Age of Alcohol Use Disorder in Women Seeking Treatment2018Conference paper (Refereed)
  • 10.
    Schückher, FS
    et al.
    Örebro University, School of Medical Sciences.
    Sellin, TS
    Örebro University Hospital. Örebro University, School of Medical Sciences.
    Engström, IE
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Berglund, KB
    Department of Psychology, University of Gothenburg, Göteborg, Sweden.
    History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder2020Conference paper (Refereed)
1 - 10 of 10
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