Amy Langbein | Deakin University (original) (raw)

Papers by Amy Langbein

9 Abstract 10 Introduction and Aims: Posttraumatic stress disorder (PTSD) is frequently linked wi... more 9 Abstract 10 Introduction and Aims: Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis 11 suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship 12 between substance abuse and PTSD symptom clusters in a methadone maintenance population. 13 Design and Methods: Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the 14 PTSD Checklist–Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. 15 Results: Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive 16 for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with 17 overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiaze...

Conclusion 31 Future research 34 References 35 The aim of this paper is to review evidence of gen... more Conclusion 31 Future research 34 References 35 The aim of this paper is to review evidence of genetic factors in the aetiology of Attention Deficit Hyperactivity Disorder (ADHD). The review examines our current understanding of ADHD, including behavioural criteria, development, and cognition. It is concluded that there are a number of limitations in our current understanding of ADHD, stemming from high levels of co-morbidity, qualitative differences among subtypes, variable research methodology and a heavy reliance on a top down approach to research. The research literature contains a large amount of variation in measurement associated with defining ADHD as a behavioural phenotype, hampering genetic research. It is concluded that there is strong evidence supporting a genetic component to ADHD. Family, twin and molecular studies suggest ADHD may be part of some continuum, with a number of disorders having common genetic vulnerability, and that many genes interacting with environmental variables may be involved. It is suggested that future research should be longitudinal and family based in order to link behavioural, cognitive and genetic characteristics of ADHD as they emerge across the lifespan, and thereby inform our understanding of ADHD on a number of levels. 10%-30% Continual display of core symptoms and development of serious psychopathology (eg alcohol abuse, Antisocial Personality Disorder). Adolescent Outcome Adolescence brings with it increased cognitive, academic, personal and social demands. Children with ADHD greet adolescence with pre-existing difficulties including learning gaps, poor social relationships and low self-esteem (Weiss & Hechtman, 1993). Research reveals an overall picture of children diagnosed with 8 ADHD going on to experience significant academic, social and conduct difficulties in high school (Weiss & Hechttnan, 1993), including significantly more grade retention, suspension and dropping out (Barkley, 1991). The core symptoms of inattention and impulsivity appear to abate with age, although scores on tests of both symptoms remain significantly poorer compared to scores of normal controls (Fischer, Barkley, Edelbrock & Smallish, 1990). Hyperactivity on the other hand appears to decline almost completely, with only residual restlessness apparent, such that "rebelliousness" rather than "overactivity" is the greater concern of people in the adolescent's life (Weiss & Hechtman, 1993). Evidence of continual symptoms of ADHD along with antisocial and drug abuse disorders presents the worst outcome for the adolescent (Manuzza, Klien, Bessler, Malloy & LaPadula, 1993). Adult Outcome The adult with ADHD is seen as disorganised, impatient, distractible, impulsive, easily bored, procrastinating, having poor concentration, difficulty following through, low frustration tolerance, mood swings, and low self-esteem (Cantwell, 1996; Hallowell & Ratey, 1997). Prospective studies have shown that while many children with ADHD outgrow the disorder, at least 11% (Marmit77n et al., 1993) and as many as 36% (Weiss, Hechtman, Milroy & Perlman, 1985) continue to experience at least one residual symptom of ADHD that significantly impairs their functioning. The discrepancy in these findings may be due to methodological differences, for example the study by Mannuzza et al., (1993) used parental reports while the study by Weiss et al., (1985) used self-reports. Weiss et al., (1985) found that adults with childhood ADHD had more symptoms of psychopathology, poorer social skills and lower self-esteem than 9 I

International Journal of Psychiatry in Clinical Practice, 2010

Abstract Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be ... more Abstract Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be common and screening may be warranted. The Mood Disorders Questionnaire (MDQ) is a screening tool for bipolar disorder that has been validated in other treatment settings. Its utility for patients with substance use disorders is assessed in this study. Methods. Clients of a methadone maintenance program were invited to complete the MDQ when they attended a public Drug and Alcohol Service for their regular scheduled appointments. Information about their history of substance use was also collected. Results. Eighty clients (43 females, 37 males) aged 35 ± 8.0 years (mean ± SD) participated in the study. Seventy-four clients completed the MDQ of which 36 (48.6%) obtained a positive screen. A check of client files suggested that only three of the 74 participants had a current working diagnosis of bipolar disorder. These three participants had screened positive on the MDQ. Conclusions. There was a high prevalence of manic symptoms reported by participants, suggesting that screening for bipolar disorder in this population may be warranted. However, there is a risk of false positives with the MDQ, as it does not clearly differentiate between symptoms of mania and drug intoxication.

Comprehensive Psychiatry, 2011

Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medicati... more Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population. Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms. In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.

International Journal of Mental Health Systems

Background COVID-19 required mental health services to quickly switch from face-to-face service d... more Background COVID-19 required mental health services to quickly switch from face-to-face service delivery to telehealth (telephone and videoconferencing). This evaluation explored implementation of a telehealth mental health response in a regional public mental health provider. Methods A mixed methods approach, combining service use data, brief satisfaction surveys, and qualitative interviews/focus groups was undertaken. Number and types of contacts from de-identified mental health service data were compared between April–May 2020 and April–May 2019. Mental health consumers and providers completed brief online satisfaction surveys after videoconferencing sessions. Attitudes and perspectives on the implementation of telehealth were further explored by applying a descriptive qualitative framework to the analysis of interview and focus group data supplied by consumers and providers. Template thematic analysis was used to elucidate key themes relating to the barriers and enablers of tele...

9 Abstract 10 Introduction and Aims: Posttraumatic stress disorder (PTSD) is frequently linked wi... more 9 Abstract 10 Introduction and Aims: Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis 11 suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship 12 between substance abuse and PTSD symptom clusters in a methadone maintenance population. 13 Design and Methods: Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the 14 PTSD Checklist–Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. 15 Results: Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive 16 for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with 17 overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiaze...

Conclusion 31 Future research 34 References 35 The aim of this paper is to review evidence of gen... more Conclusion 31 Future research 34 References 35 The aim of this paper is to review evidence of genetic factors in the aetiology of Attention Deficit Hyperactivity Disorder (ADHD). The review examines our current understanding of ADHD, including behavioural criteria, development, and cognition. It is concluded that there are a number of limitations in our current understanding of ADHD, stemming from high levels of co-morbidity, qualitative differences among subtypes, variable research methodology and a heavy reliance on a top down approach to research. The research literature contains a large amount of variation in measurement associated with defining ADHD as a behavioural phenotype, hampering genetic research. It is concluded that there is strong evidence supporting a genetic component to ADHD. Family, twin and molecular studies suggest ADHD may be part of some continuum, with a number of disorders having common genetic vulnerability, and that many genes interacting with environmental variables may be involved. It is suggested that future research should be longitudinal and family based in order to link behavioural, cognitive and genetic characteristics of ADHD as they emerge across the lifespan, and thereby inform our understanding of ADHD on a number of levels. 10%-30% Continual display of core symptoms and development of serious psychopathology (eg alcohol abuse, Antisocial Personality Disorder). Adolescent Outcome Adolescence brings with it increased cognitive, academic, personal and social demands. Children with ADHD greet adolescence with pre-existing difficulties including learning gaps, poor social relationships and low self-esteem (Weiss & Hechtman, 1993). Research reveals an overall picture of children diagnosed with 8 ADHD going on to experience significant academic, social and conduct difficulties in high school (Weiss & Hechttnan, 1993), including significantly more grade retention, suspension and dropping out (Barkley, 1991). The core symptoms of inattention and impulsivity appear to abate with age, although scores on tests of both symptoms remain significantly poorer compared to scores of normal controls (Fischer, Barkley, Edelbrock & Smallish, 1990). Hyperactivity on the other hand appears to decline almost completely, with only residual restlessness apparent, such that "rebelliousness" rather than "overactivity" is the greater concern of people in the adolescent's life (Weiss & Hechtman, 1993). Evidence of continual symptoms of ADHD along with antisocial and drug abuse disorders presents the worst outcome for the adolescent (Manuzza, Klien, Bessler, Malloy & LaPadula, 1993). Adult Outcome The adult with ADHD is seen as disorganised, impatient, distractible, impulsive, easily bored, procrastinating, having poor concentration, difficulty following through, low frustration tolerance, mood swings, and low self-esteem (Cantwell, 1996; Hallowell & Ratey, 1997). Prospective studies have shown that while many children with ADHD outgrow the disorder, at least 11% (Marmit77n et al., 1993) and as many as 36% (Weiss, Hechtman, Milroy & Perlman, 1985) continue to experience at least one residual symptom of ADHD that significantly impairs their functioning. The discrepancy in these findings may be due to methodological differences, for example the study by Mannuzza et al., (1993) used parental reports while the study by Weiss et al., (1985) used self-reports. Weiss et al., (1985) found that adults with childhood ADHD had more symptoms of psychopathology, poorer social skills and lower self-esteem than 9 I

International Journal of Psychiatry in Clinical Practice, 2010

Abstract Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be ... more Abstract Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be common and screening may be warranted. The Mood Disorders Questionnaire (MDQ) is a screening tool for bipolar disorder that has been validated in other treatment settings. Its utility for patients with substance use disorders is assessed in this study. Methods. Clients of a methadone maintenance program were invited to complete the MDQ when they attended a public Drug and Alcohol Service for their regular scheduled appointments. Information about their history of substance use was also collected. Results. Eighty clients (43 females, 37 males) aged 35 ± 8.0 years (mean ± SD) participated in the study. Seventy-four clients completed the MDQ of which 36 (48.6%) obtained a positive screen. A check of client files suggested that only three of the 74 participants had a current working diagnosis of bipolar disorder. These three participants had screened positive on the MDQ. Conclusions. There was a high prevalence of manic symptoms reported by participants, suggesting that screening for bipolar disorder in this population may be warranted. However, there is a risk of false positives with the MDQ, as it does not clearly differentiate between symptoms of mania and drug intoxication.

Comprehensive Psychiatry, 2011

Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medicati... more Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population. Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms. In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.

International Journal of Mental Health Systems

Background COVID-19 required mental health services to quickly switch from face-to-face service d... more Background COVID-19 required mental health services to quickly switch from face-to-face service delivery to telehealth (telephone and videoconferencing). This evaluation explored implementation of a telehealth mental health response in a regional public mental health provider. Methods A mixed methods approach, combining service use data, brief satisfaction surveys, and qualitative interviews/focus groups was undertaken. Number and types of contacts from de-identified mental health service data were compared between April–May 2020 and April–May 2019. Mental health consumers and providers completed brief online satisfaction surveys after videoconferencing sessions. Attitudes and perspectives on the implementation of telehealth were further explored by applying a descriptive qualitative framework to the analysis of interview and focus group data supplied by consumers and providers. Template thematic analysis was used to elucidate key themes relating to the barriers and enablers of tele...