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Papers by anju dhawan

Indian Journal of Psychological Medicine, Jul 11, 2022

Background: Although early maladaptive schemas (EMSs) have been suggested as potential vulnerabil... more Background: Although early maladaptive schemas (EMSs) have been suggested as potential vulnerability markers for alcohol dependence (AD), there is less emphasis on addressing these schemas in substance abuse treatment programs. We thus aimed to examine the change in schemas in response to cognitive therapy in individuals with AD. Methods: In this an open-label randomized controlled study, individuals with alcohol dependence syndrome (ADS, n = 84) were randomized to the intervention group ( n = 45), which received six cognitive therapy sessions combined with treatment as usual (TAU), or the control group ( n = 39), which was on TAU only. Participants were assessed on the measures of EMSs, alcohol use severity, and perceived stress at baseline and posttreatment. Results: The intervention group showed significant improvement in 5 out of 18 EMSs, that is, emotional deprivation, defectiveness, self-sacrifice, unrelenting standard, and negativity, compared to the control group, at the end of the treatment. There was a significant between-group effect for perceived stress but not for alcohol use severity. Conclusion: EMSs can be changed with cognitive therapy in individuals with AD and could be a crucial area to address in treatment programs. Further studies with long-term follow-up are warranted. The trial was registered with the Clinical Trials Registry—India (CTRI/2015/12/006441) on December 17, 2015.

Indian Journal of Psychological Medicine, May 1, 2022

Background: Dysfunctional basic cognitions have been suggested as potential vulnerability markers... more Background: Dysfunctional basic cognitions have been suggested as potential vulnerability markers for alcohol dependence (AD). Although there is a growing body of research on the role of distal cognitive vulnerability factors such as early maladaptive schema in the development of AD, little is known about the role of proximal cognitive factors such as cognitive distortions, dysfunctional attitude, and negative automatic thoughts. Methods: This comparative cross-sectional study aimed to examine dysfunctional cognitions in individuals with AD ( n = 84) in comparison with healthy individuals ( n = 60). The dysfunctional cognitions were assessed on the Young Schema Questionnaire third version of Short Form, Cognitive Distortion Scale, Dysfunctional Attitude Scale-Form A, and Automatic Thought Questionnaire. Multivariate analysis of covariance was conducted to analyze the group differences in dysfunctional cognitions. Results: After controlling for the group difference in employment status, 12 of 18 schemas were more prevalent in individuals with AD than in healthy individuals. Individuals with AD also scored higher on seven of 10 cognitive distortions, as well as in terms of dysfunctional attitude and negative automatic thoughts. Conclusion: Dysfunctional cognition may play a significant role in developing AD. The findings may enhance our understanding of the nature and severity of dysfunctional cognitions in the development of AD. The information may further assist the clinicians in implementing adequate intervention strategies to manage dysfunctional cognitions in individuals with AD.

The National Medical Journal of India, 2017

India has one of the largest proportion of children and adolescents in the world, but the threat ... more India has one of the largest proportion of children and adolescents in the world, but the threat posed by child substance use remains under-researched. Only recently a large study, the first of its kind in India, was carried out with a sample of nearly 4000 children using substances (school-going, out-of-school as well as street children) across more than a hundred cities/towns. We discuss (i) the existing knowledge on the prevalence of child substance abuse in India; (ii) perspectives and insights gained from the recent nation-wide study on its pattern and profile; and (iii) recommendations for substance use prevention and treatment among children in the Indian context. A multipronged approach involving all stakeholders is required to address the issues of prevention and treatment.

Indian Journal of Psychological Medicine, May 8, 2022

Background: Substance use among adolescents is increasing rapidly and becoming a global health co... more Background: Substance use among adolescents is increasing rapidly and becoming a global health concern worldwide. Because of the changing trends and rising magnitude in India, there is an urgent need to adapt and validate instruments to assess adolescents’ substance use. The study translated the Teen-Addiction Severity Index (T-ASI) into Hindi and assessed the psychometric properties. Methods: The instrument (T-ASI) was translated from English to Hindi using: (a) forward translation: translation from the source language into the target one, (b) comparison and synthesis of the two translated versions, (c) blind backward translation, (d) comparison of the two back-translated versions and development of prefinal version, (e) conceptual evaluation of items and pilot study, and (f) assessing the psychometric properties. Results: The content validity of Hindi T-ASI was quite high (0.97). A significant positive correlation r = 0.439* (0.014) between the T-ASI family functioning domain and the organization scale of the Family Environment Scale (FES) demonstrated good concurrent validity. Youth self-report substance use domain correlated well with youth self-report behavior problems scale r = 0.385 (0.033) and the psychiatric status domain correlated with all three internalizing 0.606 (<0.001), externalizing 0.363 (0.045), and behavior problem scale 0.546** (0.001). Construct validity showed significant differences between two groups (substance-using and nonsubstance-using groups) in all domains except school and peer status. Cross-cultural validity shows that the two versions are equivalent. The translated version showed satisfactory reliability (Cronbach’s α = 0.727). Conclusion: The translation and validation of Hindi–T-ASI show adequate psychometric properties and can be recommended for use in treatment settings across the country.

Journal of Psychoactive Drugs, Aug 4, 2020

Brain-Derived Neurotrophic Factor (BDNF) is a neuropeptide that plays an important role in Centra... more Brain-Derived Neurotrophic Factor (BDNF) is a neuropeptide that plays an important role in Central Nervous System development, plasticity, learning, and memory. Its role has been explored in alcohol-dependent patients, though the results have been inconclusive. Thus, we aimed to compare serum BDNF levels in alcohol-dependent patients during withdrawal with age and gender matched controls, and assess changes in BDNF levels in the initial abstinence period. BDNF levels of alcohol-dependent patients (n = 25) were compared with controls (n = 25) at baseline. Additionally, BDNF levels were measured in cases on days 5 and 10 of inpatient detoxification. BDNF levels of controls did not differ with cases on day 1, 5, or 10. But BDNF levels increased significantly during alcohol abstinence from baseline to day 10 (Pillai's Trace F = 3.753, p = .039, partial η 2 = 0.246), which may suggest its protective role. Thus, serum BDNF values may be potentially used as a biomarker to assess the abstinence state. However, longitudinal studies in different body samples is essential to better understand the role of BDNF in alcohol dependence.

Jaypee Brothers Medical Publishers (P) Ltd. eBooks, 2012

Indian Journal of Psychiatry, 2018

With the growing understanding of substance use problems among special populations like women, ge... more With the growing understanding of substance use problems among special populations like women, gender minority groups, as well as in the geriatric population, there is a drive to develop sensitive interventions catering to their unique needs. This chapter is a short review of psycho-social interventions targeted towards these individuals with specific needs.

Journal of Opioid Management

Objective: This study aimed to ascertain the reasons why patients with opioid dependence leave tr... more Objective: This study aimed to ascertain the reasons why patients with opioid dependence leave treatment.Design: Prospective follow-up observational study.Setting: This study was carried out at a tertiary care substance use treatment facility in north India with both outpatient and inpatient services. The facility is a public-funded institution.Participants: One hundred and twenty opioid-dependent male patients with age 18 years or more who were willing to provide a valid telephone number for follow-up and willing to consent for the study were included.Main outcome measure(s): Enquiries were made using the Reasons to Leave Treatment Questionnaire (RLTQ) and an open-ended question about why the patient left treatment.Results: As per the RLTQ, the most common reasons for patients with opioid dependence leaving treatment were in the domains of external influence, motivational inconsistencies, and problem severity. Logistic problem was another issue that was highlighted by the patients....

Indian Journal of Endocrinology and Metabolism, 2012

Aims and Objectives: To assess the effect of Comprehensive Yogic Breathing Program on glycemic co... more Aims and Objectives: To assess the effect of Comprehensive Yogic Breathing Program on glycemic control, quality of life, and cardiac autonomic functions in diabetes. Material and Methods: This is a prospective randomized controlled intervention trial. Cardiac autonomic functions were assessed in 120 diabetics. Patients were randomized into two groups, one group receiving standard therapy for diabetes (n = 56) and the other group receiving standard therapy for diabetes and comprehensive yogic breathing program (n = 64). Standard therapy included advice on diet, walk, and oral antidiabetic drugs. Comprehensive yogic breathing program was an interactive session in which Sudarshan kriya yoga, a rhythmic cyclical breathing, preceded by Pranayam was taught under guidance of a certified teacher. Change in fasting, post prandial blood sugars, glycated hemoglobin, and quality of life were assessed. Cardiac autonomic function tests were done before and six months after intervention. Results: There was significant improvement in psychological (P = 0.006) and social domains (P = 0.04) and total quality of life (P = 0.02) in the group practicing comprehensive yogic breathing program as compared to the group following standard therapy alone. In the group following breathing program, the improvement in sympathetic cardiac autonomic functions was statistically significant (P = 0.01), while the change in the standard group was not significant (P = 0.17). When both parasympathetic and sympathetic cardiac autonomic functions were considered, there was a trend toward improvement in patients following comprehensive yogic breathing program (P = 0.07). In the standard therapy group, no change in cardiac autonomic functions was noted (P = 0.76). The parameters of glycemic control were comparable in both groups. Conclusion: There was significant improvement in quality of life and cardiac autonomic functions in the diabetes patients practicing comprehensive yogic breathing program compared to those following standard treatment alone.

Background: In countries like India, the major source of error in reporting of sensitive events (... more Background: In countries like India, the major source of error in reporting of sensitive events (e.g., tobacco and alcohol use) among adolescents is deliberate misreporting. To estimate its burden, the commonly used direct interview method involves problems in reporting. To cope up, randomized response technique (RRT) is an alternative approach which uses a random device for providing more privacy to respondents. So, it may be worthwhile to compare RRT with direct interview method in assessment of burden of ever tobacco and alcohol use among Indian adolescents.Methods: A cross-sectional survey on ever tobacco and alcohol use among adolescents was conducted on 796 (401: RRT; 395: Direct interview) 9th to 12th class students from purposively selected three schools of Delhi/National Capital Region, during November-2014 to November-2016. As per conventional use of RRT, two types of questions, one related to “sensitive attribute” and other “an unrelated question” was used to estimate eve...

European Psychiatry, 2015

Introduction: The prevalence of substance use is among adolescents is on rise. In India, inhalant... more Introduction: The prevalence of substance use is among adolescents is on rise. In India, inhalant is one of the common drugs of use and acts as a gateway for illicit substance use. The mainstay of treatment for inhalant use among this population is psychosocial interventions. In India, we largely rely on western models to guide intervention programs, however, there is a need to develop and test the psychosocial interventions which are culturally relevant and effective. Objective: The present study aims to highlight the culture specific psychopathological factors associated with inhalant use among adolescents. The paper aims at studying the effectiveness of a psychosocial intervention in reducing the frequency and quantity of inhalant use among adolescent clinic population. Methodology: Four adolescents reporting to the Adolescent Clinic at the National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi were recruited for the study. A single-case design was adopted. The pre-, and post-intervention assessment were carried out. Results and Discussion: There was a significant reduction in frequency and quantity of inhalant use in the cases. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research. The psychpathological factors and challenges to intervention are discussed.

Asian Journal of Psychiatry, 2011

users (FTND-ST). Readiness to change was assessed using Transtheoretical model of stage change an... more users (FTND-ST). Readiness to change was assessed using Transtheoretical model of stage change and patients were grouped into those Not ready to change (Pre-contemplation) and Ready to change (Contemplation). A detailed semi-structured questionnaire was administered for assessment of self efficacy, relation of nicotine use to mood disorder and perceived health risks. Results: More than half were in Pre-contemplation stage. The stepwise Logistic Regression using likelihood ratio model arrived at a significant model which explained nearly 45% of the variance. The perceived self efficacy to quit and perceived relation to mood disorder emerged as predictors of Readiness to change, and were negatively related to the outcome variable. Conclusion: The increased self efficacy and the interference caused by mood disorder in quitting negatively predict the readiness to change in patients with Bipolar disorder.

PubMed, Apr 1, 2002

Craving is considered to play an important role in the persistence of drug use and relapse of dru... more Craving is considered to play an important role in the persistence of drug use and relapse of drug use. Very few studies have looked into the subjective experience of this phenomena. This study attempts to study craving comprehensively as described by the subjects. In the present study 30 patients of heroin dependence syndrome were assessed (using a semi-structured questionnaire) for the subjective experience of craving and its various dimensions. All subjects reported having experienced craving. Majority of subjects (90%) described craving as a strong desire to use the substance. About 77% reported that intensity of craving could vary while others described it as a strong urge. Majority (83.3%) reported that only heroin or other opiates could satisfy the craving they experienced for heroin. During craving, thoughts of using the drug by all means would preoccupy their mind. Withdrawal symptoms (70.0%), increased respiration (56.7%) and palpitation (53.3%) were the common physical symptoms and anger (83.3%), tension (63.3%), anxiety (50.0%) were the common emotions experienced during craving. Craving was described as difficult to control and resulted in consumption of heroin on an average of 76.7% occasions. All subjects reported multiple cues that induced craving. Frequency of craving decreased with increase in length of period of abstinence. After being abstinent for 3 months, 90% subjects did not experience craving or experienced it once in a day. Socio-cultural factors do not appear to have prominent influence on subjective experience of craving.

Drug and Alcohol Dependence

Journal of Ayurveda and Integrative Medicine

The National medical journal of India