Valerie Cedoit
City College of the City University of New York
Psychology of Prevention Science, PSY 363
Submitted to: Prof. L. E. Elcock, MA
May 9, 2010
Notable Quotable
“Alcohol doesn't console, it doesn't fill up anyone's psychological gaps, all it replaces is the lack of God.”
- Marguerite Duras
“Everybody needs a way out of that pain. Many people choose drugs and alcohol. Some people obsessively exercise or develop strange dietary habits, which is what I did. At least it got me toward a path of healthier living.”
- Mariel Hemingway
“Good humor is a tonic for mind and body. It is the best antidote for anxiety and depression. It is a business asset. It attracts and keeps friends. It lightens human burdens. It is the direct route to serenity and contentment.”
- Grenville Kleiser
“If I had not been already been meditating, I would certainly have had to start. I've treated my own depression for many years with exercise and meditation, and I've found that to be a tremendous help.”
- Judy Collins
Dedication
For my family, friends, and mentors.
For those suffering and also for those who seek the knowledge of these disorders.
Contents
I. Abstract
II. Part I: Alcohol Abuse/Dependance (p.5-p.10).
A. Risk Factors.
B. Problems and Outcomes of the Risk Pathway.
C. Malleable Risk Factors.
D. Methods of Intervention (Intervention Pathway).
E. Changes in Malleable Risk Factors.
F. Changes in Problems and Outcomes Resulting from Intervention.
III. Part II: Major Depressive Disorder (MDD, p.10-p.14).
A. Risk Factors.
B. Problems and Outcomes of the Risk Pathway.
C. Malleable Risk Factors.
D. Methods of Intervention (Intervention Pathway).
E. Changes in Malleable Risk Factors.
F. Changes in Problems and Outcomes Resulting from Intervention.
IV. Appendices (p.15-p.19).
A. DSM-IV TR Criteria: Alcohol Use Disorders (Abuse/Dependence).
B. Two-Pathway Model: Alcohol Abuse/ Dependence.
C. DSM-IV TR Criteria: Major Depressive Disorder (MDD).
D. Two-Pathway Model: MDD
V. References (p.20-21).
Abstract
Alcohol abuse and dependence have proven to be complex genetic traits that are influenced by environmental factors. Primate and human studies have shown that early life stress increases the propensity for alcohol abuse in later life. Brief interventions in substance abuse refer to a group of cost-effective and time efficient strategies that aim at reduction of substance use and/or harm related to substance use (Watkins, K, Pincus, H, & Tanielian, T, 2000). Major depressive disorder (MDD) is a common chronic but highly treatable, affective disorder. In the current climate of managed care, which limits the number of sessions and the type of treatment that can be provided, it has become important for clinicians to identify how they can best fulfill this mandate. There are many evidence-based treatments available to clinicians, including pharmacotherapy and psychotherapy, but patient preference, clinician availability, and time limitations often dictate the treatment approach. (Seligman, Martin E. P., Ph.D. 1975) This paper describes several behavioral techniques that can be easily adapted by primary care advanced practice nurses and other clinicians in order to provide brief but effective treatment to depressed patients. These techniques include: medication treatment, interventions, and therapy. The application of appropriate, evidence-based treatments by primary care clinicians will increase the number of people effectively treated for MDD and alcohol abuse and relieve some of the strain on the healthcare system.
Part I: Alcohol Abuse/Dependancy Risk Factors
Substance abuse can simply be defined as a pattern of harmful use of any substance for mood-altering purposes. According to the DSM-IV, a person can abuse a substance or become dependent on a substance but not both at the same time. Substance dependence is when a person has