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To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1468-5906.2008.00417.x Byline: JAMES ALAN NEFF (1) Abstract: Extant measures of spirituality-religiosity, not developed specifically with substance abuse treatment populations in mind, may not be culturally appropriate in regard to either: (1) the 12-step 'culture' found in many treatment programs; or (2) racial-ethnic minority populations overrepresented in publicly funded programs. A 40-item four-dimensional measure was developed, which differentiates 'religiosity' (religious practices) from 'spirituality' (an individual's relationships with God/higher power, others, and self). Instrument development involved: qualitative focus groups with individuals in seven diverse Texas treatment programs; quantitative exploratory and confirmatory (CFA) analyses to test the four-factor model conducted using data from 237 diverse clients in treatment programs in Tennessee and Virginia. Confirmatory analyses indicate acceptable fit indices (>0.90) for the four-factor model, and acceptable reliability estimates for all subdimensions ([greater than or equal to]0.70) provide further support for the measures. Results support the potential usefulness of the measures. Author Affiliation: (1)James Alan Neff is Professor of Community and Environmental Health in the College of Health Sciences, Old Dominion University, Norfolk, VA. Article note: Correspondence should be addressed to James Alan Neff, College of Health Sciences, Old Dominion University, Norfolk, VA 23529. E-mail: janeff@odu.edu

A study examines sex differences among dentists with respect to oral effects of eating disorders.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2005.10.001 Byline: James Alan Neff (a), Clayton T. Shorkey (b), Liliane Cambraia Windsor (b) Keywords: Substance abuse treatment; Faith-based treatment; Health disparities; Concept Mapping Abstract: This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear 'spiritual activities, beliefs, and rituals' dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated 'structure and discipline' as more important and 'work readiness' as less important. No differences were found for 'group activities/cohesion' and 'role modeling/mentoring,' 'safe, supportive environment,' and 'traditional treatment modalities.' Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes. Author Affiliation: (a) College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA (b) School of Social Work, University of Texas at Austin, Austin, TX, USA Article History: Received 29 December 2003; Revised 31 August 2005; Accepted 6 October 2005

This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with Simpson's (2004) treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear 'spiritual activities, beliefs, and rituals' dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated 'structure and discipline' as more important and 'work readiness' as less important. No differences were found for 'group activities/cohesion' and 'role modeling/mentoring,' 'sale, supportive environment,' and 'traditional treatment modalities.' Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes. Keywords: Substance abuse treatment: Faith-based treatment: Health disparities: Concept Mapping

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of 'spiritual transformation' in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement. Keywords: Substance abuse treatment, spiritual change, behavior change models, INTRODUCTION Recently, there has been increasing attention directed to conceptual and methodological issues surrounding spirituality, religiosity, and their implications for health and well being (1). Unfortunately, systematic empirical research regarding [...]

The study discussed in this article examined the relationship between depression symptomatology and functional impairment among white and African American elderly people and investigated the effect of race, religiosity, and social support on this relationship. Study results indicate that although African American elderly people were more impaired in the performance of activities of daily living (ADL) and instrumental activities of daily living (IADL) than white elderly people, they did not experience higher levels of depression. However, African Americans did report significantly higher levels of religiosity and social support. Key words: depression, elderly people, functional impairment, social support, religiosity, Depression constitutes a major and growing health problem for older adults. Depressive symptoms are considered to be the most common mental health problem in later life and afflict up to [...]

Studies of accidental needlestick exposure to blood containing human immunodeficiency virus (HIV) have shown that the volume of blood in an exposure is a strong predictor of subsequent infection. Illicit drug injectors, a group at elevated risk for HIV transmission, use syringes manufactured in two styles, one of which (the integral cannula type) retains substantially less blood after intravenous use than the other (the detachable needle type). In this report, we examine some of the factors associated with use of syringes with detachable needles among drug injectors in San Antonio, Texas using data from epidemiological surveys, ethnographic studies, and historical observations. We compare personal history of syringe type use with HIV serostatus in a sample of 501 active drug injectors interviewed and screened for HIV in 1997-1998. Ninety-nine percent of these respondents reported that they currently used only integral cannula syringes, but 13% had used a syringe with a detachable needle within the past 2 years, and 37% had used one in their lifetime. Only 9% had ever used one [greater than or equal to] 20 times in a year. Hispanic (Mexican American) respondents were significantly less likely than other ethnic groups to have ever used a detachable needle syringe. HIV seroprevalence was < 1% among heterosexual injectors who had never used a detachable needle syringe compared to 4% among those who had used one (p< 0.05). Keywords: Injecting drug users; HIV; Syringes; Texas; USA

The predictive validity of a treatment readiness measure designed for out-of-treatment drug users, tapping dimensions of perceived problem severity, perceived need for formal treatment, motivation for treatment, and negative attitudes toward treatment is examined using data from a National Institute on Drug Abuse (NIDA)-funded HIV outreach intervention in San Antonio, Texas. Logistic regression is used to predict use of substance abuse treatment services three months after program intake on the basis of readiness scores, controlling for demographic and drug history variables. Analyses of data from 673 drug users in an HIV outreach intervention indicated that treatment readiness dimensions accounted for a 12% increase in variation in 'use of any modality' and 14% for 'use or attempted service use'. Only Motivation to Quit was a significant predictor of 'use of any modality' and both Perceived Need for Treatment and Motivation to Quit were significant predictors of 'use or attempted use'. Findings support the importance of the individual's perception of 'readiness' to change their substance-abusing behavior and enter treatment., INTRODUCTION Identification of injection drug users (IDUs) as an HIV risk group in the early 1980s focused substantial research efforts in the United States (1) and other countries (2) on [...]

Three models of continuing education - full-day, half-day, and brief workshop - for health providers treating patients with HIV/AIDS were compared on measures of effectiveness with regard to knowledge, attitude, and practice outcomes. Analyses of pre- and postintervention data from two years of training events suggest consistent, modest, program effects in the full-day and half-day approaches, specifically in the area of knowledge enhancement.

Data from a random sample of 164 Anglo, 168 African American, and 149 Mexican American male regular drinkers compare the use of cross-sectional data on current consumption patterns versus retrospective lifetime drinking history data in studying ethnic differences in 'maturing out' of heavy drinking among male drinkers. Cross-sectional analyses among males in their 20s, 30s, and 40s on current consumption indexes suggest that maturing out of heavy drinking may be more of an Anglo phenomenon. Drinking history analyses suggest that the process takes place in both majority and minority male drinkers in their 20s, although slightly earlier among Anglos. Although Mexican Americans were less likely to report heavy or problem drinking stages, heavy drinkers in this ethnic group reported heavy drinking earlier and for longer periods of time than did other drinkers. Analyses suggest that ethnic differences in the maturing out phenomenon may be more subtle than is suggested in the cross-sectional analysis., This article examines alternative methodological approaches to evaluating the hypothesis that minority male drinkers (African Americans and Mexican Americans) may differ from non-Hispanic White (Anglo) males in the propensity to [...]

A study of 148 predoctoral psychology internship program applicants investigated their site choice criteria. They rated first, intermediate and last-choice sites by 25 variables associated with internship programs. Eight variables, necessary in choosing a site, differentiated all three preferences. Eleven variables, indicating application process and program design, distinguished the first from the last choice. Interview procedures could be very important.

The results of a survey of clinical and counselling psychologists trained between 1970 and 1992 suggest a preference for a rapid transition into private practice among graduates educated since 1980. Most of the survey respondents gravitated toward private practice by the tenth year after internship. Most respondents report that they make extensive use of neurological and psychological test instruments.

A study of the influence of parental alcoholism and parental mental illness on adult children from racially and ethnically diverse random communities reveals that higher estimates of depression, worry and somatization are seen among male drinkers whose parents had a history of alcoholism. Parental mental illness causes depression, worry, somatization and high drinking among females. The occurrence of these effects in males who reported parental alcoholism indicates the resilience of male Adult Children of Alcoholics who do not drink or drink to mediate parental alcoholism.

An analysis of differences in marital status in depressive symptoms, to examine the influence of race/ethnicity and sex, confirms that the separated and divorced exhibit higher levels of depression and lower levels of distress, respectively. Differences were insignificant among Mexican Americans and blacks. Married black women exhibited higher levels of distress than their never-married counterparts.

A recent development in the provision of substance abuse services has been the rise of the harm-reduction model and non-abstinence-based services. Harm reduction is based on the suppositions that drug [...]

Reliable and valid measures of religiosity and spiritual dimensions appropriate for ethnically diverse groups are needed. I examine the factor structure of the relatively new Fetzer multidimensional measure (Fetzer Institute 1999). Confirmatory factor analyses (CFA) of national data collected in the 1998 General Social Survey are conducted to (1) test the fit of the proposed dimensionality of the Fetzer measure, specifically comparing the Fetzer structure with a simpler single-factor model suggested by preliminary exploratory factor analyses; and (2) evaluate ethnic differences in factor structure of the Fetzer items. Data from 1,201 adults, 1,019 whites and 182 African Americans, are examined to compare the fit of the multidimensional Fetzer model against an alternative single-factor ('unitary spirituality') model. CFA analyses indicated that only the Fetzer models had acceptable fit indices (NFI and/or NNFI approaching or reaching 0.90). Ethnic differences in loadings, while significant, were not substantively different. These findings suggest that a multidimensional measure like the Fetzer is useful for multiethnic research and that combining the daily spirituality and values/beliefs dimensions into a single factor provides a simpler model overall (compared to the Fetzer model separating these dimensions out) while providing acceptable fit.

This article presents the results of a confirmatory factor analysis expanding and enhancing a previously developed measure of 'machismo' both to explore the dimensionality of the measure and to test the invariance of factor structure in a sample of Anglo, African American, and Mexican American adult male drinkers. Specifically, this article (a) describes the development of a multidimensional 13-item machismo measure, (b) tests the goodness of fit of a series of confirmatory factor models examining single versus multiple factor solutions (e.g., Does a unitary machismo factor fit, or must positive and negative dimensions be modeled?), and (c) tests the invariance of the resulting model across racial-ethnic groups. Results support the use of the measures for cross-ethnic studies and emphasize the importance of a multidimensional measure including both positive and negative dimensions.