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Although there is extensive literature on the processes and outcomes of drug and alcohol dependence treatments, little is known about specific predictors of treatment effectiveness. The present study aims to identify the predictors of abstinence in outpatient drug and alcohol dependence treatments, as well as the predictors of treatment effectiveness, according to a biopsychosocial approach. The study followed a cross-sectional research design. Participants (n = 290) were recruited from an outpatient treatment of the Intervention Division in Addictive Behaviors and Dependencies (DICAD), in the northern region of Portugal. A convenience sample was used. Data was collected using questionnaires administered at the facilities of the DICAD, in a private, quiet room. Results indicate that predictors of abstinence were involvement in treatment, psychopathology symptoms, and treatment program (i.e., outpatient drug vs alcohol dependence treatments). The full model of logistic regression analysis was significantly reliable (χ2(3) = 33.93, p

Addiction behaviours, whether referring to psychoactive substances or others of a behavioural dependencies, constitute a public health problem to be addressed. This cross-sectional and comparative exploratory study aims to identify the psychosocial profile of college students in terms of chemical and behavioural addictions. This convenience sample consisted of 260 adult college students (32 male), aged between 18 and 51 years old. Life Events Checklist 5 (LEC-5), Post-traumatic Stress Disorder Checklist 5 (PCL-5), Childhood History Questionnaire, Experiences in Close Relationships-Relationship Structures Scale (ECR-RS), Buss-Perry Aggression Questionnaire, Levenson Self-Report Psychopathy Scale (LSRPS), Alcohol Use Disorders Identification Test (AUDIT), Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and Internet Addiction Test (IAT), were used. Using the Mann-Whitney U test, significant differences were found between the low-level alcohol consumers group and moderate to high-level consumers group in aggressiveness, post-traumatic stress disorder (PTSD), and insecure attachment. Regarding Internet addiction, the results reveal differences in terms of aggressiveness, insecure attachment, and secondary psychopathy between subjects with normative use and subjects addicted to the Internet. When compared to subjects without addictions, subjects with addiction behaviours experience more adverse childhood experiences (ACE), more PTSD symptoms, higher levels of aggressiveness, greater avoidance and anxiety in affective relationships, and more predisposition to manifest deviant psychopathy behaviours. This study contributes to identifying different psychosocial profiles of college students concerning chemical and behavioural addictions and highlights the impact of those profiles on aggressiveness, PTSD, and insecure attachment, essential for the design of more effective prevention and intervention programs with these specific groups.

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Background To compare patterns of alcohol consumption and alcohol-related harm from a survey of university students sampled from universities in Denmark, England, Germany, Italy, Portugal and Switzerland. Methods A total of 2191 university students (70% female, 90% white ethnic group, age range 18–25) completed the survey. Participants completed measures of demographic variables (age, age of onset, ethnic group and sex) and the Alcohol Use Disorders Identification Test (AUDIT), which was the primary outcome. Results Sixty-three percent of the sample scored negative for harmful drinking on the AUDIT ( Conclusions European university students in our sample mainly reported low risk patterns of alcohol consumption and alcohol-related harm. However, students from Northern European countries had significantly higher AUDIT scores compared with students from Central and Southern European countries. Research is needed to replicate the present study using nationally representative samples to estimate the prevalence of alcohol use disorders among university students in different European countries.

[ES] Una de las principales razones del fracaso de las intervenciones familiares está relacionada con baja participación y retención de las familias. Las dificultades para promover participación y retención adecuadas es uno de los obstáculos más importantes en la implementación y diseminación de las intervenciones familiares basadas en la evidencia. Aunque en la literatura se describe una amplia gama de estrategias para involucrar a los padres, se sabe poco sobre qué estrategias son más efectivas para mejorar la participación. Por ello, se ha llevado a cabo una revisión sistemática de factores predictivos de la participación de los padres y las estrategias de mejora en los programas parentales de prevención. Los criterios de inclusión fueron: 1) estudios basados en evidencias con componente de intervención familiar, revisiones teóricas y empíricas de la literatura, y revisiones sistemáticas; 2) artículos publicados en Portugués, Inglés y Español; 3) publicados entre 2000 y 2018. Se encontraron 39 artículos que informaron sobre una variedad de factores predictivos de la participación familiar y métodos efectivos para involucrar a las familias en actividades preventivas. Surgieron cuatro dimensiones básicas: 1) predictores de participación; 2) características asociadas al programa; 3) obstáculos para la participación; 4) estrategias para minimizar las barreras de participación. Se identificaron cuatro grupos distintos de predictores de participación: patrones de interacción familiar; cogniciones y atribuciones de los padres sobre los problemas de conducta del niño; variables psicológicas relacionadas con los padres; percepción parental de la intervención. Varios atributos intrínsecos y extrínsecos de la intervención se asociaron con la participación en programas familiares. Algunos obstáculos para la participación incluían problemas o circunstancias logísticas del entorno social de la familia. Las estrategias para minimizar las barreras incluyeron el uso de diferentes incentivos extrínsecos, el rol del capacitador y el ajuste de las expectativas y motivaciones de los padres durante la intervención. [EN] One of the main reasons for the failure of family interventions is related to the low participation and retention of families. Difficulty in promoting adequate engagement and retention of participants is one of the most powerful obstacles and challenges to the implementation and dissemination of evidence-based family interventions. Although a wide range of strategies to involve parents in interventions is described in the literature, little is known as to what strategies are most effective in improving parental involvement. We conducted a systematic review of the predictors of parent participation and enhancement strategies in preventive parenting programs. Key inclusion criteria included: 1) evidence-based studies with a family intervention component, theoretical and empirical reviews of the literature, and systematic reviews; 2) articles published in Portuguese, English, and Spanish; 3) published between 2000 to 2018. Thirty-nine articles reported a variety of predictors of family participation and effective methods to engage families in preventive activities. Four basic dimensions emerged: 1) predictors of participation; 2) characteristics associated with the program; 3) obstacles to participation; and 4) strategies to minimize barriers to participation. Four distinct groups of participation predictors were identified: 1) patterns of family interaction; 2) parents’ cognitions and attributions regarding their child’s behavioral problems; 3) psychological variables related to parents; and 4) parental perception of intervention. A variety of intrinsic and extrinsic intervention attributes were associated with involvement in family programs. Some obstacles to participation included several logistical issues and circumstances within the family’s social environment. Strategies to minimize barriers to participation included the use of different extrinsic incentives, the role of the trainer, and adjusting parental expectations and motivations throughout the intervention.

El manuscrito presenta los resultados de un proyecto familiar de intervencion comunitaria de prevencion del consumo de drogas. El proyecto se basa en dos modelos de integracion - Modelo Estructural de Cowen y Modelo Eco-Desarrollo, adoptando una perspectiva multicausal y guiandose por el principio metodologico de empoderamiento. Este estudio tuvo dos momentos de evaluacion: (T1) una semana antes de la intervencion y (T2) una semana despues del final de la intervencion. Se presentan los datos reunidos de 42 adultos con responsabilidades parentales y los resultados indican cambios significativos a nivel familiar en el aumento de la cohesion, expresividad, el control y en el aumento de la orientacion de las actividades recreativas. Tambien se observa una disminucion de las estrategias educativas que caracterizan los estilos autoritarios y permisivos. Abstract The manuscript presents the results of a family and community intervention project to prevent drug use. The project was theoretically based in two integrative models - Structural Model of Cowen and Eco-Developmental Model and has taken a multicausal perspective and the methodological principle of empowerment. This study had two assessment moments: (T1) a week before the intervention and (T2) a week after the end of the intervention. Data collected from 42 adults with parenting responsibilities and the results indicate significant changes in the increase of cohesion, expressivity, control and the increase of the orientation for recreational activities. It is also observed a decrease of the educational strategies that characterise the authoritarian and permissive styles.

Background In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention) had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254) from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66); receiving individual psychiatric counseling (n = 68); receiving both individual psychological and psychiatric counseling (n = 102); and receiving not only individual counseling (i.e., psychology or psychiatry), but also attending group therapy (n = 18). Results Using MANOVA and Wilks’s multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603) = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual’s probability to remain abstinent.

Background Practitioners need brief instruments to monitor outcomes in both treatment of drugs and alcohol addiction because they are useful to guide decision making in a short time.Objectives This study aims to develop a brief questionnaire, based on Client Evaluation of Self and Treatment, to evaluate the treatment effectiveness in drug and alcohol addiction treatment settings.Methods A cross-sectional study using a convenience sample (N = 608) recruited from Division for Intervention on Addictive Behaviours and Dependencies (DICAD – ARS North).Results The results show a new four-factor solution that accounted for 54.4% of the total variance and that provides the best fit to the data (c2/df = 1.72, CFI = .94, GFI = .91, RMSEA = .048 [.040-.057]; prmsea = .623). It also revealed a high internal consistency (a = .82). It was found a significant negative correlation (r = - .52, p < .01) between the final version of the instrument and a self report measure of psychopathology symptoms.Discussion This brief questionnaire, with good psychometric properties, can be useful to provide a viable and rapid feedback of treatment outcomes. Further studies should be performed to continue the evaluation of the reliability of this measure.

This article presents the results of a study about risk behaviors in adolescence (drug use, sexual risk behaviors and antisocial behaviors), conducted on a representative sample of 1048 adolescents. The results on the prevalence of the different analyzed behaviors broadly confirm the data described in both international (ESPAD, 2007, 2011; HBSC, 2006) and national studies (ECTAD, 2011). These results also highlight the influence of cultural and social‑‑demographic factors in these behaviors. In addition, it was possible to verify an association between the different risk behaviors, which is consistent with the results from previous research in this domain (Brook, Whiteman, Balka, Win, & Gursen, 1998; Jessor, Van Den Bos, Vanderryn, Costa, & Turbin, 1995; Negreiros, 2008). This conclusion points to the hypothesis defended by different authors (e.g. Jessor, 1998) about the existence of a common syndrome and the need for development of an integrated approach to risk behaviors in adolescence.

Working with drug addicts we frequently face patients complains on sexual sphere .Literature doesn't elucidate about the impact of cognitive factors. Aiming to enable a better understanding of the relation between psychoactive substance use and sexuality we proposed to adapt and validate the Substance Use and Sexual Behavior Survey (SUSBS) questionnaire. We studied 488 drug addict subjects, outpatients of the public drug addiction Portuguese centers. Exploratory factor analysis indicated a four-component structure we termed: Inhibitor impact of substance of abuse in sexuality, Indissociability of sexuality and substance use, Enhancer impact of substance in sexuality, Substance use favoring risky sexual behaviors, explained approximately 65% of the total variance. The confirmatory factor analysis exhibited overall fits. The results suggested that the Portuguese version of the SUSBS has adequate psychometric properties. We present a discussion in terms of the questionnaire utility, recommend its use for clinical and research purposes. Desenvolvendo prática clínica com toxicodependentes, frequentemente nos deparamos com queixas na esfera sexual. A literatura não elucida relativamente ao impacto dos factores cognitivos, nesta dinâmica. Procurando alcançar uma melhor compreensão acerca da relação entre o uso das substâncias psicoactivas e a sexualidade propusemo-nos a adaptar e validar o questionário: Substance Use and Sexual Behavior Survey (SUSBS). Estudamos 488 sujeitos toxicodependentes, utentes dos Centros de Resposta Integrada para a toxicodependência, da Administração Regional de Saúde de Portugal. A análise exploratória resultou na indicação de uma estrutura em quatro factores, que designamos: Impacto do abuso de substâncias como inibidor da sexualidade, Indissociabilidade entre abuso de substâncias e sexualidade, Impacto do abuso de substâncias como potenciador da sexualidade e Uso de substâncias como favorecedor de comportamentos sexuais de risco. Esta estrutura explica aproximadamente 65% da variância total. A análise confirmatória exibiu valores estatísticos satisfatórios. Os resultados sugerem que a versão portuguesa do SUSBS possuiu adequadas propriedades psicométricas. Apresentamos a discussão acerca da utilidade deste questionário, recomendando o seu uso na prática clínica e na investigação.

El uso y el abuso de drogas son muy habituales en la adolescencia. Los padres desempenan un importante papel en el consumo de drogas, tanto incitando a su consumo como fomentando la proteccion y la resiliencia. Las intervenciones familiares han demostrado ser un enfoque beneficioso en la prevencion del consumo adolescente y otras conductas problematicas de la adolescencia. No obstante, los bajos indices de participacion representan una importante amenaza a la validez de las intervenciones familiares preventivas. Desde hace tiempo se viene reconociendo que uno de los principales problemas para la realizacion de intervenciones familiares es la captacion, retencion y participacion de los progenitores. Aparte de esto, se ha visto que una mayor participacion de los padres en las formaciones de prevencion para progenitores esta asociada a un efecto duradero sobre la conducta adolescente. Identificar especificamente lo que determina que la familia se implique y participe en los programas de prevencion familiares es de maxima importancia, puesto que la implicacion de los padres puede ser un factor de pronostico de la eficacia del programa. Ultimamente se ha prestado mas atencion a entender de que manera los factores individuales, contextuales y de intervencion pueden predecir la participacion parental en las intervenciones familiares de prevencion de drogodependencias. Los estudios sobre los factores de pronostico de participacion son utiles para identificar a aquellos individuos que hallan en mayor riesgo de abandonar. En este trabajo ofrecemos un repaso de la evolucion mas reciente de los diversos factores de pronostico de la participacion familiar en programas preventivos de consumo de drogas y otros problemas. A partir de los determinantes especificos y dinamicos de la participacion que se estudian en este trabajo, al final proponemos un marco teorico de la participacion familiar que presenta cuatro componentes basicos: (1) patrones de interaccion familiar; (2) conocimiento y percepciones de los padres sobre los problemas conductuales de los hijos; (3) variables psicologicas de los hijos; y (4) percepciones de los padres sobre la intervencion preventiva.

the Centre of Integrated Responses – west Oporto, composed of 114 men (95%) and 6 women (5%), between the ages of 19 and 56 (M = 38), and 90% of Portuguese nationality. All the interviewees could speak and understand Portuguese. The results suggest that the majority of the subscales present regular values of global adjustment and acceptable values of internal consistency, as can be seen in the dimensions Therapeutic process (GFI = .946-1.0, AGFI = .903-1.0, CFI = .967-1.0, RMSEA = .000-.072, a = .684-.888) and Psychological functioning (with the exception of the Self-efficacy subscale) (GFI = .963-.991, AGFI = .926-.961, CFI = .955-1.0, RMSEA = .000-.055, a = .697-.746). Unlike the results reported by Joe et al. (2002)1, some subscales present limitations: the dimension Motivation for treatment (GFI = .974-980, AGFI = .916-.941, CFI = .939-979, RMSEA = .028-.083, a = .329-.655); and, in terms of internal consistency, the subscales Self-efficacy ( a = .542), Risky behaviour (a = .665) and Social conscience (a = .406). The small size of the sample and its specificity (75% in a programme of opioid replacement therapy with methadone) may have contributed to the reported results. As so, given the inadequacy of some items of the dimension Motivation for the treatment, we have suggested the elimination of this dimension in future applications of the TCU-CEST – Portuguese version2. The results of this study also underscore the need to revising the subscales Self-efficacy, Risky behaviour and Social conscience, as to achieve a closer cultural adaptation to the Portuguese context. Finally, further research should be undertaken in order to assess the validity of the instrument TCU-CEST, by examining its adequacy with samples of users dependent on other drugs and users in different treatment programmes.

O consumo de álcool e a depressão foram investigados através das escalas AUDIT e BDI. Participaram no estudo 484 alunos do ensino secundário (n=283) e do ensino superior (n=199) de ambos os sexos (299 feminino, 185 masculino). A média de idade foi de 18.85 + 2.93, entre 15-30 anos. Os resultados do AUDIT (n=478) indicaram que 92% dos estudantes apresentaram abstinência/consumo normal e 8% um consumo de risco. Entre estes últimos, 82.5% situaram-se na zona de risco, 10% na zona prejudicial e 7.5% na zona de dependência.O consumo de risco foi predominante nos rapazes (52%), universitários (61%) e na faixa etária dos 20-24 anos (59%). O consumo prejudicial prevaleceu nos rapazes (100%), universitários (100%) e jovens com idades entre os 20-24 anos (100%). A dependência foi expressiva entre rapazes (100%), alunos do secundário (67%) e jovens de 15-19 anos (67%). Encontrou-se uma correlação significativa entre consumo de álcool e as variáveis género (r = -.190, p < .01), faixa etária (r = .147, p < .01) e escolaridade (r = .186, p < .01). Os resultados do BDI (n=420) indicaram 9% de disforia ou depressão. Verificou-se umacorrelação significativa entre os resultados do BDI com género (r = .149, p < .01) e consumo alcoólico (r = .118, p < .05). Discute-se a influência desta relação na adaptação social positiva e no desenvolvimento de estratégias para promover a saúde dos jovens. Alcohol consumption and depression have been investigated through the AUDIT and BDI scales. 484 students have participated in this study; 283 attended secondary school and 199 were college students, of both genders (299 women, 185 men). Their average age was 18.85 + 2.93, between 15 and 30 years old. The results of the AUDIT (n=478) indicate that 92%, of these students show an abstinence/normal consumption pattern and that 8% have developed a high-risk consumption pattern. Among the latter, 82.5% were considered to have high-risk consumption patterns, 10% to have harmful consumption patterns and7.5% to have alcohol dependence. The high-risk consumption was especially strong among boys (52%), university students (61%) and young people from 20 to 24 years (59%). The harmful consumption prevailed among boys (100%), university students (100%) and young people from 20 to 24 years old (100%). Dependence was significant among boys (100%), secondary school students (67%) and teenagers from 15 to 19 years (67%). A significant correlation was found betweenalcohol use, gender variables (r = -.190, p < .01), age (r = .147; p < .01) and schooling (r = .186, p

Aplicou-se a Rosenberg Self-Esteem Scale (RSES) a uma amostra de 501 adolescentes, dos quais 231 (46,1%) eram do género masculino e 270 (53,9%) do género feminino, que frequentam o ensino básico e secundário na região interior Norte do País. Procedeu-se ao estudo das características psicométricas da referida escala, que no presente estudo apresentou uma consistência interna considerada satisfatória e uma estrutura factorial bidimensional, que explicava 46% da variância total. A análise factorial confirmatória corroborou o modelo de dois factores. Foi encontrada uma auto-estima global mais elevada no género masculino. The Rosenberg Self-Esteem Scale (RSES) was completed by 501 adolescents, 231(46, 1%) male and 270 (53, 9%) female, that attend the elementary and secondary school, in the interior North of the Portugal. We have made the study of the psychometric characteristics of the above-mentioned scale, which, in the present study presented a reability considered satisfactory and a bi-dimensional factorial structure, which explains (46%) of the total variance. Confirmatory factor analyses have produced the similarly results. The differences related to the gender show that the level of self-esteem is higher in boys.

Este artigo descreve a experiência de consumidores problemáticos de drogas sobre a partilha de seringas e equipamento de injecção e a prática de comportamentos sexuais de risco. A investigação baseou-se no recurso a entrevistas qualitativas em profundidade, na linha da tradição etnográfica de compreender as experiências vividas dos sujeitos a partir das suas próprias perspectivas. Os resultados evidenciam a importância de outros factores que não os relacionados com os níveis de conhecimentos na adopção de comportamentos de risco. Com efeito, os comportamentos de risco sexual de transmissão do VIH bem como os de partilha de seringas e de outro material de injecção, surgem associados, neste estudo, a factores mais complexos, como as preferências sexuais e afectivas dos participantes; as ambiguidades em relação ao comportamentos considerados seguros; a influência dos valores culturais dominantes e, particularmente, às necessidades associadas ao contexto vivencial dos toxicodependentes sem-abrigo onde avultam as actividades de manutenção da sua dependência numa «economia de rua». This paper focuses on HIV-related sexual risk behaviors among problematic drug users. The research involved qualitative, in-depth interviews with problematic drug users, following the tradition in ethnography of understanding actors' lived experiences from their own perspectives. The interviews were loosely structured and aimed to elicit respondents' views and experiences of drug abuse and HIV risk behaviors. Interviewees' responses confirmed that factors other than lack of knowledge play a central role in deciding to have unsafe sex and sharing unclean needles. Although levels of knowledge of HIV and AIDS were generally high, unsafe sex and overall injection behavior were associated with relatively complex issues, such as participants' sexual and affective preferences, the nature of the relationship between partners, ambiguities about what is truly safe, the influence of dominant cultural values and the needs of homeless problematic drug users involved in a «street economy».

A presente investigação tem como finalidade contribuir para um conhecimento mais aprofundado da extensão e características do consumo problemático de drogas em Portugal. Nesse sentido, foram efectuados cinco estudos, baseados no método captura-recaptura, nas cidades de Matosinhos, Aveiro, Viseu, Oeiras e Beja, dos quais resultaram estimativas da população de consumidores problemáticos nos referidos concelhos. Foram igualmente examinados diferentes aspectos relacionados com a natureza do consumo problemático nas diversas cidades, centrados na caracterização dos perfis dos consumidores problemáticos, quer do ponto de vista de variáveis sócio-demográficas específicas, quer dos próprios padrões de consumo. A concluir, discutem-se os princípios e limitações gerais associados à utilização deste método. Describes a number of studies focused on prevalence estimation of problematic drug use in five Portuguese cities using the capture-recapture method. A list of agencies that deal with drug addicted populations was drawn up, which included specialized treatment agencies for drug addicts (CATs), hospital agencies, the courts and the police. The studies were conducted in the Portuguese cities of Matosinhos, Aveiro, Viseu, Oeiras and Beja and led to estimations of the size of addict populations in those cities. We further discuss some dimensions of the nature of problem drug use, describing profiles of drug users as well as patterns of drug use in relation to the specific geographic areas investigated. The results are discussed taking into consideration the general principles and limitations of the capture-recapture method.