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Polydrug using persons pose particular challenges in mental health practice that result from the complexity of cumulative intertwined effects of the addictive course on their cognitive, affective and neurobiological functioning.
At a diagnostic level, practice systematization using a thorough, multidimensional, evidence-based anamnestic protocol appears mandatory to provide the internationally recommended assessment data relevant to designing informed care pathways (cf. World Health Organization, France's ‘Haute Autorité de Santé’, Belgium's ‘Conseil Supérieur de la Santé’). At a treatment level, this protocol reveals beneficial to the practitioner–client relationship, facilitating initiation of a therapeutic contract. Further “assessment to treatment” tools, including monitoring of polydrug use through structured observational agendas and time-line analyses, respond to multiple care challenges by providing both diagnostic and follow-up data. Early treatment course application of psycho-education sessions into self-observational “homework” strategies further benefits comprehension and control of the addiction course by clients.
Evidence-based, structured “assessment to treatment” tools appear to provide valuable insights regarding polydrug use severity, dynamics and contingencies, relevant to initial multidisciplinary assessment and treatment course evaluation. Significantly, these are also found to ameliorate addiction insight along with facilitating cognitive-emotional regulation by the client. Further research and practice implications are advocated.
Recent developments in the field of polydrug use along with alcoholism provide growing insights into how cognitive, affective, motivational and neurobiological pathways are altered in addictive persons. Few of these insights have as yet been implemented in everyday care.
In as few as seven weeks, dramatic therapeutic improvements come forward. All polydrug patients referred due to long-term treatment refusal, are found to comply with the structured scientist-practitioner model approach. Multidisciplinary practitioner-observed benefits include increased or first-time therapy adherence and drug treatment compliance. Patient self-reported benefits moreover include increased addiction insight and mastery, along with enhanced cognitive-emotional regulation to gain control over addictive craving versus pleasure-seeking behaviours.
Applying an integrative model that focuses on the cognitive–emotional dynamics at hand in the addictive course with the polydrug using patient, and rigorously implementing related assessment and therapeutic methods manifestly bears immediate and middle-term benefits. Evaluation of longer term benefits is recommended, along with larger scale quantitative outcome analyses. Further research and practice implications are discussed to this respect.
Clinical and neuroscientific insights suggest that emotion regulation (ER) is a core challenge for children with Attention Deficit Hyperactivity Disorder (ADHD). Relatively few empirical studies yet explicitly address ADHD children's ER. The conceptual and practical underpinnings of ER for ADHD youth's wellbeing also remain to be fully established. Objectives and aims: To assess basic and contextual emotion recognition in children with ADHD. To advance conceptual and practical insights into ADHD children's emotional development.
A subsample of ADHD children (n = 15) with comorbid learning problems and autism spectrum symptoms (ASS) made significantly more FER errors (t (26) = -2,578, p = 0,016), especially for happiness and anger, and doubted more their choices (t (26) = -2,147, p = 0,041). Another subsample of learning disordered ADHD children without ASS (n = 20) did not differ in basic FER compared to controls (n = 20) but was less efficient in contextualising emotions, especially anxiety, and in Theory of Mind. ADHD children's behavioural problems were inversely proportional to their emotion recognition skills.
Further investigation is warranted to identify which emotion regulation components are particularly challenging for bipolar patients according to subgroup differences. A scientist-practitioner model contributes to fostering therapeutic adherence and outcomes.
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