Research update

CrossCurrents

Brains may recover after methamphetamine use
Changes in chemical activity in certain regions of the brains of former methamphetamine users who have not used the drug for a year or more suggest some recovery of neuronal structure and function, according to researchers at the University of California. Researchers compared eight methamphetamine users who had not used the drug for one to five years and 16 users who had not used the drug for one to six months with 13 non-users using proton magnetic resonance spectroscopy, which allows visualization of biochemical markers that are linked with brain neuron damage and recovery. The researchers measured markers in the anterior congulum cortex, which is associated with selective attention. Levels of N-acetylaspartate (NAA) were measured as a marker of the amount of damage. Choline (Cho), which is generated by the creation of new membranes, was measured as a marker of recovery. NAA levels were abnormally low in users and were relative to the length of use, but did not change relative to the amount of time users had been abstinent. Elevated Cho levels were found among users who had not used the drug in one to six months and normalized levels occurred in longer abstainers. The authors conclude, "When drug exposure is terminated, adaptive changes occur, which may contribute to some degree of normalization of neuronal structure and function."

Archives of General Psychiatry, April 2005, v. 62: 444-452. Thomas E. Nordahl et al., Department of Psychiatry and Behavioral Sciences, University of California, Davis.

Client, counsellor characteristics predict therapeutic alliance
Client and counsellor characteristics may predict the quality of therapeutic alliances, according to researchers at Manchester Metropolitan Univer-sity. The study recruited 187 clients aged 18-52 starting residential rehabilitation treatment in three UK services. Counsellor and client information was assessed at intake, and client and counsellor ratings of the alliance were obtained during weeks 1, 2 and 3. The intake assessment battery included scales on psychological well-being, treatment motivation, coping strategies and attachment style. Client and counsellor versions of the Working Alliance Inventory were used weekly. The study found that clients who had better motivation, coping strategies and social support and a secure attachment were more likely to develop good alliances. Findings around counsellor characteristics were less clear cut: Clients rated their relationships with ex-user counsellors, experienced counsellors and male counsellors as better, but more experienced counsellors rated their alliances as worse. The authors suggest that further studies need to establish whether the therapeutic alliance and treatment outcomes can be enhanced by working on improving clients' motivation and psychosocial resources.

Addiction, April, 2005, v. 100: 500-511. Petra S. Meier et al., Department of Psychology and Speech Pathology, Manchester Metropolitan University, Manchester, United Kingdom.

Not all smoking withdrawal symptoms due to nicotine
Smoking nicotine-free cigarettes may be sufficient for suppressing some tobacco withdrawal symptoms such as a desire for sweets, hunger and the urge to smoke, suggesting that the withdrawal smokers feel when trying to quit may not all be due to nicotine. Researchers at Virginia Commonwealth University studied 13 women and 19 men, aged 18-50, who participated in three, five-day conditions, in which they smoked either no cigarettes, nicotine-free cigarettes or cigarettes containing nicotine. Participants responded daily to a questionnaire assessing their urge to smoke, irritability, concentration, restlessness, craving, insomnia, increased eating and desire for sweets. Researchers also recorded heart rate, skin temperature and blood pressure. Researchers compared how participants felt when they did not smoke to how they felt when they smoked nicotinized cigarettes or nicotine-free cigarettes. When participants did not smoke, they experienced withdrawal and did not feel well. Participants who smoked nicotine-free cigarettes felt better but not as good as they felt when smoking nicotinized cigarettes. The authors conclude that non-nicotine factors play an important role in suppressing withdrawal and may be a valuable adjunct to nicotine replacement products.

Addiction, April 2005, v. 100: 550-559. August R. Buchhalter et al., Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia.

People with mental health issues turn to friends and family first
People with mental health issues are more likely to seek help from friends and family than health professionals, according to researchers at the Health Protection Agency South West in the United Kingdom. Researchers mailed the 12-item General Health Questionnaire (GHQ) to 15,222 members of the general population, aged 16 to 64. The response rate was 80 per cent for women and 71 per cent for men. Only 28 per cent of people with extremely high GHQ scores (eight or higher) sought help from their physician, although 78 per cent had sought some form of help. Of these, 67 per cent sought help from friends or family and 16 per cent turned to other health professionals or work-related individuals. Males, young people and people living in affluent areas were the least likely to seek help. The researchers suggest that health promotion interventions to encourage appropriate help-seeking in young people, particularly males, may lead to improvements in mental health.

British Journal of Psychiatry, April 2005, v. 186: 297-301. Maria Isabel Oliver et al., Health Protection Agency South West, Gloucestershire, United Kingdom.

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