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2 results

  • 3 - The Disease Concept

  • from Part I - Identifying the Causes and Consequences of Disordered Substance Use
  • Perry M. Duncan, Old Dominion University, Virginia
  • Book:
    Substance Use Disorders
    Published online:
    18 September 2020
    Print publication:
    17 September 2020, pp 67-92

  • Summary

    A disease-based explanation of substance use disorders is dominant in many Western countries, especially in treatment settings. Acceptance of the disease concept of SUD reduces the shame and guilt of suffering individuals, a definite benefit for treatment of the disorder. Genetic and neurological factors are basic to the disease concept of SUD. However, less severe SUD can result from factors other than a disease process, and is better explained as a behavioral disorder. Even addiction – the most extremely disordered use of drugs – is influenced by developmental, experiential, and societal factors. Basic tenets of disease theory are of limited validity, including that SUD is always a primary disorder (not caused by a psychological disorder), that progression of the disorder is inevitable, and that addictive drug use is uncontrollable. Compulsive behavior and poor impulse control are common in SUD. However, many instances of drug use by addicted individuals require deliberation and apparent full control, especially when the behavior occurs in a non-drugged state. Judgment is often impaired by addiction, but behavior is rarely actually uncontrolled.

  • Validation of the Brazilian version of the Shame and Stigma Scale (SSS-Br) for patients with head and neck cancers

  • William Eduardo Pirola, Bianca Sakamoto Ribeiro Paiva, Cleyton Zanardo de Oliveira, Giancarlo Lucchetti, Alessandra Lamas Granero Lucchetti, David Kissane, Carlos Eduardo Paiva
  • Journal:
    Palliative & Supportive Care / Volume 18 / Issue 2 / April 2020
    Published online by Cambridge University Press:
    18 July 2019, pp. 186-192
  • Objective

    To evaluate the psychometric properties of the Brazilian version of the Shame and Stigma Scale (SSS) in a sample of patients with head and neck cancers (HNC).

    Methods

    This is a validation study carried out in a Brazilian cancer hospital. Patients over 18 years old who knew about their HNC diagnosis were consecutively recruited, answering the SSS, the Functional Assessment of Cancer Therapy (General and Head and Neck supplement) questionnaire, and the University of Washington Quality of Life Questionnaire. Internal consistency, test-retest procedure, convergent validity, and responsiveness analysis were the psychometric properties evaluated.

    Results

    A total of 122 HNC patients were included. The SSS showed appropriate internal consistency (alphas ranging from 0.71 to 0.86), test-retest reliability (higher than 0.92 with exception of the “Regret domain”), and convergent validity. The responsiveness analysis with 38 patients was able to discriminate the scores before and after prosthetic procedures.

    Significance of the Results

    The Brazilian Portuguese version of the SSS may be considered a valid and reliable instrument for the evaluation of Brazilian patients with HNC. Future SSS validation studies are welcome in other developing countries in order to make cancer health providers aware of these negative feelings in their HNC patients.