Drugs and alcohol, dependence and recovery.
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Qurʾān
القرآن6 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 2:219Arabic sense: الخمر, خمر | English sense: intoxicant
۞يَسۡـَٔلُونَكَ عَنِ ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِۖ قُلۡ فِيهِمَآ إِثۡمࣱ كَبِيرࣱ وَمَنَٰفِعُ لِلنَّاسِ وَإِثۡمُهُمَآ أَكۡبَرُ مِن نَّفۡعِهِمَاۗ وَيَسۡـَٔلُونَكَ مَاذَا يُنفِقُونَۖ قُلِ ٱلۡعَفۡوَۗ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَتَفَكَّرُونَ
They ask you [Prophet] about intoxicants and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’ They ask you what they should give: say, ‘Give what you can spare.’ In this way, God makes His messages clear to you, so that you may reflect
Qur'ān 5:90Arabic sense: الخمر, خمر | English sense: intoxicant
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِنَّمَا ٱلۡخَمۡرُ وَٱلۡمَيۡسِرُ وَٱلۡأَنصَابُ وَٱلۡأَزۡلَٰمُ رِجۡسࣱ مِّنۡ عَمَلِ ٱلشَّيۡطَٰنِ فَٱجۡتَنِبُوهُ لَعَلَّكُمۡ تُفۡلِحُونَ
You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts- Satan’s doing- shun them so that you may prosper
Qur'ān 5:91English sense: intoxicant | Arabic sense: الخمر, خمر
إِنَّمَا يُرِيدُ ٱلشَّيۡطَٰنُ أَن يُوقِعَ بَيۡنَكُمُ ٱلۡعَدَٰوَةَ وَٱلۡبَغۡضَآءَ فِي ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِ وَيَصُدَّكُمۡ عَن ذِكۡرِ ٱللَّهِ وَعَنِ ٱلصَّلَوٰةِۖ فَهَلۡ أَنتُم مُّنتَهُونَ
With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up
Qur'ān 12:41Arabic sense: خمر | English sense: wine
يَٰصَٰحِبَيِ ٱلسِّجۡنِ أَمَّآ أَحَدُكُمَا فَيَسۡقِي رَبَّهُۥ خَمۡرࣰ اۖ وَأَمَّا ٱلۡأٓخَرُ فَيُصۡلَبُ فَتَأۡكُلُ ٱلطَّيۡرُ مِن رَّأۡسِهِۦۚ قُضِيَ ٱلۡأَمۡرُ ٱلَّذِي فِيهِ تَسۡتَفۡتِيَانِ
Fellow prisoners, one of you will serve his master with wine; the other will be crucified and the birds will peck at his head. That is the end of the matter on which you asked my opinion.’
Qur'ān 47:15Arabic sense: خمر | English sense: wine
مَّثَلُ ٱلۡجَنَّةِ ٱلَّتِي وُعِدَ ٱلۡمُتَّقُونَۖ فِيهَآ أَنۡهَٰرࣱ مِّن مَّآءٍ غَيۡرِ ءَاسِنࣲ وَأَنۡهَٰرࣱ مِّن لَّبَنࣲ لَّمۡ يَتَغَيَّرۡ طَعۡمُهُۥ وَأَنۡهَٰرࣱ مِّنۡ خَمۡرࣲ لَّذَّةࣲ لِّلشَّٰرِبِينَ وَأَنۡهَٰرࣱ مِّنۡ عَسَلࣲ مُّصَفࣰّ ىۖ وَلَهُمۡ فِيهَا مِن كُلِّ ٱلثَّمَرَٰتِ وَمَغۡفِرَةࣱ مِّن رَّبِّهِمۡۖ كَمَنۡ هُوَ خَٰلِدࣱ فِي ٱلنَّارِ وَسُقُواْ مَآءً حَمِيمࣰ ا فَقَطَّعَ أَمۡعَآءَهُمۡ
Here is a picture of the Garden promised to the pious: rivers of water forever pure, rivers of milk forever fresh, rivers of wine, a delight for those who drink, rivers of honey clarified and pure, [all] flow in it; there they will find fruit of every kind; and they will find forgiveness from their Lord. How can this be compared to the fate of those stuck in the Fire, given boiling water to drink that tears their bowels
Qur'ān 12:36Arabic sense: خمر
وَدَخَلَ مَعَهُ ٱلسِّجۡنَ فَتَيَانِۖ قَالَ أَحَدُهُمَآ إِنِّيٓ أَرَىٰنِيٓ أَعۡصِرُ خَمۡرࣰ اۖ وَقَالَ ٱلۡأٓخَرُ إِنِّيٓ أَرَىٰنِيٓ أَحۡمِلُ فَوۡقَ رَأۡسِي خُبۡزࣰ ا تَأۡكُلُ ٱلطَّيۡرُ مِنۡهُۖ نَبِّئۡنَا بِتَأۡوِيلِهِۦٓۖ إِنَّا نَرَىٰكَ مِنَ ٱلۡمُحۡسِنِينَ
Two young men went into prison alongside him. One of them said, ‘I dreamed that I was pressing grapes’; the other said, ‘I dreamed that I was carrying bread on my head and that the birds were eating it.’ [They said], ‘Tell us what this means- we can see that you are a knowledgeable man.’
Research library, full list
551 to 575 of 1,310Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: emerging evidence.
Delay discounting describes the devaluation of a reinforcer as a function of the delay until its receipt. Although all people discount delayed reinforcers, one consistent finding is that substance-dependent individuals tend to discount delayed reinforcers more rapidly than do healthy controls. Moreover, these higher-than-normal discounting rates have been observed in individuals with other behavioral maladies such as pathological gambling, poor health behavior, and overeating. This suggests that high rates of delay discounting may be a trans-disease process (i.e., a process that occurs across a range of disorders, making findings from one disorder relevant to other disorders). In this paper, we argue that delay discounting is a trans-disease process, undergirded by an imbalance between two competing neurobehavioral decision systems. Implications for our understanding of, and treatment fo…
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Resting state functional connectivity in addiction: Lessons learned and a road ahead.
Despite intensive scientific investigation and public health imperatives, drug addiction treatment outcomes have not significantly improved in more than 50 years. Non-invasive brain imaging has, over the past several decades, contributed important new insights into the neuroplastic adaptations that result from chronic drug intake, but additional experimental approaches and neurobiological hypotheses are needed to better capture the totality of the motivational, affective, cognitive, genetic and pharmacological complexities of the disease. Recent advances in assessing network dynamics through resting-state functional connectivity (rsFC) may allow for such systems-level assessments. In this review, we first summarize the nascent addiction-related rsFC literature and suggest that in using this tool, circuit connectivity may inform specific neurobiological substrates underlying psychological…
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Cognitive training for impaired neural systems in neuropsychiatric illness.
Neuropsychiatric illnesses are associated with dysfunction in distributed prefrontal neural systems that underlie perception, cognition, social interactions, emotion regulation, and motivation. The high degree of learning-dependent plasticity in these networks-combined with the availability of advanced computerized technology-suggests that we should be able to engineer very specific training programs that drive meaningful and enduring improvements in impaired neural systems relevant to neuropsychiatric illness. However, cognitive training approaches for mental and addictive disorders must take into account possible inherent limitations in the underlying brain 'learning machinery' due to pathophysiology, must grapple with the presence of complex overlearned maladaptive patterns of neural functioning, and must find a way to ally with developmental and psychosocial factors that influence re…
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Food and drug reward: overlapping circuits in human obesity and addiction.
Both drug addiction and obesity can be defined as disorders in which the saliency value of one type of reward (drugs and food, respectively) becomes abnormally enhanced relative to, and at the expense of others. This model is consistent with the fact that both drugs and food have powerful reinforcing effects-partly mediated by dopamine increases in the limbic system-that, under certain circumstances or in vulnerable individuals, could overwhelm the brain's homeostatic control mechanisms. Such parallels have generated significant interest in understanding the shared vulnerabilities and trajectories between addiction and obesity. Now, brain imaging discoveries have started to uncover common features between these two conditions and to delineate some of the overlapping brain circuits whose dysfunctions may explain stereotypic and related behavioral deficits in human subjects. These results …
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The SEEKING mind: primal neuro-affective substrates for appetitive incentive states and their pathological dynamics in addictions and depression.
Appetitive motivation and incentive states are essential functions sustained by a common emotional brain process, the SEEKING disposition, which drives explorative and approach behaviors, sustains goal-directed activity, promotes anticipatory cognitions, and evokes feelings of positive excitement which control reward-learning. All such functions are orchestrated by the same "archetypical" neural processes, activated in ancient subcortical areas and transported to the forebrain by the mesolimbic dopamine (ML-DA) system. In mammals, the neurophysiology of the SEEKING urge is expressed by DA-promoted high-frequency oscillations, in the form of transient and synchronized gamma waves (>30Hz) emerging in limbic forebrain and diffusing throughout basal ganglia-thalamocortical (BG-T-C) circuits. These patterns may be considered basic "SEEKING neurodynamic impulses" which represent the primary-pr…
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Detar DT (2011)reviewMEDLINE-indexed journal, not yet read by usPrimary care3 citations Alcoholics anonymous and other twelve-step programs in recovery.
Recovery is a new way of life for many patients; a life without substances to alter their moods but with a major change improving the physical, psychological, and emotional stability with improved overall health outcomes. The Twelve Steps of the Alcoholics Anonymous (AA) are the foundation of the AA, describing both the necessary actions and the spiritual basis for the recovery program of the AA. The Twelve Steps of the AA provide a structure for which a patient with alcoholism may turn for an answer to their problem of alcohol use, abuse, or dependence.
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Enoch MA (2011)reviewMEDLINE-indexed journal, not yet read by usPsychopharmacology441 citations The role of early life stress as a predictor for alcohol and drug dependence.
Rationale: Genetic and environmental influences on the development of alcohol and drug dependence are equally important. Exposure to early life stress, that is unfortunately common in the general population, has been shown to predict a wide range of psychopathology, including addiction.
Objective: This review will look at the characteristics of early life stress that may be specific predictors for adolescent and adult alcohol and drug dependence and will focus on studies in humans, non-human primates and rodents.
Results: Experiencing maltreatment and cumulative stressful life events prior to puberty and particularly in the first few years of life is associated with early onset of problem drinking in adolescence and alcohol and drug dependence in early adulthood. Early life stress can result in permanent neurohormonal and hypothalamic-pituitary-adrenal axis changes, morphological changes…
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Not supposed to feel this: traditional masculinity in psychotherapy with male veterans returning from Afghanistan and Iraq.
Traditional masculine socialization presents challenges in psychotherapy, for example, by decreasing the likelihood of help-seeking and by making emotion-laden content more difficult to address. While this has been established in civilian populations, more intense forms of masculine socialization found in military settings may amplify such issues in male veteran populations. Male veterans returning from and Afghanistan (OEF) and Iraq (OIF) exhibit strong traditional masculine socialization and generally present in a unique manner. It is posited that OEF/OIF male veterans' unique presentation is in large part because of an interaction between high degrees of endorsement of traditional masculine gender role norms, relative youth, recency of distressing events, and recent experience in the social context of the military where traditional masculinity is reinforced. The impact of these variab…
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Adolescent brain development and the risk for alcohol and other drug problems.
Dynamic changes in neurochemistry, fiber architecture, and tissue composition occur in the adolescent brain. The course of these maturational processes is being charted with greater specificity, owing to advances in neuroimaging and indicate grey matter volume reductions and protracted development of white matter in regions known to support complex cognition and behavior. Though fronto-subcortical circuitry development is notable during adolescence, asynchronous maturation of prefrontal and limbic systems may render youth more vulnerable to risky behaviors such as substance use. Indeed, binge-pattern alcohol consumption and comorbid marijuana use are common among adolescents, and are associated with neural consequences. This review summarizes the unique characteristics of adolescent brain development, particularly aspects that predispose individuals to reward seeking and risky choices du…
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Clinical assessment and diagnosis of adults with attention-deficit/hyperactivity disorder.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder in adult psychiatry, particularly in out-patient settings. There are no objective, laboratory-based tests that can establish this diagnosis. Present diagnostic criteria for ADHD are formulated primarily according to behavior in childhood, based on age inappropriate and impairing levels of hyperactivity, impulsivity and inattention. Other symptoms, such as mood instability and frustration intolerance, are not included in current criteria for ADHD, but are very prevalent in this patient group. ADHD is often comorbid with alcohol and substance abuse and other psychiatric disorders, in particular anxiety and personality disorders. Thus, the diagnostic assessment should both include a comprehensive clinical interview, rating scales for past and present symptoms and collateral information from multiple informants, as well …
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Laxative abuse: epidemiology, diagnosis and management.
Laxatives have been used for health purposes for over 2000 years, and for much of that time abuse or misuse of laxatives has occurred. Individuals who abuse laxatives can generally be categorized as falling into one of four groups. By far the largest group is made up of individuals suffering from an eating disorder such as anorexia or bulimia nervosa. The prevalence of laxative abuse has been reported to range from approximately 10% to 60% of individuals in this group. The second group consists of individuals who are generally middle aged or older who begin using laxatives when constipated but continue to overuse them. This pattern may be promulgated on certain beliefs that daily bowel movements are necessary for good health. The third group includes individuals engaged in certain types of athletic training, including sports with set weight limits. The fourth group contains surreptitious…
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The insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making.
We have recently shown that damage to the insula leads to a profound disruption of addiction to cigarette smoking (Naqvi et al., Science 315:531-534, 2007). Yet, there is little understanding of why the insula should play such an important role in an addictive behavior. A broad literature (much of it reviewed in this issue) has addressed the role of the insula in processes related to conscious interoception, emotional experience, and decision-making. Here, we review evidence for the role of the insula in drug addiction, and propose a novel theoretical framework for addiction in which the insula represents the interoceptive effects of drug taking, making this information available to conscious awareness, memory and executive functions. A central theme of this framework is that a primary goal for the addicted individual is to obtain the effects of the drug use ritual upon the body, and rep…
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Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems.
Tobacco use exerts a huge toll on persons with mental illnesses and substance abuse disorders, accounting for 200,000 of the annual 443,000 annual tobacco-related deaths in the United States. Persons with chronic mental illness die 25 years earlier than the general population does, and smoking is the major contributor to that premature mortality. This population consumes 44% of all cigarettes, reflecting very high prevalence rates plus heavy smoking by users. The pattern reflects a combination of biological, psychosocial, cultural, and tobacco industry-related factors. Although provider and patient perspectives are changing, smoking has been a historically accepted part of behavioral health settings. Additional harm results from the economic burden imposed by purchasing cigarettes and enduring the stigma attached to smoking. Tailored treatment for this population involves standard cessat…
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Lateral hypothalamic orexin/hypocretin neurons: A role in reward-seeking and addiction.
Orexins (synonymous with hypocretins) are recently discovered neuropeptides made exclusively in hypothalamus. Behavioral, anatomical, and neurophysiological studies show that a subset of these cells, specifically those in lateral hypothalamus (LH), are involved in reward processing and addictive behaviors. Fos expression in LH orexin neurons varied in proportion to conditioned place preference (CPP) for morphine, cocaine, or food. This relationship occurred both in drug-naïve rats and in animals during protracted morphine withdrawal, when drug preference was elevated but food preference was decreased. Inputs to the LH orexin cell field from lateral septum and bed nucleus of the stria terminalis were Fos-activated during cocaine CPP in proportion to the preference expressed in each animal. This implies that these inputs may be involved in driving the conditioned responses in LH orexin neu…
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Baca CT, Yahne CE (2009)reviewMEDLINE-indexed journal, not yet read by usJournal of substance abuse treatment176 citations Smoking cessation during substance abuse treatment: what you need to know.
Patients in substance abuse treatment frequently smoke cigarettes and often die of tobacco-related causes. Substance abuse treatment programs too often ignore tobacco use. Many patients have expressed interest in stopping smoking, although they may be ambivalent about smoking cessation during substance abuse treatment. This article provides a review of tobacco cessation literature and successful methods of intervention. Research supports two key findings: (a) smoking cessation during substance abuse treatment does not impair outcome of the presenting substance abuse problem and (b) smoking cessation may actually enhance outcome success. We will discuss how to incorporate smoking cessation.
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Role of lateral hypothalamic orexin neurons in reward processing and addiction.
Orexins (also known as hypocretins) are recently discovered neuropeptides made exclusively in hypothalamic neurons that have been shown to be important in narcolepsy/cataplexy and arousal. Here, we conducted behavioral, anatomical and neurophysiological studies that show that a subset of these cells, located specifically in lateral hypothalamus (LH), are involved in reward processing and addictive behaviors. We found that Fos expression in LH orexin neurons varied in proportion to preference for morphine, cocaine or food. This relationship obtained both in drug naïve rats and in animals during protracted morphine withdrawal, when drug preference was elevated but food preference was decreased. Recent studies showed that LH orexin neurons that project to ventral tegmental area (VTA) have greater Fos induction in association with elevated morphine preference during protracted withdrawal tha…
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Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury.
Soldiers with a traumatic brain injury (TBI) present with an array of neuropsychiatric symptoms that can be grouped into nosological clusters: (1) cognitive dysfunctions: difficulties in memory, attention, language, visuospatial cognition, sensory-motor integration, affect recognition, and/or executive function typically associated with neocortical damage; (2) neurobehavioral disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as agitation, sleep problems, and libido loss, that may have been caused by damage to the cortex, limbic system, and/or brain stem monoaminergic projection systems; (3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium, taste, and somatosensory perception frequently caused by trauma to the sensory organs or their projections through the brain stem to central processing systems; (4) somatic symptoms: headache and chro…
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De Santis JP (2009)reviewMEDLINE-indexed journal, not yet read by usThe Journal of the Association of Nurses in AIDS Care : JANAC115 citations HIV infection risk factors among male-to-female transgender persons: a review of the literature.
Male-to-female (MTF) transgender women experience a host of psychosocial issues such as discrimination, stigmatization, and marginalization. These challenges often limit economic opportunities, affect mental health, and may place members of this population at an increased risk for HIV infection. This report presents a review of the literature that focuses on risk factors for HIV infection specific to the MTF population. Factors including needle sharing and substance abuse, high-risk sexual behaviors, commercial sex work, health care access, lack of knowledge regarding HIV transmission, violence, stigma and discrimination, and mental health issues have been identified in the literature as risk factors for the acquisition of HIV infection by members of this population. Implications for care provided to MTF transgender persons are presented, and suggestions for future research are identifie…
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The role of interoception and alliesthesia in addiction.
This review presents a novel conceptualization of addiction, integrating the concepts of interoception (i.e., the CNS representation of visceral feelings) and alliesthesia (i.e., that rewarding properties of stimuli are dependent on the internal state of the individual) with existing theories. It is argued that the body state, as defined by the integration of interoceptive information, is a crucial arbiter of the risk for initiation of and transition to compulsive use of addictive compounds. Overall, individuals at risk for drug dependence are characterized by an altered internal bodily state that leads to a change in hedonic and incentive motivational properties of addictive drugs. Specifically, drug dependent individuals experience alliesthesia of interoceptive processing, leading to increased incentive motivational properties of the drug over time and thereby increasing the probabilit…
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Kalivas PW (2009)reviewMEDLINE-indexed journal, not yet read by usNature reviews. Neuroscience1,026 citations The glutamate homeostasis hypothesis of addiction.
Addiction is associated with neuroplasticity in the corticostriatal brain circuitry that is important for guiding adaptive behaviour. The hierarchy of corticostriatal information processing that normally permits the prefrontal cortex to regulate reinforcement-seeking behaviours is impaired by chronic drug use. A failure of the prefrontal cortex to control drug-seeking behaviours can be linked to an enduring imbalance between synaptic and non-synaptic glutamate, termed glutamate homeostasis. The imbalance in glutamate homeostasis engenders changes in neuroplasticity that impair communication between the prefrontal cortex and the nucleus accumbens. Some of these pathological changes are amenable to new glutamate- and neuroplasticity-based pharmacotherapies for treating addiction.
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Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior.
Disruptive physician behavior may diminish productivity, lead to medical errors, and compromise patient safety. The purpose of this paper is to review how common psychological conditions such as depression, stress, and burnout may drive disruptive behavior in the workplace and result in impaired patterns of professional conduct similar to what is seen with substance abuse. Problems related to these psychological morbidities may be more effectively managed with improved understanding of the conditions and behaviors, their associated risk factors, and the barriers that exist to reporting them. Further research and educational programs are warranted to address how these conditions might affect radiology.
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Pachter LM, Coll CG (2009)reviewMEDLINE-indexed journal, not yet read by usJournal of developmental and behavioral pediatrics : JDBP185 citations Racism and child health: a review of the literature and future directions.
Objective: Racism is a mechanism through which racial/ethnic disparities occur in child health. To assess the present state of research into the effects of racism on child health, a review of the literature was undertaken.
Methods: A MEDLINE review of the literature was conducted between October and November 2007. Studies reporting on empirical research relating to racism or racial discrimination as a predictor or contributor to a child health outcome were included in this review. The definition of "child health" was broad and included behavioral, mental, and physical health.
Results: Forty articles describing empirical research on racism and child health were found. Most studies (65%) reported on research performed on behavioral and mental health outcomes. Other areas studied included birth outcomes, cardiovascular and metabolic diseases, and satisfaction with care. Most research has be…
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Attention-deficit-hyperactivity disorder: an update.
Attention-deficit-hyperactivity disorder (ADHD) is a common neuropsychiatric disorder that impairs social, academic, and occupational functioning in children, adolescents, and adults. In patients with ADHD, neurobiologic research has shown a lack of connectivity in key brain regions, inhibitory control deficits, delayed brain maturation, and noradrenergic and dopaminergic dysfunction in multiple brain regions. The prevalence of this disorder in the United States is 6-9% in youth (i.e., children and adolescents) and 3-5% in adults. Prevalence rates for youth are similar worldwide. Children with ADHD are at greater risk than children without ADHD for substance abuse and delinquency whether or not they receive drug therapy; however, early treatment with psychoeducation as well as drug therapy and/or behavioral intervention may decrease negative outcomes of ADHD, including the rate of conduc…
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Cancer pain and analgesia.
Pain ranges in prevalence from 14-100% among cancer patients and occurs in 50-70% of those in active treatment. Cancer pain may result from direct invasion of tumor into nerves, bones, soft tissue, ligaments, and fascia, and may induce visceral pain through distension and obstruction. Cancer pain is multifaceted. Clinicians may describe cancer pain as acute, chronic, nociceptive (somatic), visceral, or neuropathic. Despite implementation of the WHO guidelines, reports of undertreatment of cancer pain persist in various clinical settings and in spite of decades of work to reduce unnecessary discomfort. Substantial obstacles to adequate pain relief with opioids include specific concerns of patients themselves, their family members, physicians, nurses, and the healthcare system. The WHO analgesic ladder serves as the mainstay of treatment for the relief of cancer pain in concert with tumori…
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Engstrom M (2008)reviewMEDLINE-indexed journal, not yet read by usFamily process16 citations Involving caregiving grandmothers in family interventions when mothers with substance use problems are incarcerated.
The alarming rate of incarceration of women disproportionately affects women of color, frequently intersects with the women's substance use problems, and often results in grandmothers providing care for their grandchildren during their daughters' incarceration. Numerous factors complicate the grandmothers' caregiving experiences and contribute to strains that exceed those typically associated with grandparent caregiving. Such complicating factors include the stresses associated with their daughters' substance use problems and incarceration; the complex biopsychosocial needs of many of their grandchildren; the challenging relational issues they must address; and often, the long-term, multifaceted effects of poverty. Despite the critical roles they play, the multiple vulnerabilities they face, and the potential for multigenerational, culturally relevant family interventions to yield gains …
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