Posttraumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. We compared a behaviorally-specific comprehensive multiple-item traumatic event measure to a single-item measure to determine their impact on traumatic event identification and subsequent PTSD diagnosis. In a within-subject, counterbalanced design, the Traumatic Life Events Questionnaire (TLEQ; Kubany et al., 2000) was compared to the single-question traumatic event assessment in the Structured Clinical Interview for DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 1998) in 129 participants in opioid dependence treatment. The TLEQ produced a 9-fold higher rate of traumatic events reported by the participants as compared to the SCID. As a result, PTSD diagnoses in the sample increased to 33% after the TLEQ measure from 24% after the SCID. The increase in potential traumatic event identification and PTSD diagnosis was greater in women than men. This study provides strong support for the use of comprehensive traumatic event assessments to measure traumatic events and PTSD diagnoses, particularly in women.

Treatment-seeking opioid dependent individuals frequently report sleep-related problems (Dyer & White, 1997;Puigdollers et al., 2004). The present study provides a detailed assessment of sleep duration and quality in this population, including their effect on daily functioning and relationship to psychiatric severity and drug use. New admissions to opioid-agonist maintenance treatment (n = 113) completed a series of questionnaires to assess sleep functioning, psychiatric severity, and drug use due to sleep problems over the past 30-days. The results showed that study participants reported considerable sleep-related difficulties that had little effect on their appraisals of daily functioning. Nevertheless, sleep problems were associated with psychiatric distress, and those reporting substance use specifically to increase or decrease sleepiness endorsed more sleep problems and lower levels of daily functioning. Overall, these results replicate and extend previous work showing poor sleep functioning in this population, and show that sleep problems are associated with variables that often have an adverse impact on substance abuse treatment outcome.

Men have poorer health and declining social outcomes when compared to women, and research suggests that behaviors related to restrictive and traditional male gender roles contribute to this disparity. This study is an examination of The ManKind Project International (MKPI), a community-based organization that provides alternative male gender norms and a community support system to help reinforce them. The MKPI runs an intensive, experiential "Training Adventure Weekend" (TAW), followed by voluntary, on-going peer-led support and integration groups (I-Groups). One hundred men completed a pre-TAW questionnaire, an interview, and a long-term follow-up (>18 mo.) questionnaire. The study examined if there was change on the primary study variables at follow-up, and the relationship of background characteristics (age, self-help group experience) and factors related to participation (MKPI beliefs, social support, I-Group participation) to the criterion variables (depression symptoms, gender role conflict, and life satisfaction) at follow-up. Results indicated significant change in the expected directions on the primary study variables, suggesting that for these men, participation has a positive impact. Most importantly, changes in MKPI-related beliefs and social support significantly predicted positive outcomes. Also, more positive outcomes were found among men 30-44 years of age, but not among those with more prior self-help experience or I-Group participation. Possible explanations for these findings and directions for further research are discussed.

The present study evaluated psychiatric distress as a predictor of treatment enrollment in out-oftreatment injection opioid users newly registered at the Baltimore Needle Exchange Program (BNEP). Study participants (n = 281) completed the Addiction Severity Index (ASI), the Risk Assessment Battery (RAB), and the Symptom Checklist-90 (SCL-90-R), and were randomly assigned to one of three different conditions for 4-months that evaluated referral strategies designed to promote treatment interest and enrollment. The Global Severity Index (GSI) of the SCL-90 was used as a measure of psychiatric distress. A logistic regression showed that higher GSI scores predicted more treatment enrollment (Adjusted OR = 2.15, CI = 1.10 -4.23, p < .05), after controlling for study condition, demographic variables, syringe exchange site, and severity of drug use. The results suggest that the data from the assessment of psychiatric distress in syringe exchange settings can be used to support motivational strategies for encouraging syringe exchangers to seek substance abuse treatment.Keywords syringe exchange; psychiatric distress; substance abuse treatment I.0 IntroductionInjection drug users enrolled in community syringe exchange programs (SEPs) exhibit rates of other psychiatric disorders that are higher than reported in general population estimates (Brienza et al., 2000; Kessler et al., 2005;Kidorf et al., 2004). At least three practical concerns are associated with the high rates of psychiatric comorbidy in this subgroup of injection drug users. The first is that the psychiatric distress associated with the presence of other psychiatric disorders may further impair their already poor psychosocial functioning (e.g., Brooner et al., Phone: (410) Fax: (410) 550-2957, mkidorf@jhmi.edu. Contributors Drs. Kidorf and Brooner designed the study. Dr. Kidorf wrote the first draft of the manuscript. Ken Kolodner conducted the statistical analyses. Drs. Van King, Jessica Pierce, Christopher Burke, and Robert Brooner provided assistance with literature searches and editing subsequent drafts of the manuscript. All of the authors contributed to and have approved the final manuscript. Conflict of InterestAll authors declare that they have no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A relationship between psychiatric distress and treatment enrollment has been suggested across a number of epidemiological studies (Mojtabai et al., 2002; Ross, Linn, & Cunningham, 1999). Most recently, Cohen et al. (2007) showed that individuals with both an alcohol use disorder and a c...