Heterogeneity of person and place: Assessing co-occurring addictive and mental disorders.

Lehman, Michael

doi:10.1037/h0080152

Cited by 29 publications

(16 citation statements)

References 41 publications

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“…A formidable challenge to implementing treatment for people with a cooccurring disorder is the lack of a practical way of screening people for this comorbid disorder, as Lehman [4] pointed out the lack of screening and assessment for cooccurring disorders was an important barrier that prevented less than effective treatment reaching people with a cooccurring disorder. One approach that can be used to identify people with a cooccurring disorder is to conduct two assessments (one to identify a substance use disorder and one to detect a mental health disorder) on everyone who asks for help with a behavioral health disorder [5].…”

Section: The Need For An Integrated Screening Toolmentioning

confidence: 99%

The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity

Cherry

Dillon

2013

Journal of Addiction

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The principal barriers to universal screening for the cooccurring disorders of mental illness and substance abuse are training, time, cost, and a reliable and valid screen. Although many of the barriers to universal screening still remain intact, the lack of a cooccurring screen that is effective and can be administered in a cost efficient way is no longer an obstacle. This study examined the reliability, factor structure, and convergent validity of the 15-item AC-OK Cooccurring Screen. A total of 2,968 AC-OK Cooccurring Screens administrated to individuals who called or went to one of the nine participating mental health and substance abuse treatment facilities were administrated and analyzed. Principal axis factor (PAF) analysis was used in the confirmatory factor analysis to identify the common variance among the items in the scales while excluding unique variance. Cronbach's Alpha was used to establish internal consistency (reliability) of each subscale. Finally, the findings from the AC-OK Cooccurring Screen were compared to individual scores on two standardized reference measures, the addiction severity index and the Client assessment record (a measure of mental health status) to determine sensitivity and specificity. This analysis of the AC-OK Cooccurring Screen found the subscales to have excellent reliability, very good convergent validity, excellent sensitivity, and sufficient specificity to be highly useful in screening for cooccurring disorders in behavioral health settings. In this study, the AC-OK Cooccurring Screen had a Cronbach's Alpha of .92 on the substance abuse subscale and a Cronbach's Alpha of .80 on the mental health subscale.

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Section: The Need For An Integrated Screening Toolmentioning

confidence: 99%

The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity

Cherry

Dillon

2013

Journal of Addiction

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“…However, substance abuse and/or mental health care provided by general medical providers or primary care physicians may be inadequate (23,24). For instance, comorbid mood and anxiety disorders are more common among women with alcohol abuse or dependence than among their male counterparts (4,5), but general medical providers may fail to adequately assess the possibility of comorbid mental health or substance abuse problems and non-health-care agencies may be unable to provide a full-scale psychiatric assessment (24).…”

Section: Discussionmentioning

confidence: 99%

Alcohol Dependence and Use of Treatment Services Among Women in the Community

Wu¹,

Ringwalt²

2004

AJP

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Objective-This study examined the extent and characteristics of alcohol dependence and the perceived need for and use of alcohol treatment services among women compared with men in a nonclinical sample of adults 18-64 years of age.Method-Data were drawn from the 1999 National Household Survey on Drug Abuse. The authors calculated rates and correlates of alcohol dependence and treatment among adult alcohol users in this sample.Results-About 3% of the women in the survey met criteria for DSM-IV alcohol dependence in the previous year. About 13% of these women received alcohol treatment services in the same period. Only 8% of the women who did not receive treatment perceived a need for treatment. Younger women -those who were 18-25 years of age-were more likely to be dependent on alcohol but less likely to perceive a need for treatment or to use treatment services. Among alcohol-dependent women who received no treatment, those with a family income of $75,000 or more, those who had two or more children living with them, and those who were not dependent on psychotherapeutic medications were less likely to perceive a need for help.Conclusions-There were no significant differences between men and women in use of treatment services, location of services received, and perceived need for treatment. However, correlates of treatment service use varied somewhat by gender. These findings suggest that the goal of efforts to reduce barriers to alcohol treatment services should be to change people's attitudes toward alcohol abuse and seeking professional help.

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“…Either because of how they identify their chief complaint, or by the nature of their current crisis, people are likely to receive assistance for the problems that are typically addressed at their point of contact with services (Lehman et al 1994). Although there are challenges in developing accurate assessments for individuals with co-occurring disorders, the omission of any screening or assessment procedures has been the major barrier to effective intervention (Lehman 1996 Screening is the 'presumptive identification of unrecognized disease...by the application of tests, examinations or other procedures which can be applied rapidly to sort out apparently well persons who probably have a disease from those who probably do not.' Screens should address important health problems for which there are accepted and available diagnostic procedures and treatments.…”

Section: Introductionmentioning

confidence: 98%

Mental Health Screening in Addiction, Corrections and Social Service Settings: Validating the MMS

Alexander

Haugland

Shang

et al. 2007

Int J Ment Health Addiction

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Objective This paper tests the validity of a simple and easy to use scale, the Modified Mini Screen (MMS) to identify people with mental health problems in the treatment ecology for chemical dependency, including specialty sector substance abuse treatment settings, and shelters, jails and street community outreach programs. Methods Four hundred and seventy-six individuals in chemical dependency treatment and in jails, shelters and outreach settings completed a set of 22 items to screen for mental disorders-the MMS-and a validation interview-the Structured Clinical Interview for Diagnosis (SCID). ROC curve analysis was used to (1) determine the optimal range of cut points for identifying mental health problems in this culturally heterogeneous sample and wide range of treatment and community settings, and (2) calculate overall accuracy, sensitivity, specificity, and positive and negative predictive values for the MMS. Results Forty three percent of the sample met criteria for a DSM-IV diagnosis of anxiety, mood or psychotic disorder. At cut points of 6-9, the sensitivity of the MMS ranged from 0.63-0.82, its specificity ranged from 0.61-0.83, and its overall accuracy ranged from 70-75%. At these cut points, the MMS screen performed equally well for men and women, and for African Americans and Caucasians, and is comparable to the performance of other screens validated for less compromised populations. A decision tool has been developed based on these results that is available from the authors.

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Heterogeneity of person and place: Assessing co-occurring addictive and mental disorders.

Cited by 29 publications

References 41 publications

The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity

The AC-OK Cooccurring Screen: Reliability, Convergent Validity, Sensitivity, and Specificity

Alcohol Dependence and Use of Treatment Services Among Women in the Community

Mental Health Screening in Addiction, Corrections and Social Service Settings: Validating the MMS

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