Impact of attention-deficit hyperactivity disorder and other psychopathology on treatment retention among cocaine abusers in a therapeutic community

Levin, Frances R.; Evans, Suzette M.; Vosburg, Suzanne K.; Horton, Terry; Brooks, Daniel J.; Ng, Jennifer

doi:10.1016/j.addbeh.2004.03.041

Cited by 102 publications

(90 citation statements)

References 5 publications

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“…A co-occurring ADHD diagnosis is also associated with an earlier onset and more severe course of a SUD, poorer treatment adherence, more difficulty achieving treatment goals and progress in treatment, and higher rates of relapse (Carroll and Rounseville, 1993;Wise et al, 2001;Levin et al, 2004;Wilens et al, 1997). In a study by Kolpe and Carlson, (2007), the presence of clinically significant ADHD symptoms just prior to admission to a methadone program was associated with a poorer outcome in that program.…”

Section: Introductionmentioning

confidence: 99%

Correlates of co-occurring ADHD in drug-dependent subjects: Prevalence and features of substance dependence and psychiatric disorders

Arias

Gelernter

Chan

et al. 2008

Addictive Behaviors

185

143

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We examined the prevalence and course of psychiatric and substance dependence (SD) disorders in subjects with SD and attention deficit hyperactivity disorder (ADHD).Method-We interviewed 1,761 adults with a lifetime diagnosis of cocaine and/or opioid dependence using the Semi-Structured Assessment for Drug Dependence and Alcoholism. Generalized linear regression with generalized estimating equation analysis was used to examine the associations between a lifetime diagnosis of ADHD and indicators of clinical course, and to identify unique correlates of ADHD.Results-Lifetime ADHD prevalence in the SD sample was 5.22% (vs. 0.85% in a group of individuals without SD). ADHD was associated with an earlier age of first substance use, more SD and psychiatric diagnoses, a greater likelihood of attempted suicide, and more hospitalizations. After controlling for conduct disorder and bipolar type I disorder, there were unique effects of ADHD on age of first substance use and number of SD diagnoses.Conclusion-In subjects with cocaine or opioid dependence, ADHD is associated with greater SD and psychiatric comorbidity and a more severe course of illness.

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Section: Introductionmentioning

confidence: 99%

Correlates of co-occurring ADHD in drug-dependent subjects: Prevalence and features of substance dependence and psychiatric disorders

Arias

Gelernter

Chan

et al. 2008

Addictive Behaviors

185

143

View full text Add to dashboard Cite

show abstract

“…De acuerdo con nuestro objetivo principal, la prevalencia de comorbilidad psicopatológica de este estudio a lo largo de la vida ha sido alta (61,8%) en un rango parecido a los estudios realizados sobre distintos tipos de muestras con personas consumidoras de cocaína, tanto en tratamiento ambulatorio como de comunidades terapéuticas, así como en población no clínica (Adamson, Tood, Sellman, Huriwai y Porter, 2006;Arias et al, 2012;Herrero et al, 2008;Levín, Evans, Vosburg, Horton y Brooks, 2004;Mardsen, Gossop, Stewart, Rolfe y Farrell, 2000;Swendsen et al, 2010;Tortajada et al,2012). Tanto los estudios llevados a cabo en población general como los de muestras clínicas refieren que la prevalencia de la concurrencia de trastornos por consumo de sustancias y otras psicopatologías es elevada, situándose entre el 15-80% (Nocon, Bergé, Astals, Martín-Santos y Rodríguez-Llera et al, 2006;).…”

Section: Discussionunclassified

Comorbilidad psicopatológica en consumidores de cocaína en tratamiento ambulatorio

et al. 2014

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“…Three studies focused solely on cocaine users in their research (Levin et al, 2004;Vergara-Moragues et al, 2012;Vergara-Moragues, González-Saiz, Lozano, & Verdejo García, 2013), and further three focused solely on opiate dependence (Dekel, Benbenishty, & Amram, 2004;Keen, Oliver, Rowse, & Mathers, 2001;Zoccali et al, 2007). Of the multi-substance studies, the classification methodology was widely varied.…”

Section: Drug Use Patternsmentioning

confidence: 99%

“…Vergara-Moragues, González-Saiz, Lozano, and Verdejo García (2012) found that 68.3% of residents stayed in treatment more than 90 days. Finally, Levin, Evans, Vosburg, Horton, Brooks, and Ng (2004) reported mean lengths of stay in three groups; no Axis I diagnosis, other Axis I diagnosis and ADHD (Ms = 49.1 weeks, 59.2 weeks, and 37.4 weeks, respectively).…”

Section: Retention and Dropout As Well As Mean Length Of Stay In Treamentioning

confidence: 99%

“…The studies in this review measured symptoms of depression (Dermatis et al, 2001) and stress (Marcus et al, 2009), and traits such as impulsivity (Bankston et al, 2009) and personality (Polimeni et al, 2010), but only two studies specifically investigated comorbid disorders (De Wilde et al, 2007;Levin et al, 2004). One example of a missed opportunity is Posttraumatic Stress Disorder (PTSD), which is known to be prevalent in TC samples (Gielen et al, 2012;Jacobsen et al, 2001;Yates & Wilson, 2001), yet was addressed by only one included study.…”

Section: Gaps In the Researchmentioning

confidence: 99%

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Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

Perryman¹

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The purpose of this body of research is twofold. First, to investigate posttraumatic stress disorder (PTSD) in a sample of adults undergoing substance use disorder (SUD) treatment in a therapeutic community (TC) and, second, to apply major psychological theories to help understand the nature of this comorbidity in ways that inform treatment. The focal theories of this research are: emotion dysregulation (Gratz & Roemer, 2004), and revised Reinforcement Sensitivity Theory (rRST; Corr, 2008;Gray & McNaughton, 2000). Rash Impulsiveness will be included as an important dimension of rRST that has been consistently linked to substance misuse. Chapter 1 presents an overview of research related to the thesis as a whole. In Chapter .72, p < .00). Furthermore, the correlations between PTSS and two of the facets of rRST, BAS and fight-flight-freeze sensitivity (FFFS), were significantly correlated (r = -.23 and .49, p < .01, respectively). BAS sensitivity was shown to negatively correlate with PTSS, indicating that lower BAS sensitivity related to higher PTS severity. No relationship was found between the Behavioural Inhibition System (BIS) and PTSS. Finally, Rash Impulsivity significantly correlated with PTSS at intake, r = .50, p < .00. Contrary to hypotheses, and previous research, Rash Impulsivity did not significantly correlate with retention. Theoretical mechanisms linking PTSS and substance misuse were investigated further, with tests of theoretical models in which individual difference factors (facets of the rRST) were related to retention and outcomes from treatment, and facets of emotional dysregulation were tested as mediators of this relationship. Upon investigation through linear regression, no suitable variable was found the mediate the relationship between PTSS and retention.iii The final moderated mediated model, therefore, was not suitable for this population. Limited moderation, though, occurred between the two facets of rRST and retention. Specifically, investigation of the simple slopes showed that FFFS and Rash Impulsivity both moderate the relationship between PTSD and retention at high (+1 SD) and mean scores. These findings indicate that high levels of both facets do interact with PTSD to negatively influence treatment retention.The null findings for both mediation and the moderated mediation model contradict previous research, and may be due to homogeneity in scores across the population. Overall, some implications for treatment can be extrapolated. First, PTSD is highly prevalent in the TC population, and should be assessed using psychometrically valid measures, such as the PCL-C, and addressed in treatment. Second, treatment for SUD does not exacerbate PTSD; on the contrary, PTSS significantly decreased during TC treatment. Finally, as there is solid theoretical support to suggest an influence of emotion dysregulation and Rash Impulsiveness on retention and outcomes, more research needs to be conducted on the role of these two constructs with the intent of creating a better suited rehabi...

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Impact of attention-deficit hyperactivity disorder and other psychopathology on treatment retention among cocaine abusers in a therapeutic community

Cited by 102 publications

References 5 publications

Correlates of co-occurring ADHD in drug-dependent subjects: Prevalence and features of substance dependence and psychiatric disorders

Correlates of co-occurring ADHD in drug-dependent subjects: Prevalence and features of substance dependence and psychiatric disorders

Comorbilidad psicopatológica en consumidores de cocaína en tratamiento ambulatorio

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

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