Maltreatment Issues by Level of Adolescent Substance Abuse Treatment: The Extent of the Problem at Intake and Relationship to Early Outcomes

Abstract

Differences in self-reported victimization and outcomes for residential (n = 114) vs. outpatient (n = 73) substance abuse treatment samples were examined. Repeated measures MANOVAs for victimization level by level of care were performed on days of alcohol and marijuana use and substance-related problems. Residential treatment participants reported higher prevalence of victimization and higher levels of general victimization but did not differ on acute (high) victimization at intake. Analyses revealed a significant interaction between follow-up outcomes and level of care for adolescents with acute intake victimization. Adolescents placed in residential treatment were more likely to reduce their days of alcohol and marijuana use and past month substance-related problems at follow-up. Adolescents with low intake levels of victimization did not differ by level of care. Findings suggest that clinicians must carefully weigh placement recommendations for adolescents with maltreatment histories and that researchers should study ways to increase outpatient treatment effectiveness for these adolescents.

Experiences of victimization among adolescents with Substance Abuse Disorders in Sweden

“…These results agree with the results that have emerged in previous studies (13,20,28,(30)(31)(32). The prevalence of various types of exposure to violence is also generally high among the target group and varies from 11% to 45%.…”

“…A significant proportion of adolescents who enter substance abuse treatment have experienced victimization earlier in their lives (13,20,28,(30)(31)(32). Histories of multiple types of abuse are relatively common in this group, with between 40% and 90% of these patients having such backgrounds (5).…”

“…There seems to be a relationship between the severity of victimization and the seriousness of substance abuse; in other words, those who experience more severe forms and a higher frequency of victimization go on to use heavier drugs (13,20,26). It also seems that adolescents who have been exposed to more severe forms of abuse and violence are more likely to be found in inpatient care rather than outpatient care (13,30,31).…”

“…Some studies show that treatment outcomes of adolescents with a history of victimization do not generally differ from the outcomes of those who do not have such a history (13). In addition, the severity of victimization does not seem to have any impact on treatment, but adolescents who are placed in residential treatment appear to be more successful as compared with those who undergo outpatient treatment (30,31). Nevertheless, in general, high levels of alcohol and drug use seem to linger for a longer time among those who have been more severely victimized (30).…”

Victimization Among African-American Adolescents in Substance Abuse Treatment

“…It is widely established that victimization can be a traumatic life event, challenging an individual's resources and negatively impacting developmental processes (Kaukinen 2002). A large body of research shows that victimization among adolescents is associated with higher degrees of depressive symptoms, substance use, PTSD symptoms, suicidality, physical aggression, and delinquent behavior (Goldstein et al 2007;Sullivan, Farrell & Kliewer 2006;Champion et al 2004;Moran, Vuchinich & Hall 2004;Funk et al 2003;Grella & Joshi 2003; NIJ 2003;Liebschutz et al 2002;Caviola & Schiff 2000;Cleary 2000;Fitzpatrick & Bolidizar 1993).…”