Prospective Risk Factors and Treatment Outcomes among Adolescents in DATOS-A

Abstract

The relationships between risk factors and outcomes in adolescents participating in the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A) were examined. The study included 292 admissions to nine outpatient drug-free (ODF) and 418 admissions to eight residential (RES) programs. Assessments were administered at intake into treatment and 12 months following discharge. For ODF participants, (a) severity of drug use predicted less retention in treatment, and (b) family drug involvement predicted more alcohol use after treatment. For RES participants, (a) family drug involvement and criminal involvement predicted less treatment retention, and (b) conduct disorder predicted more marijuana use at follow-up. The findings underscore the need for intervention strategies that address the intrapsychic and interpersonal functioning of drug-abusing adolescents to improve their behavioral outcomes.

Adolescents entering chemical dependency treatment in private managed care: ethnic differences in treatment initiation and retention

“…Family environment is critical; greater family involvement is associated with higher engagement and treatment retention [21,22]. Co-existing psychiatric problems, common in adolescents with substance use disorders, can impede treatment response; adolescents with greater psychiatric severity are more difficult to engage, spend less time in treatment [23,24], and experience poorer outcomes [23,25,26]. Greater alcohol and drug use severity is also associated with shorter retention [23].…”

“…Co-existing psychiatric problems, common in adolescents with substance use disorders, can impede treatment response; adolescents with greater psychiatric severity are more difficult to engage, spend less time in treatment [23,24], and experience poorer outcomes [23,25,26]. Greater alcohol and drug use severity is also associated with shorter retention [23]. African American and Asian American adolescents report lower problem severity than other ethnic groups [4,7,8], and Native American teens report greater alcohol and drug use severity and more psychiatric comorbidities [4,7,8].…”

Importancia del apoyo social en la permanencia de la abstinencia del consumo de drogas

“…Se encontró que por cada punto de incremento en la escala de autopercepción de apoyo social, el riesgo de recaída disminuye en tres puntos porcentuales. Estos resultados corroboran lo encontrado por otros autores que sustentan la hipótesis de que el apoyo familiar o social diferencian a consumidores de no consumidores [27][28][29] . Rhoads encontró, en individuos en tratamiento por adicción a heroína, que en aquellos que disponían de más soporte social disminuyó significativamente el consumo de heroína y otras drogas duras, así como los niveles de depresión y ansiedad 30 modelos por los cuales el apoyo social podría ejercer un efecto protector sobre la salud, existiendo evidencia consistente para ambos 12 .…”

Motivation for reducing substance use among minority adolescents: Targets for intervention

“…Some research suggests that higher levels of pretreatment substance use are predictive of poor treatment retention (Galaif et al, 2001) and outcome (Hsieh, Hoffman, & Hollister, 1998), whereas other research indicates that more severe pretreatment substance use actually predicts better treatment retention (Harrison & Asche, 2001) and outcome (Jainchill, Hawke, De Leon, & Yagelka, 2000) among teens. The relation between substance use severity and motivation to change substance use is no less ambiguous.…”

“…There is speculation that a variety of psychosocial and contextual factors may influence adolescents' motivation for change. For example, externalizing behavior disorders, such as conduct disorder, negatively impact treatment response and retention (Galaif, Hser, Grella, & Joshi, 2001;Kaminer, Tarter, Bukstein, & Kabene, 1992), but it is unclear whether externalizing disorders also influence a teen's motivation to reduce substance use behavior. Battjes, Gordon, O'Grady, Kinlock, and Carswell (2003) explored the relationship between motivation ("internal recognition of the need to change") and measures of deviant behavior, including a variety of conduct disorder symptoms, aggressive behavior, and days of illegal activities in the prior 90 days.…”