Substance Abuse Problems, Psychiatric Symptoms, and Post-Treatment Status in MCMI Psychopathology Subgroups of Cocaine Dependent Males

Abstract

This study involved cluster analysis of Millon Clinical Multiaxial Inventory-II (MCMI-II) records of 304 cocaine dependent males and examined differences among personality-based clusters in medical, legal, employment, drug, alcohol, family, and psychiatric problem severity at treatment intake and in outcome status during the 12 months after completion of residential drug treatment. A hierarchical cluster analysis (Ward's method) was used to identify 4 cluster subgroups: antisocial, subclinical, neurotic, and high psychopathology. MANOVA revealed that membership in Neurotic and High Psychopathology Cluster subgroups was linked with more severe family and psychiatric problems at treatment intake than found in the Subclinical Cluster Subgroup (all ps < .05). The High Psychopathology Cluster Subgroup also had more severe drug problems at intake than did the Subclinical Subgroup (p < .05). Logistic regression analysis revealed that membership in the High Psychopathology Subgroup predicted relapse/loss to follow-up status after controlling for age, education, ethnicity, treatment program attended, and pretreatment cocaine use frequency (X(2) = 21.25, df = 3, p < .001).

Abandono del tratamiento en adictos a la cocaína

“…Los estudios sobre los factores relacionados con la retención en los tratamientos para la adicción a la cocaína suelen incluir dos tipos de variables, las relacionadas con los pacientes y las relacionadas con el tratamiento. Dentro de los primeros, se ha encontrado que variables como la psicopatología asociada 8 , la edad, el empleo o el estado civil 9 , el sexo 10 , la satisfacción con el tratamiento 11 , las deficiencias cognitivas 12 o la impulsividad y la búsqueda de sensaciones 13 pueden estar asociadas a la retención. Los estudios sobre las variables relacionadas con el tratamiento sugieren que la mayor oferta en los servicios 14,15 , el empleo de servicios psiquiátricos 16,17 , una mayor intensidad en el tratamiento 18 , la alianza terapéu-tica 19 , la participación en grupos de autoayuda 20 , el nivel de implicación en las tareas de terapia entre sesiones 21 , el uso de disulfiram 22 , o el empleo de incentivos 23 pueden disminuir la retención e incrementar la abstinencia.…”

The effect of social desirability on reported motivation, substance use severity, and treatment attendance

“… 2 Research fairly consistently suggests associations between higher treatment attendance and both higher drug (Blood & Cornwall, 1994; Brecht, Greenwell, & Anglin, 2005; Zanis, Coviello, Lloyd, & Nazar, 2009) and psychiatric (Blood & Cornwall, 1994; Evans, Li, & Hser, 2009; Green, Polen, Dickinson, Lynch, & Bennett, 2002; Haller & Miles, 2004; Mangrum, 2009; McMahon, 2008; Petry & Bickel, 1999) severity, as well as associations between higher stage of change and alcohol and drug problem severity (Carpenter, Miele, & Hasin, 2002; Field, Adinoff, Harris, Ball, & Carroll, 2009; Maisto et al, 2011; Satre, Chi, Eisendrath, & Weisner, 2011). …”

Psychosocial Predictors of Relapse in Cocaine-Dependent Patients in Treatment

“…Research has identified numerous risk factors that predict cocaine use during or after treatment. Some of these factors include individual aspects, such as sociodemographic characteristics (Heinz, Wu, Witkiewitz, Epstein, & Preston, 2009), psychopathology (McMahon, 2008;Messina, Farabee, & Rawson, 2003;Tate et al, 2008;Waldrop, Back, Verduin, & Brady, 2007), addiction severity (McCamant, Zani, McFarland, & Gabriel, 2007;Poling, Kosten, & Sofuoglu, 2007), low self-efficacy (Dolan, Martin, & Rohsenow, 2008;Hser et al, 2006), craving (Weiss et al, 2003;Lopez et al, 2010), alcohol use (Alterman et al, 2000) or greater presence of psychosocial problems (Simpson, Joe, & Broone, 2002). Also, some treatment-related variables have been seen to be associated with better outcomes, such as greater service intensity and satisfaction (Grella, Hser, & Hsieh, 2003;Hser, Evans, Huang, & Anglin, 2004), use of psychiatric services (Ray, Weisner, & Mertens, 2005) or advice about legal matters (Hser, Joshi, Anglin, & Fletcher, 1999).…”