Diagnostic interviewing with drug abusers.

Principles of diagnostic interviewing with adult male drug abusers are discussed in the light of changing concepts of addiction/dependency, confidentiality, and countertransference, and basic research relevant to each major content section is highlighted. A case example illustrates these ideas, and the article concludes with some practical recommendations for interviewing substance abusers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vocational rehabilitation of drug abusers.

Employment has been identified as an important element in the rehabilitation of drug abusers and, together with abstinence from illicit drugs and criminal involvement, is frequently used as a criterion of treatment outcome. The research literature for the last 20 years on variables affecting employment and the vocational rehabilitation of drug abusers is reviewed with an emphasis on (a) the identification of variables influencing the employment of drug abusers and (b) the evaluation results of interventions that have been developed for this purpose. It is concluded that a number of programs have been demonstrated to have had some success in the vocational rehabilitation of drug abusers. Specific recommendations are made concerning both the direction of further research in this area and the application of existing knowledge in current practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family ties of drug abusers.

Examined the family ties of heroin addicts applying for drug treatment. Information was abstracted from the intake applications of 98 consecutive admissions to methadone maintenance program to determine the extent to which applicants were connected with family members. Results indicate that approximately 67% of Ss lived with a family member, including 26% who lived with a parent; 52% of Ss were born in the local area; 75% claimed to have close relationships with their mothers. Results imply that drug treatment programs might increase their effectiveness by using a family systems approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An MMPI comparison of polydrug and heroin abusers.

Researchers recently have resurrected the relevance of the addiction-prone personality hypothesis for explaining drug abuse by faulting previous studies for failing to control non-drug-related S background characteristics. This notion was tested by comparing MMPI clinical and content scores of 122 polydrug and 132 heroin abusers under conditions in which covariates were controlled and not controlled. The covariates age, education, socioeconomic status, and admission status interacted significantly but did not change results. Polydrug abusers consistently scored higher than heroin users on clinical scales, but differences for multivariate ANOVAs and analyses of covariance were either not significant or not large enough to be clinically meaningful. The variety of personality types found for both heroin and polydrug abusers is interpreted as refuting the notion that one personality type is addiction-prone. Contributions of personality to drug abuse remain suspected but as yet unspecified. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality characteristics of male spouse abusers.

84 men in abusive or nonabusive but distressed relationships completed the Millon Clinical Multiaxial Inventory—II (MCMI—II), the State-Trait Anger Scale (S-TAS), the Child's Attitude Toward Mother–Father, and the Narcissistic Personality Inventory. Results indicate that abusive men represent a heterogeneous group and show greater elevations on certain subscales of the MCMI—II and S-TAS. Abusive men viewed their paternal relationships more negatively and as children had witnessed more conflict between their parents. Results are consistent with previous research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality characteristics of incarcerated speed abusers.

Compared the personality characteristics of 105 offenders, comprising 2 groups of speed users, a multidrug group and a nonuser group, on the MMPI. There were marked similarities in the MMPI profiles of these groups which did not support the claim that speed abusers have distinct personality traits. Also, the degree of drug use and situational-motivational variables were not related to MMPI profile elevation. Results are discussed in relation to other drug abuse personality research. Recommendations for future research are outlined. (French summary) (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug preferences of multiple drug abusers.

Attempted to develop a reliable measure of preferences among types of controlled drugs, and examined the correspondence between the most preferred drug and the drug most frequently used. 130 17–29 yr old active multiple drug abusers rated their preferences among 11 combinations of controlled drugs and common methods of administration (e.g., smoking marihuana, snorting cocaine, shooting cocaine, injesting amphetamines, shooting amphetamines) using the method of paired comparisons. Edwards' coefficient of consistency indicated that preferences were highly consistent (.92) and therefore internally reliable. Nearly half of the Ss most preferred drugs other than the type that they most frequently used, and their preferences were related to the method of administration. Results suggest that preference is one of several determinants of drug use. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem gambling and violence among community-recruited female substance abusers.

Problem gambling (PG) may be associated with depression, victimization, and violence characterizing a substance-abusing lifestyle. The study explored associations of PG with these correlates among heavy-drinking and drug-using out-of-treatment women recently enrolled in 2 National Institutes of Health-funded, community-based HIV prevention trials. Female substance abusers with PG (n = 180) and without PG (NPG; n = 425) were examined according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Whereas PGs had higher rates of each correlate than did NPGs, significant associations existed for antisocial personality disorder, specifically for violent tendencies. Logistic regression indicated that substance abusers with violent tendencies were about 3 times as likely as those without such tendencies to be PGs, after controlling for sociodemographics. Future research addressing whether underlying constructs, confounding variables, or interactions exist will further specify PG risk and inform prevention and intervention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal and emotional problem solving among narcotic drug abusers.

"Real-life" interpersonal and emotional problem solving was measured in 40 narcotics abusers in ambulatory treatment, 20 in "good" standing and 20 in "poor" standing. A modified means–ends problem-solving procedure was used that required narrative responses containing relevant means (RMs) for solving 7 problems. Good Ss had more total RMs, used more introspective and emotional RMs, were better at RM recognition, but did not have more sufficient narratives than the poor Ss. Results are consistent with those of previous studies of problem-solving thinking. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caregiver stability and day care.

Two studies examined the responses of 44 12–28 mo old children to stable and nonstable caregivers in laboratory and day-care environments. The environmental context was critical to whether children evidenced a preference between caregivers. Ss revealed a preference for stable over nonstable caregivers only in the day-care setting. In the laboratory many Ss either did not approach caregivers or approached them only as a last resort. Most preferred to spend time in proximity to the mother and were often upset when left with caregivers. At the day-care center most Ss did not become distressed or attempt to follow the mother when left with caregivers. The need for research on factors that may influence day-care quality is discussed. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A typology of alcohol abusers: Correlates and implications.

Used data from 725 individuals (mean age 38.1 yrs) seeking help for alcohol-related problems who had been administered the Michigan Alcoholism Screening Test; the Social Readjustment Rating Scale; the Personality Research Form; Rotter's Internal–External Locus of Control Scale; the Standard Progressive Matrices; the Vocabulary and Digit Symbol subscales of the WAIS; and measures of alcohol use, lifetime drinking history, basic personality, SES variables, and response styles to cluster analyze for types of drinkers. Analysis yielded 3 types: Type 1 Ss (early-stage problem drinkers) represented a fairly heterogeneous group, Type 2 Ss (affiliative, moderately dependent drinkers) were more socially oriented and drank on a daily basis, and Type 3 Ss (schizoid, severely dependent drinkers) were socially isolative, tended to drink in binges, and reported the most severe symptoms of alcoholism. A speculative model is proposed that consists of the 3 types superimposed on an underlying continuum of alcohol dependence; it is suggested that the model has heuristic value for stimulating further research on the etiology and differential treatment of alcohol abuse. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delayed nonmatch-to-sample performance in HIV-seropositive and HIV-seronegative polydrug abusers.

Working memory (WM) deficits are common in HIV-seropositive (HIV+) individuals and can be amplified by manipulating a variety of task parameters, such as increasing memory load or information complexity. The authors investigated the role of timing in HIV-associated WM defects by varying the amount of time required to maintain information online while holding memory load and information complexity constant. The authors studied 50 HIV+ and 35 HIV-seronegative (HIV-) polydrug abusers abstinent at testing and well-matched on demographic variables. The HIV- group outperformed the HIV+ group across all stimulus-response time delays. HIV-associated WM defects are not critically dependent on the amount of time stimulus representations must be maintained and might be attributed to impaired encoding or retrieval of stimulus representations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social skill deficit interventions for substance abusers.

Because substance abusers demonstrate significant cognitive and behavioral skill deficits, 2 social competency models of habilitation are proposed to increase abusers' life management skills and coping abilities. Social problem-solving training programs focus on generic cognitive problem-solving deficits, while social skills training programs address specific behavioral deficiencies. Social problem solving is a cognitive-behavioral approach that teaches people how to think, emphasizing thinking that is alternative, consequential, means-end, perspective taking, and social-causal. Social skills training may be taught using modeling, role playing, rehearsal, coaching, and feedback. Both approaches have been successful for increasing social adjustment and diminishing psychopathology among high-risk substance abusers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating alcohol and substance abusers in an independent practice setting.

Discusses the various aspects of treating alcohol and substance abusers in an independent practice. Assessment issues, phases of treatment, and the concepts of relapse are addressed. The treatment process, treatment skills, the role of the therapist, and approaches to treating and referring abusers are delineated. In the initial phase, when abstinence is the goal, the therapist may need to see the patient 5–6 times per wk so that the therapist can substitute for the drug. In time, the frequency of visits decreases, and the therapist becomes the transitional object substitute. Self-help groups may also be essential. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral pharmacological similarities between methylphenidate and cocaine in cocaine abusers.

Six human participants with recent histories of cocaine use were trained to discriminate 200 mg oral cocaine hydrochloride. A range of doses of oral cocaine (50–300 mg), methylphenidate (15–90 mg), triazolam (0.125–0.75 mg), and placebo were then tested to determine whether they shared discriminative–stimulus and participant-rated effects with 200 mg cocaine. Cocaine and methylphenidate dose-dependently increased cocaine-appropriate responding, produced prototypical stimulant-like participant-rated drug effects (e.g., increased participant ratings of Drug Liking), and increased heart rate and blood pressure. Triazolam produced low levels of cocaine-appropriate responding and impaired performance. Thus, consistent with previous studies, humans can reliably discriminate oral cocaine. Consistent with in vivo behavioral neuropharmacological data, the discriminative–stimulus, participant-rated, and physiological effects of oral cocaine and methylphenidate were similar. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical issues in informed consent with substance abusers.

Alcohol and drug abusers present issues that complicate the informed consent process. The present study examined the practices of federally funded clinical investigators in obtaining informed consent from alcohol and drug abusers. Ninety-one (51%) researchers completed a 27-item survey on informed consent issues. The majority of investigators (57%) recruited participants susceptible to coercion; most used procedures to minimize coercion. Two thirds of researchers used objective means to determine competence to give consent and comprehension of consent forms. Virtually all investigators had policies to deal with suicidality, homicidality, or reports of child abuse; less than 1/2 informed participants of these limits to confidentiality. Almost 50% of investigators had dealt with intoxicated or suicidal participants; 12% had encountered homicidal participants; and 23% had encountered child abuse or neglect. Half of the sample used collateral data sources; about 1/2 of these obtained written informed consent from collaterals. Guidelines for informed consent with substance abusers are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attendance-enhancing procedures in group counseling for domestic abusers.

A quasi-experimental design was used to examine the effectiveness of motivational enhancement techniques in increasing session attendance and reducing dropout among 189 men undergoing group domestic abuse counseling. The treatment retention procedures were associated with significantly greater session attendance and lower dropout rates even after controlling for demographic factors. Increased session attendance was associated with lower posttreatment relationship violence and criminal recidivism among those who received the treatment retention intervention. The intervention appeared to be particularly effective with ethnic minority clients. Findings indicate that supportive treatment retention procedures during the course of therapy can reduce the high dropout rates commonly reported in counseling programs for male domestic abuse perpetrators. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A competency-based parent training program for child abusers.

Evaluated an intervention program for child abusers using multiple outcome criteria and extended follow-up. 16 families were given the Parent–Child Interaction Form and the Eyberg Child Behavior Inventory and were assigned to either treatment or control groups. All families were supervised by protective services, and none had requested help voluntarily. A treatment program involving group parent training in the clinic and competency-based training and rehearsal in the home was provided. Findings indicate that training abusive Ss in child-management and self-control techniques resulted in improvements in parenting skills as measured by home observations, parental reports of child-behavior problems, and caseworker reports of family problems. A 1-yr follow-up indicated that no incidences of child abuse among treatment families had been reported to or suspected by caseworkers. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Buss-Durkee assessment and validation with violent versus nonviolent chronic alcohol abusers.

26 male 27–47 yr old chronic alcohol abusers who had been violent while intoxicated and 25 male 34–52 yr old nonviolent alcohol abusers were administered the Buss-Durkee Hostility-Guilt Inventory. All Ss were Caucasians with a reported daily intake of ethanol of 227 ml?±?89 ml for at least the last 5 yrs. Violence was documented by police records and by patient and family reports. Violent drinkers scored significantly higher than controls on the Total Hostility score and on subscales measuring Assault, Irritability, Verbal Hostility, Indirect Hostility, and Resentment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)