title: Clinical characteristics as a function of referral status among substance users in residential treatment.
abstract: In the United States, substance users who voluntarily (VO) elect to receive treatment and substance users who are court-mandated (CM) to receive treatment typically obtain care within the same facilities. Little is known about the clinical characteristics that differentiate these individuals. The current study provides rates of specific DSM-IV Axis I and Axis II psychiatric and substance use disorders, comorbidities, childhood trauma, motivation, and other clinical and demographic characteristics as a function of referral status, among individuals in residential substance use treatment (463 participants, M age=43.3; 69.7% male; 88.4% African American). Participants were interviewed and diagnosed using the Structure Clinical Interview for DSM-IV and the Diagnostic Interview for Personality Disorders. Within our sample, VO individuals, as compared to CM individuals had significantly higher rates of psychiatric disorders (68.7% versus 55.2%, respectively), including mood disorders, major depressive disorder, generalized anxiety disorder, and borderline personality disorder. Additionally, they were significantly more likely to have alcohol dependence (43.0% versus 20.8%) and cocaine dependence (66.5% versus 48.9%). Elevated rates of comorbidities and childhood abuse were also observed among VO individuals, while motivation did not differ as a function of referral status. Overall, VO individuals appeared to have more severe problems than their CM counterparts which may suggest that they require more intensive or different types of treatment.
authors: Center for Addictions, Personality, and Emotion Research, , Department of Psychology, University of Maryland-College Park, MD 20742, United States. banducci@umd.edu
authors: Anne N
authors: AN
authors: Banducci
authors: Jennifer
authors: J
authors: Dahne
authors: Jessica F
authors: JF
authors: Magidson
authors: Kevin
authors: K
authors: Chen
authors: Stacey B
authors: SB
authors: Daughters
authors: C W
authors: CW
authors: Lejuez
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data; D001741:Black or African American / Q000706:statistics & numerical data; D000437:Alcoholism / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009042:Motivation; D010554:Personality Disorders / Q000453:epidemiology; D012017:Referral and Consultation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012114:Residential Treatment / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology
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