title: A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China.
abstract: BACKGROUND
  Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target.
  
  
  METHODS
  A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC).
  
  
  RESULTS
  Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status.
  
  
  CONCLUSIONS
  Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment.
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China.
authors: Chang
authors: C
authors: Qi
authors: Purdue University, 610 Purdue Mall, West Lafayette, IN 47907, USA.
authors: Brian C
authors: BC
authors: Kelly
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China.
authors: Yanhui
authors: Y
authors: Liao
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China.
authors: Haoyu
authors: H
authors: He
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China.
authors: Tao
authors: T
authors: Luo
authors: Department of Psychiatry and Behavioral Sciences, University of Texas at Houston Medical School, 1941 East Rd., Houston, TX 77054, USA.
authors: Huiqiong
authors: H
authors: Deng
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China. Electronic address: tiegezhongguo@126.com.
authors: Tieqiao
authors: T
authors: Liu
authors: Mental Health Institute, The Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha 410011, Hunan, PR China.
authors: Wei
authors: W
authors: Hao
authors: Children's National Medical Center, 111 Michigan Avenue, Washington, DC 20010, USA; George Washington University, 2121 Eye Street, Washington, DC, USA.
authors: Jichuan
authors: J
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D055030:Drug Users / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support; D016320:Substance Abuse Treatment Centers / Q000379:methods*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D055815:Young Adult
keywords: China; Differential item functioning (DIF); Drug treatment; Internal barriers; Multiple Indicators Multiple Causes (MIMIC)