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Mournet AM, Gunin G, Shinall J, Brennan E, Jadav N, Istvan E, Kleiman EM, Bal VH. The impact of measurement on clinical trials: Comparison of preliminary outcomes of a brief mobile intervention for autistic adults using multiple measurement approaches. Autism Res 2024; 17:432-442. [PMID: 38321822 DOI: 10.1002/aur.3095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
Initial studies of the emotional safety plan (ESP), a new, brief telehealth and mobile intervention to support autistic adults to cope with periods of distress, have reported feasibility and acceptability (Bal et al., 2023, Autism, 1-13). Herein we report the preliminary clinical outcomes of thirty-six autistic adults who developed a personalized ESP, with a specific interest in comparing "outcomes" demonstrated by different instruments and assessment frequencies in order to inform outcome measurement in future clinical trials. Comparison of pre-intervention baseline to post-monitoring outcome (pre-post) anxiety symptoms (Generalized Anxiety Disorder-7 [GAD-7]) and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) revealed medium effect sizes for reduction in symptoms, though, low effect sizes were observed for pre-post Adult Self-report Anxiety and Depressive Problems scales and the Emotion Dysregulation Inventory Reactivity and Dysphoria scales. Weekly assessments showed an initial decrease in GAD-7 anxiety symptoms but no effect on weekly PHQ-9 depressive ratings. Ecological momentary assessment (EMA) data suggested that, when participants reported feeling sad or agitated and used the ESP, reduced negative feelings and increased positive states were reported in subsequent EMA. Perhaps not surprisingly, preliminary outcomes of these feasibility trials differed depending on measure chosen. Implications for the design of clinical trials are discussed.
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Affiliation(s)
- Annabelle M Mournet
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Gabrielle Gunin
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Jacqueline Shinall
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Emily Brennan
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Nikita Jadav
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Emily Istvan
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Vanessa H Bal
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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Wang J, Deane FP, Kelly PJ, D Robinson L. Goals and Reasons for Entering Inpatient Withdrawal Treatment, and Perceptions of Help Received. J Dual Diagn 2023; 19:166-176. [PMID: 37347718 DOI: 10.1080/15504263.2023.2221980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Abstinence has been the primary treatment goal for alcohol and other drug (AOD) users attending withdrawal treatment. However, other outcomes including harm reduction have also been identified. This observational study aimed to describe participants' goals and reasons for seeking inpatient withdrawal treatment and compare the needs of clients with comorbid mental health problems and those without. METHODS Participants completed questionnaires at intake and discharge. Questionnaires assessed reasons for entering withdrawal treatment, goals, comorbidity, and perceived help received. RESULTS The sample comprised 1746 participants (69.4% male). Participants endorsed diverse reasons for entering withdrawal treatment. The most and least endorsed reasons were "stop using" (97.9%) and "legal reasons" (43.1%). Comorbidity groups varied significantly in their endorsement of reasons for mental health, physical health, harm reduction, financial, and legal. CONCLUSION AOD users enter withdrawal treatment with a variety of reasons and goals including harm reduction. Variations in rates of endorsement highlight the importance of identifying individual needs dependent on mental health comorbidity.
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Affiliation(s)
- Jing Wang
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
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Walji A, Romano I, Levitt E, Sousa S, Rush B, MacKillop J, Urbanoski K, Costello MJ. Psychometric evaluation of the treatment entry questionnaire to assess extrinsic motivation for inpatient addiction treatment. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 2:100014. [PMID: 36845886 PMCID: PMC9949302 DOI: 10.1016/j.dadr.2021.100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Valid multi-faceted measurement of motivation for substance use disorder (SUD) treatment is needed to help inform treatment approaches and predict outcomes. This study examined evidence of validity for the Treatment Entry Questionnaire (TEQ-9). METHODS Data represented individuals entering inpatient SUD treatment (n = 1455). We used confirmatory factor analysis (CFA) to assess the three-factor structure of the TEQ-9 [identified (i.e., values/personally chooses treatment), introjected (i.e., internally controlled by guilt/shame) and external motivations (i.e., external pressure/demands)], and examined measurement invariance across gender, age, and ethno-racial identity. Correlation with readiness and confidence assessed convergent validity, while correlations with substance use problem severity and previous substance use treatment assessed meaningful group differences. RESULTS A three-factor structure was confirmed with all items loading significantly onto their respective factors (ps < 0.001). Each subscale demonstrated high internal consistency (Identified α = 0.90; Introjected α = 0.79; External α = 0.85). Each subscale demonstrated measurement invariance up to the scalar level across all sub-groups. Readiness, confidence, and substance use problem severity correlated as expected across various substances with the identified (rs = 0.098 - 0.262, ps < 0.05), and external (rs = -0.096 - -0.178, ps < 0.05) subscales. Additionally, the mean Identified subscale score was significantly higher among those who previously engaged in SUD treatment (p < 0.001). Findings for the Introjected subscale were more ambiguous. CONCLUSIONS Findings provide evidence for factorial validity, measurement invariance, convergent validity and group differences of the TEQ-9 in a large clinically mixed inpatient SUD treatment population, providing further support of its clinical and research utility.
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Affiliation(s)
- Alyna Walji
- Homewood Research Institute, Guelph, ON, Canada
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Isabella Romano
- Homewood Research Institute, Guelph, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Emily Levitt
- Homewood Research Institute, Guelph, ON, Canada
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Sarah Sousa
- Homewood Research Institute, Guelph, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Brian Rush
- Homewood Research Institute, Guelph, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - James MacKillop
- Homewood Research Institute, Guelph, ON, Canada
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Karen Urbanoski
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Canadian Institute for Substance Use Research, University of Victoria, BC, Canada
- School of Public Health and Social Policy, University of Victoria, BC, Canada
| | - Mary Jean Costello
- Homewood Research Institute, Guelph, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Ventura CAA, Carrara BS, Bobbili SJ, Eugênio SJ, de Ávila Domingos SG, Ferreira PS. Perspectives About Treatment Services From People Who Use Illicit Drugs. J Psychosoc Nurs Ment Health Serv 2020; 58:28-37. [DOI: 10.3928/02793695-20200211-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/05/2019] [Indexed: 11/20/2022]
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Barberi D, Taxman FS. Diversion and Alternatives to Arrest: A Qualitative Understanding of Police and Substance Users’ Perspective. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619861273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diversion to treatment is not a new concept in the criminal justice system. Successful strategies require the participation of both law enforcement officers and individuals with a substance use disorder (SUD). This study relies on interviews and focus groups to explore the perceptions and attitudes of these two different populations about non-arrest programs. From the police perspective, the study found that the biggest barrier to using alternatives is the police culture, while championship by leadership and collaborations with community stakeholders facilitate opportunities for using non-arrest options. Clients with SUDs had positive attitudes about non-arrest programs, but negative perspectives about the justice system and the police overall. Policy implications for future efforts are highlighted, particularly as efforts increase to expand the use of non-arrest options including diversion programs.
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Chen DT, Ko TM, Allen AA, Bonnie RJ, Suratt CE, Appelbaum PS, Nunes EV, Friedmann PD, Lee JD, Gordon MS, McDonald R, Wilson D, Boney TY, Murphy SM, O'Brien CP. Personal Control Over Decisions to Participate in Research by Persons With Histories of Both Substance Use Disorders and Criminal Justice Supervision. J Empir Res Hum Res Ethics 2018; 13:160-172. [PMID: 29460668 DOI: 10.1177/1556264618755243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individuals must feel free to exert personal control over decisions regarding research participation. We present an examination of participants' perceived personal control over, as well as reported pressures and threats from others, influencing their decision to join a study assessing the effectiveness of extended-release naltrexone in preventing opioid dependence relapse. Most participants endorsed a strong sense of control over the decision; few reported pressures or threats. Although few in number, participants' brief narrative descriptions of the pressures and threats are illuminating and provide context for their perceptions of personal control. Based on this work, we propose a useful set of tools to help ascertain participants' sense of personal control in joining research.
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Affiliation(s)
- Donna T Chen
- 1 University of Virginia, Charlottesville, VA, USA
| | | | | | | | | | - Paul S Appelbaum
- 2 Columbia University, New York, NY, USA.,3 New York State Psychiatric Institute, New York City, USA
| | - Edward V Nunes
- 2 Columbia University, New York, NY, USA.,3 New York State Psychiatric Institute, New York City, USA
| | - Peter D Friedmann
- 4 University of Massachusetts Medical School-Baystate, Springfield, USA
| | | | | | | | - Donna Wilson
- 4 University of Massachusetts Medical School-Baystate, Springfield, USA
| | - Tamara Y Boney
- 7 Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
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Gallagher JR, Bremer T. A Perspective from the Field: The Disconnect between Abstinence-Based Programs and the Use of Motivational Interviewing in Treating Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2017. [DOI: 10.1080/07347324.2017.1355223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Traci Bremer
- School of Social Work, Indiana University South Bend, Indiana, USA
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Abstract
This article uses the behavioral model for vulnerable populations to evaluate the use of substance abuse treatment services among a sample of 926 substance abusers with one or more vulnerable health designations. A two-stage hierarchical logistic regression was completed to determine the influence of vulnerable and traditional need factors on the probability of receiving substance abuse treatment. Among traditional covariates, increased odds of receiving substance abuse treatment are associated with being either non-Hispanic White, Hispanic, having an income > US$5,000, and having a regular source of care. Among vulnerable covariates, injection drug use (odds ratio [OR] = 2.19, confidence interval [CI] = [1.46, 3.27]) and the receipt of public benefits (OR = 1.98, CI = [135, 2.92]) remain independent risk factors for the receipt of substance abuse treatment. Many who experience substance abuse disorders can also experience a multitude of other vulnerable health classifications, suggesting the need for a comprehensive, multidisciplinary approach to the treatment of substance use disorders.
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