Rasch model of the GAIN substance problem scale among Canadian adults seeking residential and outpatient addiction treatment

Specifying the Relations among PTSD Symptom Clusters and Parenting Stress in Mothers Engaged in Substance Use Treatment

INTRODUCTION

Parenting stress is often heightened in mothers receiving treatment for substance use. Experiences of trauma are commonly seen in this population, which may give rise to Posttraumatic Stress Disorder (PTSD) symptoms, including intrusion, avoidance, negative cognition and mood, and affective arousal. While past research has demonstrated a significant relation between PTSD symptoms and parenting stress, no studies have examined the relative contributions of these symptoms to parenting stress in mothers engaged in substance use treatment.

METHODS

Seventy-four mothers attending outpatient substance use treatment who were parenting children aged 0-3 years completed measures of parenting stress, PTSD, substance use, and depression symptoms.

RESULTS

A canonical correlation analysis indicated two canonical variates accounting for significant variance between PTSD symptom clusters and parenting stress measures. The first canonical variate, primarily reflecting depressive and PTSD cognition and mood symptoms, was predominantly related to the parental distress aspect of parenting stress (40%). The second canonical variate, primarily reflecting intrusion and avoidance PTSD symptoms, was associated with increased parental perceptions of their child as difficult (10%).

CONCLUSION

Future research directions and clinical implications of these results are discussed for designing parenting interventions with mothers attending substance use treatment who present with PTSD symptoms.

Exposure to Violence and Posttreatment Substance Use Among Patients With Opioid Use Disorder

Exposure to violence can lead to a dramatic increase in the likelihood of the development of a substance use disorder (SUD). Given the overlap between the two, substance use for survivors of violence, then, can be a coping mechanism to manage the traumatic effects of abuse and persistent use can evolve into a diagnosable SUD. This study was designed to examine the posttreatment substance use among adults who have a history of exposure to violence and sought treatment for opioid use disorder. Data for this study were drawn from the Comprehensive Addiction Treatment Outcome Research system. Among the 13,105 patients included in the study, 444 (3.4%) received a formal diagnosis for opioid use disorder. Female victims of violence are at a greater risk of suffering injuries related to violence, resulting in increased levels of medical care utilization, which may prompt the initiation and prolonged use of prescription pain relief medication. Related to this important finding is another indicating that exposure to violence at multiple points in the past was associated with more severe indicators of substance use. These data show that there is a relationship between exposure to violence, SUDs, and relapse among patients seeking treatment. Not only must patients and treatment providers address these past violent experiences as important psychological factors in recovery, but in the context of opioid use disorder, physical injuries contributing to chronic pain may also trigger persistent substance use.

Rasch Analysis of the Global Appraisal of Individual Needs in the City of São Paulo

INTRODUCTION

Approximately 5% of the global population used an illicit drug in 2013. Regarding licit drugs, alcohol is responsible for the occurrence of approximately 200 diseases, among them depression. In addition to health impairments, alcohol is also implicated in many acts of violence. This study aimed to measure the properties of the Rasch model of the Portuguese version of the Global Appraisal of Individual Needs-Short Screener based on evidence obtained during care for users of alcohol and other drugs.

METHOD

To collect the data, 128 interviews were held at the Psychosocial Care Center for Alcohol and Other Drugs in the state capital, during which the scale was applied.

RESULTS

The Rasch model revealed that the subscales of the instrument were appropriate, with all items having mean infit and outfit values from 0.5 to 1.5, considered optimal for measurement. There was no evidence of differential performance for gender. Substance use and crime and violence items presented redundancy for severity measures.

CONCLUSION

Given the need for validated instruments for use in Brazil, it is encouraging that the Portuguese version of the scale was valid for the Rasch model. The results are consistent with studies using the other American, Brazilian, and Canadian versions of the instrument.

Substance Use Risk Indicators and Offending Patterns Among Local Jail Inmates

This study examined clinical indicators of adult jail inmates' substance use severity and offending patterns. Clinical assessment and booking data were gathered from a random sample of 283 adult inmates using the Comprehensive Addiction and Psychological Evaluation-5, which is consistent with diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Greater substance use risk was associated with increased likelihood of detention for property-related offenses, nonviolent offenses, and multiple jail admissions. Inmates with greater substance use risk were also significantly less likely to be detained for violent offenses. The assessment and coordination of care for jail inmates in local detention centers is paramount to reducing jail bookings, especially for nonviolent offenses.

The entanglement between relapse and posttreatment criminal justice involvement

BACKGROUND

Research has established a connection between substance use and criminal activity, but much less is known about the association between posttreatment relapse and related contact with the criminal justice system.

OBJECTIVE

The current study was designed to elucidate this relationship by examining the long-term effects of relapse on arrest. The study also investigated the probability of relapse into substance use as it followed an arrest.

METHOD

Data from 5,822 adults who participated in the Comprehensive Assessment and Treatment Outcome Research (CATOR) system were analyzed. This prospective longitudinal research design included 0-6, 6-12, 12-18, and 18-24 month follow-up data.

RESULTS

A series of logistic regression analyses indicated that relapse was associated with posttreatment arrest within the observed follow-up period, but did not significantly influence the likelihood of arrest in future follow-up periods. In comparison, posttreatment arrest in the 6-12 month follow-up period had lasting effects for relapse to substance use in the 12-18 and 18-24 month periods. Arrest in the 0-6 month posttreatment period was also associated with increased risk for relapse in the 18-24 month period.

CONCLUSIONS

Given the evidence that demonstrated within follow-up period associations between relapse and arrest, relapse prevention is critical to preventing contact with the criminal justice system. In addition, the lasting impact of an arrest must be mitigated to maintain posttreatment recovery from substance use for adults who come into contact with the criminal justice system.

Rasch model of the GAIN substance problem scale among inpatient and outpatient clients in the city of São Paulo, Brazil

Introduction

This study used the Rasch model to evaluate the psychometric properties of the Portuguese version of the Substance Problem Scale (SPS) of the “Global Appraisal of Individual Needs - Initial” for use in Brazil. The SPS measures alcohol and drug problem severity within a DSM-IV-TR framework. The goal of the Rasch analysis was to assess scale dimensionality, item severity, and differential item functioning (DIF).

Methods

Data was collected from 40 inpatients and 70 outpatients in São Paulo, Brazil. The Rasch model fit and DIF by gender and level of care were examined.

Results

The SPS fit the Rasch model, with no items distorting the measure. Only three of the sixteen items performed differently between men and women and three performed differently by level of care.

Conclusions

The results were compatible with those from Rasch analyses of the American English and Canadian English versions of the scale. The Portuguese version of the SPS is, thus, valid for use in Brazil, both with men and women in inpatient and outpatient programs.