Problem drinking and depression among DWI offenders: a three-wave longitudinal study

Hazardous drinking, depression, and anxiety among sexual-minority women: self-medication or impaired functioning?

OBJECTIVE

Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women.

METHOD

Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study.

RESULTS

Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression.

CONCLUSIONS

Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood.

A randomized trial of oral naltrexone for treating opioid-dependent offenders

Offenders with a history of opioid dependence are a particularly difficult group to treat. A large proportion of offenders typically relapse shortly after release from prison, commit drug-related crimes, and then are arrested and eventually re-incarcerated. Previous research demonstrated that oral naltrexone was effective in reducing opioid use and preventing recidivism among offenders under federal supervision. The 111 opioid-dependent offenders in this study were under various levels of supervision that included county and federal probation/parole, a treatment court, an alternative disposition program, and an intermediate punishment program. Subjects were randomly assigned to receive 6 months of either 300 mg per week of oral naltrexone plus standard psychosocial treatment as usual (n = 56) or standard psychosocial treatment as usual (TAU) without naltrexone (n = 55). While the TAU subjects who remained in treatment used more opioids than the naltrexone subjects who remained, the high dropout rate for both groups made it difficult to assess the effectiveness of naltrexone. The study provides limited support for the use of oral naltrexone for offenders who are not closely monitored by the criminal justice system.

Depressive symptoms, drinking consequences, and motivation to change in first time DWI offenders

BACKGROUND

Psychological disorders are common among driving-while-intoxicated (DWI) offenders; thus, a DWI arrest may serve as an important opportunity for further screening and subsequent treatment.

OBJECTIVES

The current study examined the extent to which mild to moderate pretreatment depressive symptoms, as measured by the Beck Depression Inventory (BDI), could predict intervention outcomes in 284 first-time DWI offenders.

METHODS

Participants were given drinking-related and psychosocial assessments at the beginning and end of a 10-week intervention and at 6- and 12-month follow-ups.

RESULTS

After the intervention and at both follow-ups, all participants reported declines in depressive symptoms, alcohol consumption, and negative drinking consequences and higher self-efficacy to avoid high-risk drinking. It was notable, however, that offenders with depressive symptoms reported more drinking-related consequences and lower self-efficacy at all time points, but greater motivation to change their drinking behavior.

CONCLUSIONS

The findings suggest that offenders with depressive symptoms have more severe symptomatology than nondepressed offenders but may be more amenable to changing their drinking.

SCIENTIFIC SIGNIFICANCE

The BDI may be a useful screening tool for determining which offenders are in need of an intervention following a DWI arrest.