Self-report and urine drug screen concordance among women with co-occurring PTSD and substance use disorders participating in a clinical trial: Impact of drug type and participant characteristics

BACKGROUND

Self-report measures are important in substance use assessment, yet they are susceptible to reporting errors. Urine drug screens (UDS) are often considered a more valid alternative. However, collecting in-person UDS may not always be feasible, contributing to the need to understand factors that influence the validity of self-reported substance use.

METHODS

In this secondary analysis of data from 295 women with co-occurring PTSD and substance use disorders (SUD) who participated in a clinical trial testing behavioral interventions, we examined concordance and discordance between self-reported drug use and associated UDS results. Generalized linear mixed models were used to examine the impact of treatment type and participant characteristics on the associations between self-reported drug use and UDS results.

RESULTS

Findings revealed higher disagreement between self-report and UDS for opioids and sedatives (ranging from.77 to.90) and lower disagreement rates for cannabis and cocaine (ranging from.26 to.33). Treatment type was not a significant moderator of the associations between self-report and UDS across all drugs. Among those with a positive opioid UDS, those who reported employment in the past three years were more likely to self-report no opioid use compared to their counterparts without employment in the past three years.

CONCLUSIONS

Findings add to the literature that supports the validity of self-reported cannabis and cocaine use. The greater discrepancies between self-report and UDS test results of opioids and sedatives suggest adjunctive UDS may be required, although a variety of factors other than inaccurate self-report may be associated with this discrepancy.

Aerobic and anaerobic enzymatic activity of orange roughy (Hoplostethus atlanticus) and alfonsino (Beryx splendens) from the Juan Fernandez seamounts area

The aerobic and anaerobic enzymatic activity of two important commercial bathypelagic species living in the Juan Fernández seamounts was analyzed: alfonsino (Beryx splendens) and orange roughy (Hoplostethus atlanticus). These seamounts are influenced by the presence of an oxygen minimum zone (OMZ) located between 160 and 250 m depth. Both species have vertical segregation; alfonsino is able to stay in the OMZ, while orange roughy remains at greater depths. In this study, we compare the aerobic and anaerobic capacity of these species, measuring the activity of key metabolic enzymes in different body tissues (muscle, heart, brain and liver). Alfonsino has higher anaerobic potential in its white muscle due to greater lactate dehydrogenase (LDH) activity (190.2 μmol NADH min(-1) g ww(-1)), which is related to its smaller body size, but it is also a feature shared with species that migrate through OMZs. This potential and the higher muscle citrate synthase and electron transport system activities indicate that alfonsino has greater swimming activity level than orange roughy. This species has also a high MDH/LDH ratio in its heart, brain and liver, revealing a potential capacity to conduct aerobic metabolism in these organs under prolonged periods of environmental low oxygen conditions, preventing lactic acid accumulation. With these metabolic characteristics, alfonsino may have increased swimming activity to migrate and also could stay for a period of time in the OMZ. The observed differences between alfonsino and orange roughy with respect to their aerobic and anaerobic enzymatic activity are consistent with their characteristic vertical distributions and feeding behaviors.

An analysis of the RCMAS Lie scale in a clinic sample of anxious children

Examined Revised Children's Manifest Anxiety Scale (RCMAS) Lie scores in a sample of 284 anxious children. Lie scores were examined in relation to children's age, ethnicity/race, and gender, and in relation to Total Anxiety scores. The utility of Lie scores also was examined in terms of whether they were predictive of children's anxiety levels as rated by children themselves, parents, and clinicians. Between-group differences in children's Lie scores were examined as well. Results indicated that younger children had significantly higher Lie scores than older children, and Hispanic American children had significantly higher Lie scores than European American children. There were no significant gender differences in Lie scores, and no significant relation was found between RCMAS Lie scores and Total Anxiety scores for the total sample. Subgroup analyses indicated that Lie scores were predictive of children's anxiety levels. Results also indicated that Lie scores were significantly different between children who presented with anxiety disorders and children who presented with anxiety and externalizing disorders. Findings are discussed in terms of the usefulness of RCMAS Lie scores.

Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions

OBJECTIVE

To examine the test-retest reliability of the DSM-IV anxiety symptoms and disorders in children with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions (ADIS for DSM-IV:C/P).

METHOD

Sixty-two children (aged 7-16 years) and their parents underwent two administrations of the ADIS for DSM-IV:C/P with a test-retest interval of 7 to 14 days.

RESULTS AND CONCLUSIONS

Results revealed that the ADIS for DSM-IV:C/P is a reliable instrument for deriving DSM-IV anxiety disorder symptoms and diagnoses in children. The ADIS for DSM-IV:C/P was found to have excellent reliability in symptom scale scores for separation anxiety disorder, social phobia, specific phobia, and generalized anxiety disorder and good to excellent reliability for deriving combined diagnoses of these disorders, as well as using child-only and parent-only interview information. Reliability coefficients were generally similar and, in most instances, superior to those found in previous ADIS-C/P reliability studies. Limitations and directions for future research are discussed.

The discrimination of children's phobias using the Revised Fear Survey Schedule for children

The discriminant validity of children's and parents' ratings of the child's fear on the Revised Fear Survey Schedule for Children (FSSC-R; Ollendick, 1983) was examined using a clinic sample of children who met DSM criteria for phobic disorders (N = 120). Discriminant function analyses and item analyses were conducted to determine if children meeting diagnostic criteria for a primary disorder of social phobia, simple phobia of the dark/sleeping alone, simple phobia of animals, or a simple phobia of shots/doctors could be differentiated on the basis of FSSC-R subscale scores and items. Results of the discriminant function analyses indicated that the child-completed as well as the parent-completed FSSC-Rs were similarly useful in differentiating the specific types of phobias. Results of the item analyses indicated that child-completed FSSC-R items could discriminate among the different simple phobias but not social phobia and that parent-completed FSSC-R items could discriminate not only the different simple phobias but also social phobia. Results are discussed in terms of the utility of the FSSC-R in the assessment of clinically significant fears in children with phobic disorders and the relative utility of child and parent ratings in the assessment of childhood fears.