Relationship between perceived health care quality and attitude toward substance abuse treatment

Despite the considerable investment made in recent years in Spain in substance abuse care, treatment adherence remains one of the aspects that determine the effectiveness of programs. Several authors have noted the importance of perceived service quality in this context. This paper is presented with dual purpose of highlighting the role that management of the quality of care for drug addicts has, both as a modulator of users' attitudes and perceptions about the treatment, and as a work philosophy, typical of an organization committed to continuous improvement. Conducting personal interviews with 670 users of drug abuse care services in Galicia and through the application of covariance structure analysis, the close relationship between two factors (perceived quality and attitude toward treatment) was revealed. This research also provides professionals and researchers with a new scale for service evaluation that is short, easy to use and with adequate psychometric properties.     

Factor analysis of the social performance survey schedule

There are several studies suggesting that the Social Performance Survey Schedule (SPSS) is a reliable and valid measure of social skill. However, the factorial structure of the SPSS has never been examined. In the present study, SPSSs taken by 652 college students were factor analyzed by the method of principal components and the resulting factors were rotated according to the varimax criterion. Separate factor analyses were conducted for men and women. Seven factors, which accounted for a little over a third of the total variance, were retained for each sex. A large general factor labeled Prosocial Competence emerged for both sexes. Beyond this, the factorial solutions for the two sexes tended to diverge, with males showing a large negative factor (Social Offensiveness) and three smaller negative factors and females showing five relatively small negative factors. Suggestions were made concerning additional factor analytic studies of the SPSS and the ways in which derived factors might be used in research and clinical work.This research was supported by funds from the Rutgers University Research Council. Thanks are due to Leona Aiken for her statistical consultation.     

Factor analysis of the 122 item fear survey schedule

The 122 item fear survey schedule was factor analyzed in an attempt to discover whether various stimuli cluster together in their capacity to evoke anxiety. The method of factor analysis involved a rotation to an oblique structure with the result that 5 conceptually pure factors emerged accounting for at least 90 per cent of the variance. The factors were named as follows: (1) fears related to small animals, (2) fears of the precipitators and manifestations of hostility, (3) moralistically related fears and sexual fears, (4) fears of isolation and loneliness, and (5) fears of anatomical destruction and physical pain. Using the items that correlated 0.35 or better with factors, a 40 item fear survey schedule emerged. Suggestions for clinical use of this fear survey schedule were made.     

The interactive effects of low self-control and commitment to school on substance abuse among college students

This study examined the combined influence of two predicting factors-low self-control and commitment to schooling-that research has shown have independent effects on substance abuse. In a sample of 598 college students, this study tested the interactive effects of these factors while controlling for other established predictors of binge drinking and drug use. Analysis showed that participants who had both low self-control and low schooling commitment had significantly higher scores on substance abuse than would be expected from the independent influences of the component factors, which suggests that the combined effects of these predictors on substance abuse have a greater influence than their direct influences.     

A parenting group for women dealing with child sexual abuse and substance abuse

This article describes a group developed to address the parenting needs of women dealing with child sexual abuse and substance abuse. A solution-focused 12-week group intervention is described, and the results of an evaluation are presented. Participants included 29 women who attended seven parenting groups. The results suggest that the group was perceived as beneficial by the women, who reported an increase in self-esteem, parenting satisfaction, and parenting self-esteem and an improvement in their attitudes toward their children.     

Factor analysis of a Venezuelan fear survey schedule

A Fear Survey Schedule, developed for use by university students in Venezuela, was administered to 871 first-year students at the Simón Bolivar University, Caracas, and subjected to several analyses to identify its factorial structure. Five factors were identified in the male group: Fear of aversive interpersonal events; of Violence and physical assault; of Loss of self-control; of Injuries and surgical operations; and of Animals and insects. Seven factors were identified in the female group, four of them coincided with the male group: Fear of interpersonal events; of Animals and insects; of Injuries and surgery; of Responsibility; of Death and physical threats; of Doctors and hospitals; of Violence and physical assault. The results were compared to those obtained with similar fear surveys of North American and Israeli University students.     

The therapeutic alliance in adolescent substance abuse treatment: a one-with-many analysis

Studies of the therapeutic alliance typically use a one-with-many (OWM) design in which each therapist (the one) treats multiple clients (the many). This study used Kenny, Kashy, and Cook's (2006) OWM method to examine the composition of the therapeutic alliance and to analyze the association between alliance and outcome in a sample of 398 adolescents treated for substance abuse by 14 therapists. Both the client and therapist alliance ratings yielded large relationship variances, with limited consensus among clients treated by the same therapist about the quality of the alliance. If a client reported an especially strong alliance with his or her therapist, the therapist was likely to also report an especially strong alliance with that client (dyadic reciprocity). The association between the components of the alliance and treatment outcome was complicated, with different levels of measurement and different components of the alliance (perceiver, partner, or relationship) derived from different informants (therapist or client) relating to different outcomes.     

Factor analysis of MMPI-2 basic scales among college students

The MMPI-2 was administered to 288 college students (178 women and 110 men) between the ages of 18 and 34 years. Scores on the basic 13 (three validity and ten clinical) scales were correlated and subjected to principal component analyses separately for men and women. In each case, four factors were retained and subjected to varimax rotation. Coefficients of congruence were calculated for all possible pairs of factors across two samples of college students and the normative adults, separately for men and women, and across genders within each sample. Results indicated that the factorial structure of the MMPI-2 basic scales seemed to possess considerable uniformity across samples and genders, but not without some notable exceptions.     

Sex role attitude and perception of psychological abuse

This study focuses on the relationship between sex role attitude—traditionality and nontraditionality—and perception of psychological abuse. It was hypothesized that nontraditional women would be more adept at perceiving abuse than traditional women. Two hundred and fourteen subjects were polled using the Attitude Toward Women Scale. The 30 most traditional and 30 least traditional women were compared in terms of their reactions to vignettes depicting marital interactions. Several factors were analyzed in an attempt to explain why the nontraditional women were more sensitive in their perception of psychological abuse. Among these factors were educational level, tolerance for conflict, participation in consciousness-raising groups, psychological sophistication, and religious background.     

Treatment of co-occurring child maltreatment and substance abuse

Despite high prevalence and severe negative consequences of child maltreatment (e.g., Brown, G. R., & Anderson, B., (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61; Jaudes, P. K., Ekwo, E., & Van Voorhis, J.V., (1995). Association of drug abuse and child abuse. Child Abuse and Neglect, 19, 1065–1075; Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., & Goshkom, M., (1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse and Neglect, 15, 197—211), the treatment of perpetrators and victims of child abuse and neglect remains grossly understudied (Behl, L. E., Conyngham, H. A., & May, P. F., (2003). Trends in child maltreatment literature. Child Abuse and Neglect, 27, 215–229). More than half of parentes founded for the abuse and neglect of their children have evidenced drug abuse, yet no treatments have been validated that concurrently address these problems. The reciprocal interaction between substance abuse and child maltreatment supports the need to concurrently treat these problems. This article illustrates the relationship between child maltreatment and parental substance abuse and proposes a behavioral model to explain the reciprocal influence of drug abuse and child maltreatment. A behavioral treatment plan that is designed to concurrently address drug abuse and child abuse is proposed and suggestions are made for future directions in this area.     

MMPI substance abuse scales on drug addicts with and without concurrent alcoholism

The range and utility of the MMPI-derived MacAndrew Alcoholism Scale (MAC) and the Heroin Addiction Scale (He) was assessed with a large sample of drug addicts with and without concurrent alcoholism. Results indicated that addicts with a co-existing alcohol problem obtained higher MAC scores than addicts without a current alcohol problem. Opiate abusers scored higher on the MAC than non-opiate abusers. No such effects were observed with the He scale. The MAC is a particularly robust scale that taps generic substance abuse and may even be sensitive enough to detect alcoholism in drug addicts.     

A cross-validation of MMPI-2 substance abuse scales.

We evaluated the efficacy of the Addiction Potential Scale (APS) and the Addiction Acknowledgement Scale (AAS), two new scales designed to assess substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in samples from settings different from those used in their development. Results replicate earlier findings that both scales discriminate between psychiatric and substance abuse samples and do so more effectively than other substance abuse scales designed for use with the MMPI and carried over to the MMPI-2. Results also suggest that APS may be more resistant than AAS to response distortion.     

The role of theory in treating adolescent substance abuse

The adolescent substance abuser, like adult addicts, is most commonly considered from the perspective of the disease model. The usefulness of the disease model in conceptualizing adolescent substance abuse is questioned, and an alternative view of the topic is set forth. Substance abuse, is regarded as an adaptive aspect of the ongoing interactive processes within the family. The developmental process of the adolescent substance abuser is seen as a functional dynamic in the family's preservation. Three characteristic elements of parental interaction common to the development of adolescent substance abuse are highlighted.An earlier version of this paper was presented at the Texas Association for Marriage and Family Therapy annual conference on January 28, 1993 in Houston Texas.a research associate and director of the Don D. Jackson Archive at the Mental Research Institute, Palo Alto, CA. Authors are listed alphabetically.     

The relation of distressful childhood experiences and empathy in college undergraduates

We assessed the relation between the empathic responsiveness of young adults and the relative frequency and intensity of distressful events they experienced as children. Undergraduate subjects (N = 111; 56 men and 55 women) were led to believe that they were participating in two separate studies. In the first study, students completed the Distress Experiences in Childhood questionnaire, a filler task, and a slightly abbreviated version of the Mehrabian and Epstein (1972) empathy measure. In the second study, students watched an emotion-laden videotape of a patient (actually an actress) in a therapy session and subsequently completed an emotional-response questionnaire adapted from Batson, O'Quin, Fultz, Vanderplas, and Isen (1983). Students who rated their distressful childhood experiences as highly distressing scored higher on both measures of empathy than did students who rated their experiences as relatively less distressing. In contrast, the number of distressful childhood experiences reported was generally unrelated to empathy scores.     

Correlates of success following treatment for adolescent substance abuse

To date, little research is available examining the course and features of recovery from substance abuse following adolescent treatment. The current study evaluated the functioning of 142 teens for 2 years following treatment for substance abuse. Adolescent drug and alcohol outcome was examined in relation to functioning on five major life domains: academic involvement, interpersonal problems, emotional well-being, family relations, and social and occupational activities. Results of this investigation demonstrate that psychosocial functioning is associated with adolescent posttreatment drug and alcohol use. Teens who were abstinent and those with less substance use involvement generally displayed better functioning. The relationship between teen alcohol and drug use and improvement in functioning varied across psychosocial domains. Clinical implications of these findings are discussed along with advances in teen substance abuse research and treatment.     

Diagnostic profiles of offenders in substance abuse treatment programs

This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.