Psychiatric Comorbidity and 12-Step Participation: A Longitudinal Investigation of Treated Young Adults

Bergman, Brandon G.; Greene, M. Claire; Hoeppner, Bettina B.; Slaymaker, Valerie; Kelly, John F.

doi:10.1111/acer.12249

Cited by 16 publications

(11 citation statements)

References 57 publications

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“…Despite higher pre-treatment rates of psychotropic medication use and psychotherapy attendance in the current sample (Bergman et al, in press) possibly mitigating the debilitating behavioral correlates of psychiatric comorbidity, it appears COD patients are still likely to present to treatment with greater clinical severity than their SUD-only peers. As a corollary, greater clinical severity at intake may be indicative of a co-occurring psychiatric disorder, warranting more in-depth assessment to aid in treatment planning.…”

Section: Discussionmentioning

confidence: 69%

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Young adults with co-occurring disorders: substance use disorder treatment response and outcomes

Bergman

Greene

Slaymaker

et al. 2014

Journal of Substance Abuse Treatment

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Compared to other life stages, young adulthood (ages 18–24) is characterized by qualitative differences including the highest rates of co-occurring substance use and psychiatric disorders (COD). Little is known, however, regarding young adults’ response to SUD treatment, especially those with COD. Greater knowledge in this area could inform and enhance the effectiveness and efficiency of SUD care for this patient population. The current study investigated differences between 141 COD and 159 SUD-only young adults attending psychiatrically integrated residential SUD treatment on intake characteristics, during-treatment changes on clinical targets (e.g., coping skills; abstinence self-efficacy), and outcomes during the year post-discharge. Contrary to expectations, despite more severe clinical profiles at intake, COD patients showed similar during-treatment improvements on clinical target variables, and comparable abstinence rates and psychiatric symptoms during the year post-treatment. Clinicians referring young adults with COD to specialized care may wish to consider residential SUD treatment programs that integrate evidence-based psychiatric services.

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Section: Discussionmentioning

confidence: 69%

“…Modifications were made to subsequent assessments to capture the entire time period elapsed since the most recent assessment (see Bergman, Greene, Hoeppner, Slaymaker, & Kelly, in press). Percent days abstinent (PDA) was calculated by dividing abstinence days reported for each assessment period by number of days in the assessment period.…”

Section: Methodsmentioning

confidence: 99%

Young adults with co-occurring disorders: substance use disorder treatment response and outcomes

Bergman

Greene

Slaymaker

et al. 2014

Journal of Substance Abuse Treatment

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“…Given this selection bias, we cannot assume that our comorbidity results generalize to abstinent alcoholics who are not current members of such groups. Within the samples studied, we are not sure the degree to which recovery groups are important in helping abstinent alcoholics maintain abstinence in the face of ongoing psychiatric and psychological distress (e.g., see (Bergman et al 2014)). The work above focused on individuals in and post treatment for alcoholism and other SUDs and shows little change in psychiatric and psychological distress from STAA to LTAA groups.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Comorbidity in Alcohol Dependence

Fein

2015

Neuropsychol Rev

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We review our clinical studies of psychiatric comorbidity in short-term and long-term abstinent and in treatment naïve alcoholics (STAA, LTAA and TNA). TNA ypically have less severe alcoholism than treated abstinent samples and evidence less severe psychiatric disturbance. Lifetime psychiatric diagnoses are the norm for STAA and LTAA but not for TNA. Individuals with alcohol and drug use disorders show greater antisocial personality disturbance, but do not show differences in the mood or anxiety domains or in borderline personality disorder (BPD) symptoms. The studies show that alcoholics can achieve and maintain abstinence in the face of ongoing mood, anxiety, or BPD problems. By contrast, for ASPD, LTAA essentially stop current antisocial behaviors in all seven domains of antisocial behaviors. We believe that ongoing antisocial behavior is not consistent with maintaining abstinence, and that LTAA modify their antisocial behavior despite continued elevated social deviance proneness and antisocial dispositionality. Abstinent individuals without lifetime psychiatric disorders and TNA show more (subdiagnostic threshold) psychiatric symptoms and abnormal psychological measures than nonalcoholic controls in the mood, anxiety, BPD, and antisocial domains. In summary, our studies show that although LTAA have achieved multi-year abstinence, they still report significant psychological distress compared to NAC. We believe this distress may negatively affect their quality of life. This suggests the importance of developing effective care models to address comorbid mental health problems in LTAA. We also show that antisocial personality disorder symptoms decline to the levels seen in normal controls, and that excluding individuals from research with a psychiatric diagnosis does not control for subdiagnostic psychiatric differences between alcoholics and controls.

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“…It is important to note, prior to conducting contemporaneous analyses outlined above, consistent with our recent work on this sample (Bergman et al, 2014a; Kelly et al, 2013), we first conducted time-lagged analyses (e.g., the effect of 1-month outpatient treatment on 3-month abstinence), in order to bolster support for a causal relationship between professional continuing care services/12-step MHO involvement and abstinence. The pattern of results from both the time-lagged and contemporaneous models was the same.…”

Section: Methodsmentioning

confidence: 90%

The effects of continuing care on emerging adult outcomes following residential addiction treatment

Bergman

Hoeppner

Nelson

et al. 2015

Drug and Alcohol Dependence

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Background Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults’ participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts. Methods Emerging adults (N = 284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, SUD medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates. Results Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups). Conclusions Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment.

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Psychiatric Comorbidity and 12-Step Participation: A Longitudinal Investigation of Treated Young Adults

Cited by 16 publications

References 57 publications

Young adults with co-occurring disorders: substance use disorder treatment response and outcomes

Young adults with co-occurring disorders: substance use disorder treatment response and outcomes

Psychiatric Comorbidity in Alcohol Dependence

The effects of continuing care on emerging adult outcomes following residential addiction treatment

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