Experiences and narratives – Drug users with antisocial personality disorder retelling the process of treatment and change

Abstract

Experiences and narratives-Drug users with antisocial personality disorder retelling the process of treatment and change.

Why run the risk? Motivation for offences by patients with substance use and antisocial personality disorders which they rated as most risky to their own well‐being

“…Study participants were selected from 175 patients who participated in a pragmatic randomised trial (Watkins et al, ; Delgadillo et al, ) to test the efficacy of a brief psychoeducational intervention for ASPD – the Impulsive Lifestyle Counselling program as a supplement to standard substance abuse treatment in an outpatient context (see also Thylstrup et al, , ; Thylstrup & Hesse, ). The trial took place between January 2012 and June 2014 at 13 public outpatient substance abuse treatment services in Denmark.…”

“…Patients who met inclusion criteria completed baseline assessment, including the OMQ, the Buss–Perry Aggression Questionnaire (BPAQ) and the Addiction Severity Index (ASI) (see subsequent discussions). In the parent study, 175 patients were included, and 192 were excluded; among the latter, 124 did not satisfy criteria for ASPD, and 78 declined to participate (Thylstrup et al, , ). One hundred and twenty‐seven of the trial participants could be included in the present study; 48 were excluded for various reasons (five reported no past year offending behaviour; two did not nominate a most risky offence; and 41 had missing data on one or more of the study questionnaires).…”

“…Motivation for offending behaviour is associated with risk factors for crime and is therefore central in the prevention of re‐offending (Levine & Jackson, ; Walters, ; Walters, ). Knowledge about individual motives for offending provides us with important information about individual differences concerning motives to commit criminal acts, which can be incorporated into programmes for reducing offending behaviour (Maruna & Mann, ; Thylstrup et al, , ). At present, little is known about individual differences associated with motives for offending, although some significant studies have contributed to this important field.…”

Patient-centred care-perhaps the future of substance abuse treatment

“…As there were no differences between treatment conditions in the intake, dose titration, drug screening and methadone take-home procedures, there were missed opportunities to test these additional PCC principles. This is particularly relevant, as methadone patients have previously reported dissatisfaction with the comprehensiveness of this treatment [7] and its limited opportunities for shared decision-making [7].…”

“…People in substitution treatment face societal stigmatization and are often highly disciplined by institutions, and these factors may hinder recovery and the development of positive pro-social identities [5,6]. The task for treatment providers will be to develop ways to engage individuals and patient populations in formulating the goals for treatment and specifying what is important to them [7], although this may be difficult [8,9].…”