Persistence of Addictive Disorders in a First-Offender Driving While Impaired Population

Abstract

Context We compared the prevalence of alcohol use and other psychiatric disorders in offenders 15 years after a first conviction for driving while impaired with a general population sample. Objective To determine whether high rates of addictive and other psychiatric disorders previously demonstrated in this sample remain disproportionately higher compared with a matched general population sample. Design Point-in-time cohort study. Setting Pacific Institute for Research and Evaluation, Albuquerque, New Mexico. Participants We interviewed convicted first offenders using the Composite International Diagnostic Interview 15 years after referral to a screening program in Bernalillo County, New Mexico. We calculated rates of diagnoses for non-Hispanic white and Hispanic women (n=362) and men (n=220) adjusting for missing data using multiple imputation and compared psychiatric diagnoses with findings from the National Comorbidity Survey Replication by sex and Hispanic ethnicity. Results Eleven percent of non-Hispanic white women and 12.8% of Hispanic women in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with 1.0% and 1.8%, respectively, in the National Comorbidity Survey Replication (comparison) sample. Almost 12% of non-Hispanic white men and 17.5% of Hispanic men in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with to 2.0% and 1.8%, respectively, in the comparison sample. These differences were statistically significant. Rates of drug use disorders and nicotine dependence were also elevated compared with the general population sample, while rates of major depressive disorder and posttraumatic stress disorder were similar. Conclusion In this sample, high rates of addictive disorders persisted over 10 years among first offenders and greatly exceeded those found in a general population sample.

Randomized Controlled Trial of Contingency Management for Stimulant Use in Community Mental Health Patients With Serious Mental Illness

“…Methodologically, the lower treatment completion rate in the contingent condition, relative to the non-contingent condition, resulted in group differences in rates of missing data. However, we utilized robust statistical methods (i.e., multiple imputation), that have been frequently used in psychiatric research where comparable levels of missing data were observed (34, 35), to account for missing data (see the Data Analysis section) and conducted multiple sensitivity analyses to corroborate the findings of our multiple imputation approach. Despite these consistent results, it is important to note that all imputation strategies bias study results, with some (e.g., single imputation) introducing more bias than others.…”

“…This approach has significant advantages over single imputation or listwise deletion (31) or other techniques (32, 33) in conjunction generalized estimation equation analyses and has frequently been used in psychiatric studies with similar levels of missing data (34, 35). Multiple imputations requires the assumption of ‘missing at random.’ This method of is a more conservative approach compared to the default listwise deletion used in generalized estimation equations analyses which assumes ‘missing completely at random.’ Preliminary analyses identified 12 variables that predicted missingness due to treatment dropout.…”

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“…The Structured Clinical Interview for DSM-IV – Axis I (SCID; First, Spitzer, Gibbon, & Williams, 1998) was used to identify Axis I DSM-IV disorders other than PTSD and to determine whether potential participants met exclusion for a psychotic disorder. The antisocial and borderline personality disorder modules of the SCID – Axis II (First, Spitzer, Gibbon, & Williams, 1997) assessed the most common personality disorders in people with chronic SUD and PTSD (Friborg, Martinussen, Kaiser, Overgård, & Rosenvinge, 2013; Hasin et al, 2011). …”

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