Prevalence of Psychiatric Disorders Among Persons Convicted of Driving While Impaired

Lapham, Sandra C.; Smith, Elizabeth M.; Baca, Janet C’de; Chang, Iyiin; Skipper, Betty J.; Baum, George; Hunt, William C.

doi:10.1001/archpsyc.58.10.943

Cited by 110 publications

(124 citation statements)

References 44 publications

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“…Functioning may be poorer among repeat DWI offenders than among fi rst-or one-time offenders. More severe alcohol disorders, low self-effi cacy, and more severe psychiatric profi les were associated with a higher likelihood of DWI recidivism (DeYoung, 1997;Freeman et al, 2005;Greenberg et al, 2004Greenberg et al, , 2005Lapham et al, 2001Lapham et al, , 2006LaPlante et al, 2008;Shaffer et al, 2007).…”

Section: Mechanisms To Explain Reductions In Dwimentioning

confidence: 97%

“…Regarding functioning, more frequent and heavier drinking (Duncan et al, 1999;Gruenewald et al, 1996), higher levels of impulsivity and depression, less self-esteem (Donovan and Marlatt, FIGURE 1. Model of changes in driving while intoxicated (DWI) frequency over time Holt et al, 2009;Lapham et al, 2001;Reynolds et al, 1991;Veneziano and Veneziano, 1992), and less social support (Kennedy et al, 1997;Nelson et al, 1999) were related to a higher likelihood of and more frequent occurrences of DWI. People who experienced a poor life context (high rates of negative life events) and coped poorly also were more likely to have driving problems or drive while they were intoxicated (Su et al, 2009;Veneziano and Veneziano, 1992;Woldt and Bradley, 2002).…”

Section: Mechanisms To Explain Reductions In Dwimentioning

confidence: 99%

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Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups

Timko¹,

Desai²,

Blonigen³

et al. 2011

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: This study examined associations between frequency of driving while intoxicated (DWI) at baseline and obtaining alcohol-related help at follow-up, and between obtaining help and subsequent reductions in DWI. It also examined improvements on personal functioning and life context indices as mediators between obtaining help and reduced occurrences of DWI. Method: A total of 628 individuals who were initially untreated for alcohol use problems completed a baseline inventory; follow-ups were 1, 3, and 16 years later. Results: More extended participation in outpatient treatment and Alcoholics Anonymous (AA) during Year 1 was associated with a lower likelihood of DWI at the 1-year follow-up. More extended participation in AA through Year 3 was associated with a lower likelihood of DWI at the 16-year follow-up. Improvement on personal functioning and life context indices was associated with reduced risk of subsequent occurrences of DWI. Decreases in drinking-related problems, impulsivity, and drinking to reduce tension mediated associations between more AA participation and reductions in DWI at 1 year. Conclusions: Among initially untreated individuals, sustained mutual help may be associated with a reduced number of occurrences of DWI via fewer drinking consequences and improved psychological functioning and coping. Treatment providers should attend to these concomitants of DWI and consider actively referring individuals to AA to ensure ongoing AA affi liation. The majority of studies of DWI have focused on community samples or samples of people arrested and convicted for DWI who were mandated to treatment. In contrast, we examined DWI in a sample of individuals who, at entry into the study, had initiated help seeking but were untreated for alcohol use problems; these individuals were followed for 16 years. Compared with non-help-seeking community samples, these help seekers likely have more severe alcohol-related dysfunction (George and Tucker, 1996;Tucker, 1995) but also more recognition of their alcohol misuse, motivation to change, and commitment to abstinence (Timko et al., 1994). However, compared with individuals reporting previous treatment for alcohol use disorders, these individuals likely have less severe alcohol-related dysfunction but also less motivation to change and commitment to abstinence (LoCastro et al., 2008). Thus, in the context of previous studies of DWI, we examined a sample that, by virtue of seeking help for the fi rst time, was unique in terms of severity of alcoholrelated disorder and motivation to change.To examine the behavior of DWI, this study used the conceptual framework developed by Moos and colleagues (Moos and Finney, 1983;Moos et al., 1990b) and adopted by other investigators (e.g., Buri et al., 2007) to examine the context of alcohol-related outcomes (Figure 1). The framework suggests that there is an association between (a) the individual's functioning and life context (e.g., severity of alcohol misuse, psychological symptoms, negative life events, social su...

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Section: Mechanisms To Explain Reductions In Dwimentioning

confidence: 97%

Section: Mechanisms To Explain Reductions In Dwimentioning

confidence: 99%

Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups

Timko¹,

Desai²,

Blonigen³

et al. 2011

J. Stud. Alcohol Drugs

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“…Because psychoactive drugs may impair driving ability, their users are at increased risk of traffic accidents (Dassanayake et al, 2011;Gustavsen et al, 2008;Hetland and Carr, 2014). Moreover, mental health problems as well as substance use disorders are more common (Freeman et al, 2011;Karjalainen et al, 2012;Lapham et al, 2001) and psychoactive drugs are more commonly prescribed among drug-impaired drivers than in the general population.…”

Section: Introductionmentioning

confidence: 99%

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Tjäderborn

Jönsson

Sandström

et al. 2016

Drug and Alcohol Dependence

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Aims: To determine the prevalence of non-prescribed drug use among subjects suspected of drug-impaired driving with a confirmed intake of a psychoactive prescription drug, and to identify associated factors. Methods:Subjects investigated for drug-impaired driving in Sweden during 2006-2009 with a confirmed intake of diazepam, flunitrazepam, tramadol, zolpidem or zopiclone were identified using the Swedish Forensic Toxicology Database. Information on dispensed prescription drugs was retrieved from the Swedish Prescribed Drug Register. Non-prescribed use was defined as a confirmed use of a psychoactive prescription drug intake confirmed by toxicological analysis in a subject by whom it was not dispensed in the 12 months preceding the sampling. Prevalence proportions were calculated for each drug and logistic regression was used to identify associated factors. Results: In total, 2225 subjects were included. The median age (range) was 34 (15-80) years and 1864 (83.8%) subjects were male. Non-prescribed use was found in 1513 subjects (58.7%); for flunitrazepam 103 (76.3%), diazepam 1098 (74.1%), tramadol 192 (40.3%), zopiclone 60 (29.7%), and zolpidem 60 (21.2%) subjects, respectively. Younger age and multiple-substance use were associated with nonprescribed use, whereas ongoing treatment with other psychoactive drugs was negatively associated with nonprescribed use. Conclusions: Non-prescribed use of psychoactive prescription drugs was common in subjects suspected of drug-impaired driving and was more frequent for benzodiazepines and tramadol compared to zolpidem and zopiclone. The young and multi-substance users were more likely, whereas subjects with ongoing prescribed treatment with other psychoactive drugs were less likely, to use non-prescribed drugs.

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“…Repeat DUI offenders are at high risk of co-occurring psychiatric disorders (Lapham et al, 2001;Lapham et al, 2006), and psychiatric comorbidity has a negative impact on the course, treatment outcome, and prognosis of both syndromes (Regier et al, 1990). Additionally, many persons providing DUI screening, assessment, and treatment services have not been adequately trained in the areas of co-occurring disorders, and this compounds the problem (Cavaiola & Wuth, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this population is at great risk of co-occurring psychiatric disorders, with estimates ranging from 33% to 65% of lifetime psychiatric disorders comorbid with alcohol use disorders for men, and 50% to 79.7% for women (Lapham et al, 2001;Lapham, Kapitula, C'de Baca, & McMillan, 2006). Recognizing the tremendous negative personal and public health consequences of relapse among repeat DUI offenders, this population is commonly mandated to alcoholism treatment when convicted (Dill & Wells-Parker, 2006).…”

Section: Introductionmentioning

confidence: 99%

Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment

McMillan

Timken²,

Lapidus

et al. 2008

Journal of Substance Abuse Treatment

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Repeated offenders for driving under the influence (DUI) offenders are routinely mandated to alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment. The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown. As part of a larger study to investigate the impact of sanction conditions on probation outcomes, we screened 233 subjects for psychiatric conditions and compared those findings to the psychiatric conditions identified during mandatory treatment by independent treatment providers. Adjusted rates of under-diagnosis were commonly high: 97.2% of bipolar, 67.5% of major depression, 100% of obsessive-compulsive, and 37.3% of drug use disorders remained undiagnosed during treatment. Rates of over-diagnosis were low for all disorders, with the exception of drug use disorders. These rates of under-diagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders.

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Prevalence of Psychiatric Disorders Among Persons Convicted of Driving While Impaired

Abstract: Drunk-driving offenders need assessment and treatment services not only for alcohol problems but also for drug use and the other psychiatric disorders that commonly accompany alcohol-related problems.

Cited by 110 publications

References 44 publications

Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups

Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment

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