Sexual Abuse and the Outcome of Addiction Treatment

Abstract

The objective of this prospective follow-up study was to examine the effects of sexual abuse on substance use disorder patients' clinical presentation and course in treatment. Consecutive admissions to the MUHC's Addictions Unit were assessed at intake (N=206) and six-month follow-up (n=172). Assessments evaluated socio-demographic and psychiatric characteristics, addiction severity, and physical and/or sexual abuse histories. Upon entering treatment, 23% reported prior sexual abuse with or without physical abuse. Patients with a sexual abuse history had higher rates of psychological problems, stronger family histories of substance use disorders, and more impaired family relationships. At six months, there were no differences between patients with and without sexual abuse histories in their response to treatment, or their utilization of treatment services. The current study failed to show that prior sexual abuse compromised short-term treatment outcomes.

Lifetime physical and sexual abuse and substance use treatment outcomes in men

“…among SUD patients. In recent research with mixed gender samples, history of physical or sexual abuse was not associated with more severe alcohol or drug use at intake or with differences in abstinence rates at 6 months postintake (Charney et al, 2007;Pirard et al, 2005). However, in a study of over 20,000 veterans with an SUD, patients with a history of physical or sexual abuse reported more severe alcohol and drug problems at treatment intake relative to patients without an abuse history (Ouimette, Kimerling, Shaw, & Moos, 2000), and history of physical or sexual abuse was associated with more severe alcohol problems but not drug problems at the 1-year follow-up (Rosen, Ouimette, Sheikh, Gregg, & Moos, 2002).…”

“…Methodological limitations and sparse research have led to confusion regarding the need for SUD treatment programs to address issues related to physical or sexual abuse history. In particular, some have argued that failure to identify and provide additional treatment for patients with a history of physical or sexual abuse may compromise SUD treatment (Pirard, Sharon, Kang, Angarita, & Gastfriend, 2005;Rice et al, 2001;Windle, Windle, Scheidt, & Miller, 1995), whereas others contend that the impact of abuse on SUD treatment outcomes is negligible (Charney, Palacios-Boix, & Gill, 2007;Fiorentine et al, 1999).…”

The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans

“…This study represents an extension of previous work (Charney et al, 2007;Schneider et al, 2008aSchneider et al, , 2008b by assessing the unique influences of sexual abuse and physical abuse victimization. As our results demonstrate, the type of abuse victimization has a significant impact on the severity of a patient's problems.…”

“…Further, in a study of more than 20,000 veterans, male and female participants with an abuse history demonstrated significantly higher rates of alcohol problems (Rosen et al, 2005). Finally, even among the few studies that have assessed group differences among nonabused, physically abused, and sexually abused participants, there is mixed evidence, with one study of male patients with SUD finding that both sexually abused and physically abused participants had higher rates of drug use at treatment intake (Schneider et al, 2008a(Schneider et al, , 2008b) and a study of male and female patients finding no group differences (Charney, Palacios-Boix, & Gill, 2007). These mixed results, potentially accounted for by differences in the patient samples, highlight the importance of assessing the unique and common influence of physical abuse and sexual abuse victimization on SUD outcomes among men.…”

“…Heightened psychiatric problems were maintained across a 1-year follow-up period for both men and women (Pirard et al, 2005). In a study of male and female patients with SUD, nonabused patients showed the lowest rates of depression, suicide attempts, and suicidal thoughts; physically abused patients showed higher rates of these problems; and sexually abused patients showed the highest or most severe scores on each measure of psychiatric problems (Charney et al, 2007). In a primarily male sample, Schneider et al (2008aSchneider et al ( , 2008b also found that sexually abused patients had significantly higher levels of psychiatric problems, suicide attempts, and suicidal thoughts compared with nonabused patients, but no differences emerged between nonabused and physically abused patients with SUD on psychiatric indexes (Schneider et al, 2008a(Schneider et al, , 2008b.…”