The US National Comorbidity Survey: overview and future directions

Kessler, Ronald C.; Anthony, James C.; Blazer, D; Bromet, Evelyn J.; Eaton, William W.; Kendler, Kenneth S.; Swartz, Marvin S.; Wittchen, Hans‐Ulrich; Zhao, Shanyang

doi:10.1017/s1121189x00008575

Cited by 125 publications

(154 citation statements)

References 28 publications

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“…The Epidemiologic Catchment Area study reported lifetime prevalence of 29% for drug dependence among those with a mental health disorder and lifetime prevalence of a mental disorder of 53% among those with a drug use disorder (Regier et al, 1990). Similar rates of comorbidity were found in the National Comorbidity Study 4 (Kessler, 1995). A generalizable study of 130 low income, inner city U.S. residents reported a lifetime prevalence of dual diagnoses of 60% among patients in a mental health clinic and 67% among patients in outpatient substance user treatment (Hien et al, 1997).…”

Section: Prevalence Of Co-occurring Disordersmentioning

confidence: 58%

“…There is considerable evidence that comorbid disorders are more severe and chronic than single psychiatric disorders (Hagnell & Grasbeck, 1990;Hirschfeld et al, 1990;Kessler, 1995;Murphy, 1990). In the general population, persons with lifetime comorbidity are more likely than those with only one disorder to experience major impairments with economic domains (e.g., unemployment, financial problems), social isolation, and interpersonal conflicts (Kessler, 1995).…”

Section: Consequences Of Co-occurring Disordersmentioning

confidence: 99%

“…In the general population, persons with lifetime comorbidity are more likely than those with only one disorder to experience major impairments with economic domains (e.g., unemployment, financial problems), social isolation, and interpersonal conflicts (Kessler, 1995). Comorbidity is highly predictive of negative treatment outcomes (Gonzalez and Rosenheck, 2001;Donat and Haverkamp, 2004).…”

Section: Consequences Of Co-occurring Disordersmentioning

confidence: 99%

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Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Magura

2008

Substance Use & Misuse

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Over five million adults in the U.S. have a co-occurring substance use disorder and serious psychological distress. Mutual aid ("self-help") can usefully complement treatment, but people with co-occurring substance use and psychiatric disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons recovering from cooccurring disorders. An evaluation of DTR was conducted by interviewing 310 persons attending 24 DTR meetings in New York City in 1998 and following them up for two years, in 1999 and 2000. The evaluation produced 13 articles in 12 peer reviewed journals, the main results of which are summarized here. The sample's characteristics were: mean age, 40 years; women, 28%; black, 59%; white, 25%; Hispanic, 14%; never married, 63%; live in supported community residence, 53%; high school graduate or GED, 60%; arrested as adult, 63%; diagnoses of: schizophrenia, 39%; major depression, 21%; or bipolar disorder; 20%; currently prescribed psychiatric medication, 92%; primary substance used, current or past: cocaine/crack, 42%; alcohol 34%; or heroin, 11%. Overall, the findings indicate that DTR participation has both direct and indirect effects on several important components of recovery: drug/alcohol abstinence, psychiatric medication adherence, self-efficacy for recovery, and quality of life. The study also identified several "common" therapeutic factors (e.g., internal motivation, social support) and unique mutual aid processes (helper-therapy, reciprocal learning) that mediate the influence of DTR participation on recovery. For clinicians, these results underline the importance of fostering stable affiliation with specialized dual focus 12-step groups for their patients with co-occurring disorders, as part of a comprehensive recovery-oriented treatment approach.

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Section: Prevalence Of Co-occurring Disordersmentioning

confidence: 58%

Section: Consequences Of Co-occurring Disordersmentioning

confidence: 99%

Section: Consequences Of Co-occurring Disordersmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Magura

2008

Substance Use & Misuse

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“…There is also evidence that those with lifetime comorbidity are more likely than those with a single disorder to experience major impairments in economic roles (e.g., unemployment, financial problems) and social roles (e.g., social isolation, interpersonal conflicts; see Kessler, 1995).…”

Section: Introductionmentioning

confidence: 99%

Double trouble in recovery: Self-help for people with dual diagnoses.

Vogel¹,

Knight²,

Laudet³

et al. 1998

Psychiatric Rehabilitation Journal

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Self-help is gaining increased acceptance among treatment professionals as the advent of managed care warrants the use of cost-effective modalities. Traditional "one disease-one recovery" self-help groups cannot serve adequately the needs of the dually diagnosed. This article discusses Double Trouble in Recovery (DTR), a 12-step self-help group designed to meet the special needs of those diagnosed with both a psychiatric disability and a chemical addiction, DTR differs from traditional self-help groups by offering people a safe forum to discuss their psychiatric disabilities, medication, and substance abuse. Preliminary data collected at four DTR sites in NYC indicate that DTR members have a long history of psychiatric disabilities and of substance abuse, and extensive experience with treatment programs in both areas. They are actively working on their recovery, as evidenced by their fairly intensive attendance at DTR. Recent substance use is limited, suggesting that participation in DTR (in conjunction with format treatment when needed) is having a positive effect. Most members require medication to control their psychiatric disabilities, and that alone may make attendance at "conventional" 12-step groups uncomfortable. Ratings of statements comparing DTR to other 12-step meetings suggest that DTR is a setting where members can feel comfortable and safe discussing their dual recovery needs.

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“…Parents who met diagnostic criteria at either time point were assigned to the FA group. The UM-CIDI is a widely used diagnostic interview designed to assess substance abuse and dependence with high interrater reliability, high test-retest reliability, and good validity with regard to concordance with clinical diagnoses (see Kessler, 1995).Parents' depression-Parents' depression was assessed at 12 and 18 months with the Center for Epidemiological Studies Depression Inventory (CESD; Radloff, 1977), a scale designed to measure depressive symptoms in community populations. The CESD is a screening instrument with 20 symptoms of depression.…”

mentioning

confidence: 99%

A conceptual model for the development of externalizing behavior problems among kindergarten children of alcoholic families: Role of parenting and children's self-regulation.

Eiden¹,

Edwards²,

Leonard³

2007

Developmental Psychology

180

164

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The purpose of this study was to test a conceptual model predicting children's externalizing behavior problems in kindergarten in a sample of children with alcoholic (n = 130) and nonalcoholic (n = 97) parents. The model examined the role of parents' alcohol diagnoses, depression, and antisocial behavior at 12-18 months of child age in predicting parental warmth/sensitivity at 2 years of child age. Parental warmth/sensitivity at 2 years was hypothesized to predict children's self-regulation at 3 years (effortful control and internalization of rules), which in turn was expected to predict externalizing behavior problems in kindergarten. Structural equation modeling was largely supportive of this conceptual model. Fathers' alcohol diagnosis at 12-18 months was associated with lower maternal and paternal warmth/sensitivity at 2 years. Lower maternal warmth/sensitivity was longitudinally predictive of lower child self-regulation at 3 years, which in turn was longitudinally predictive of higher externalizing behavior problems in kindergarten, after controlling for prior behavior problems. There was a direct association between parents' depression and children's externalizing behavior problems. Results indicate that one pathway to higher externalizing behavior problems among children of alcoholics may be via parenting and self-regulation in the toddler to preschool years. Keywordsalcoholism; parenting; self-regulation; externalizing behavior problems It is now well established that children of alcoholic parents are at increased risk for interpersonal and behavior problems, psychiatric disturbances, substance abuse (including early onset of alcohol use), and developmental trajectories of persistent alcohol problems (Chassin, Flora, & King, 2004;Jackson, Sher, & Wood, 2000;Jacob & Windle, 2000). Researchers have speculated that one pathway to later substance abuse disorders among children of alcoholics is through higher incidence of behavior problems or behavioral undercontrol, characterized by higher aggression, impulsivity, and sensation seeking (Sher, 1991). This model has been supported by empirical evidence indicating that children of alcoholic fathers have higher ratesCorrespondence concerning this article should be addressed to Rina D. Eiden, 1021 Main Street, Buffalo, NY 14203. E-mail: E-mail: eiden@ria.buffalo.edu. of externalizing behavior problems and behavioral undercontrol (e.g., Blackson, 1994;DeLucia, Belz, & Chassin, 2001;Edwards, Eiden, Colder, & Leonard, 2006;Jacob & Windle, 2000). However, with the exception of recent reports from the Michigan Longitudinal Study (e.g., Loukas, Zucker, Fitzgerald, & Krull, 2003), few studies have investigated the mediational pathways explaining the association between parental alcohol problems and children's externalizing behavior problems using longitudinal data. Two important mediators of this association that have been implicated in studies using other high-risk samples are children's self-regulatory abilities and lower parental warmth/sensitivity. NIH Publi...

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The US National Comorbidity Survey: overview and future directions

Cited by 125 publications

References 28 publications

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Double trouble in recovery: Self-help for people with dual diagnoses.

A conceptual model for the development of externalizing behavior problems among kindergarten children of alcoholic families: Role of parenting and children's self-regulation.

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