Coping styles in substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).

Linda M Kronenberg,Wim Van Den Brink,Jooske Van Busschbach,Theo Van Achterberg,Peter J.J Goossens

doi:10.1186/s12888-015-0530-x

Abstract

BackgroundPatients with a substance use disorder (SUD) and co-occurring attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often start using substances in an attempt to cope with the stress related to their ADHD or ASD. To improve treatment for these patient groups, it is important to identify and compare the various coping styles between SUD patients with and without ADHD or ASD and with subjects from a general population sample.MethodsCross-sectional study using the Utrecht Coping List (UCL) in 50 SUD patients, 41 SUD + ADHD patients, 31 SUD + ASD patients and 1,200 railway employees.ResultsCompared with the reference group, all three SUD groups showed a significant higher mean on the Palliative reaction, Avoidance, and Passive reaction subscales of the UCL. The scores for all UCL subscales of the SUD and the SUD + ADHD groups were very similar. However, the SUD + ASD group scored higher on Passive reaction and lower on Reassuring thoughts than the SUD and the SUD + ADHD groups and lower on Expression of emotions subscale in comparison with the SUD + ADHD group.ConclusionsRegardless of the presence of a co-occurring disorder, SUD patients reported more palliative, avoidant and passive coping when confronted than people in the general population. In addition, SUD patients with co-occurring ASD were different from other SUD patients in their coping and professionals should take this into account when working on more adaptive coping strategies with these patients.

Highlights

Patients with a substance use disorder (SUD) and co-occurring attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often start using substances in an attempt to cope with the stress related to their ADHD or ASD
We have shown that patients with a substance use disorder (SUD) and co-occurring ADHD or ASD initially started to use alcohol and/or drugs to cope with ADHD and ASD associated stress
A total of 122 patients participated in the study: 50 patients with SUD only, 41 patients with SUD + ADHD and 31 patients with SUD + ASD

Summary

Results

A total of 122 patients participated in the study: 50 patients with SUD only, 41 patients with SUD + ADHD and 31 patients with SUD + ASD. The SUD + ASD group scores are significantly higher on Passive reaction and lower on Reassuring thoughts compared to the SUD and SUD + ADHD groups and lower on Expression of emotions compared to the SUD + ADHD group These findings only partly supported our first hypothesis, namely that patients with SUD + ADHD would show more confronting behaviour and more positive reappraisal than patients with SUD and SUD + ASD. The patients with SUD + ADHD in our study did not show more Active problem solving behaviour than the other groups while their average score on Reassuring thoughts was higher than in the SUD + ASD group but not the SUD group. We cannot extrapolate from the current findings to draw conclusions about female patients with SUD, SUD + ADHD or SUD + ASD This is important, because it is well known that males and females differ considerably in coping strategies [26]. The care professional might collaborate with the patient on the development of a relapse prevention plan, for example, and help the patient to anticipate problems and prevent them or be better prepared to deal with them in a functional as opposed to dysfunctional manner

Conclusions

Background

Methods