Patient pre-treatment expectations and substance use treatment outcomes

Abstract

Drug and Alcohol Dependence 156 (2015) e183–e245 e201 conducted utilizing a subset of the NSCAW II in which the children remained in the home following a CPS investigation. A random half sample was drawn (n=1087) to conduct two separate models for female and male caregivers. Results were confirmed on the second half of the sample. PDU was measured continuously with the 20-itemDrugAbuse Screening Test. Caregiver depressionwasmeasuredwith the Composite InternationalDiagnostic Interview-Short Form. CIB was measured continuously with the internalizing subscale of the Child Behavior Checklist. Control variables were child age, child gender, and familypoverty. Analyses accounting for stratification, clustering, andweightingwere conductedwithMplus 7.0. Standardized estimates and asymmetrical confidence intervals are reported. Results: Female caregivers’ depressionwas found to fullymediate the relationship from PDU to CIB ( = .048, ⌠= .015, 95% CI .021–.081). Among male caregivers, depression was not a significantmediator in the relationship fromPDU toCIB ( = .007, ⌠= .039, 95% CI−.068 to .099). Fit for the female caregivermodel was strong (RMSEA= .000, p= .99; CFI = 1.00). Conclusions: Among families reported to CPS where a female caregiver is engaged in PDU, thepresence of comorbiddepression is an important indicator of need for intervention. Addressing these comorbid disorders may lead to decreases in CIB. Unavailable in this dataset, future research should examine anxiety as another potential mediator. Financial support: F31DA034442; T32DA015035; Doris Duke Fellow; Fahs-Beck Scholar. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.540 Patient pre-treatment expectations and substance use treatment outcomes Kelly Serafini2,∗, Suzanne Decker2,3, Brian D. Kiluk1, Luis Anez2, Manuel Paris2, Tami Frankforter2, Kathleen M. Carroll 2 1 Psychiatry, Yale School of Medicine, West Haven, CT, United States 2 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, United States 3 West Haven VA, West Haven, CT, United States Aims: To determine if expectations at pre-treatment are associated with substance use treatment outcomes. Methods: Treatment expectations were examined in two randomized controlled trials (RCTs) utilizing Motivational Enhancement Therapy (MET) for the treatment of substance use conducted in the CTN. One RCT was delivered in English (MET-E) and one was delivered in Spanish (MET-S). There were 461 participants MET-E sample and 405 participants MET-S. Participants responded to the following item at pre-treatment: “Do you think you will reduce or stop your use of drugs or alcohol as a result of this treatment?” ANOVAs and chi-square tests were used to examine the relationship between treatment expectations and treatment outcomes in the two samples. Results: Treatment expectations were not associated with any of the treatment outcomes in MET-E. However, in MET-S, expectationswere significantly associatedwithmost of the post-treatment outcomes. Among these, treatment expectationswere significantly associated with the percentage of drug positive urines within the treatment period, F (1, 1,163) =18.83, p= .000, and the percentage of days abstinent from primary drug use while in treatment and through follow-up, F (1, 1,364) =23.78, p= .000. Conclusions: There are several possible interpretations to the divergent findings between samples. The first is that the MET-S sample had fewer previous treatments, and that when a treatment is novel, expectations may have more of an influence. The second interpretation is that there may be cultural components that may affect how an individual relates to the treatment process. These findings are preliminary and future research should examine treatment expectations across cultures. Financial support: This research was supported in part through a National Institute on Drug Abuse (NIDA) T-32 grant, 5T32DA007238-23 (Petrakis), anduseddata fromstudies thatwere funded by the Clinical Trials Network. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.541 Does craving intensity influence cue exposure reports? An ecological momentary assessment study in patients with alcohol, tobacco, cannabis and heroin use disorder F. Serre1,∗, M. Fatseas1, J. Swendsen2, Marc Auriacombe1 1 Addiction Psychiatry (CNRS USR 3413), Universite Bordeaux, Bordeaux, France 2 CNRS UMR 5284 INCIA University Bordeaux,