The relationship of patients' cognitive status and therapists' ratings of psychological distress among psychoactive substance users in long-term residential treatment.

Abstract

Patients in a long-term residential substance abuse treatment program (N = 168) were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), a brief inventory that measures psychological distress in nine symptom areas. Using the Symptom Checklist-90 Analogue (SCL-90 Analogue), which allows raters to assess patients along the same dimensions measured by the SCL-90-R, therapists also estimated the degree of psychological distress they observed in their patients. Significantly larger discrepancies were found between therapists' ratings of their patients and patients' ratings of themselves when patients were cognitively impaired (N = 57) than when patients did not display these decrements (N = 111). Furthermore, these patient-therapist assessment differences were negatively related to measures of patients' participation in treatment and length of stay in the program. Clinical and research implications of these findings are discussed.