Greater Problem Severity Research Articles

Random versus nonrandom assignment in the evaluation of treatment for cocaine abusers.

Cocaine-abusing patients randomly assigned to day-hospital or inpatient rehabilitation were compared with patients who self-selected these treatment settings to examine differences in substance use and psychosocial outcomes under experimental and nonexperimental designs. There was little evidence of setting or assignment effects or Setting x Assignment interactions over the 12-month follow-up period. However, Assignment x Time interactions were obtained with 2 measures of cocaine use and measures of family-social and psychiatric problem severity. These interactions indicated greater problem severity at intake among the randomized patients coupled with greater improvements by the 3-month follow-up relative to the nonrandomized patients. Findings suggest that randomized studies of treatment for cocaine abuse may produce somewhat larger estimates of improvement than what is observed in more typical treatment situations.

Pretreatment Variables That Predict Completion of an Adolescent Substance Abuse Treatment Program

The present study was designed to determine the utility of pretreatment data in predicting completion and dropout from adolescent substance abuse treatment. One hundred thirty-two consecutively admitted adolescents (mean age = 16.4 years; 93 male subjects, 39 female subjects) with significant substance abuse were administered a battery of standardized substance abuse, psychopathology, and social questionnaires immediately after admission to an intensive, set-length substance abuse treatment program. Seventy-four adolescents completed the program. Using discriminant function analyses, five pretreatment measures were found to predict treatment completion in male subjects, including: greater severity of problems with alcohol; greater use of drugs other than alcohol, cannabis, and tobacco; higher degree of internalizing problems; and lower self-esteem. Significant predictors for completion by female subjects were not found. The role of treatment readiness and motivation for male subjects is examined, and the lack of significant findings for female subjects is discussed.