Predictors of Dropout from Psychosocial Treatment in Opioid-Dependent Outpatients

被引:72
作者
McHugh, R. Kathryn [1 ,2 ]
Murray, Heather W. [3 ]
Hearon, Bridget A. [3 ]
Pratt, Elizabeth M. [3 ]
Pollack, Mark H. [4 ]
Safren, Steven A. [2 ,5 ]
Otto, Michael W. [3 ]
机构
[1] McLean Hosp, Div Alcohol & Drug Abuse, Belmont, MA 02478 USA
[2] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[3] Boston Univ, Dept Psychol, Boston, MA 02215 USA
[4] Rush Univ, Med Ctr, Dept Psychiat, Chicago, IL 60612 USA
[5] Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02114 USA
关键词
DISTRESS TOLERANCE; ANXIETY SENSITIVITY; TREATMENT OUTCOMES; SUBSTANCE USE; RETENTION; MAINTENANCE; ATTRITION; ADDICTION; COCAINE; HEROIN;
D O I
10.1111/j.1521-0391.2013.00317.x
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background and Objectives Early dropout is common in substance abuse treatment settings and may lead to poorer outcomes relative to those completing a full course of treatment. Attempts to identify predictors of dropout have yielded mixed results, highlighting the need for additional research in this area to clarify risk and protective factors to guide intervention and retention efforts. This study evaluated predictors of dropout from psychosocial treatment among opioid-dependent patients on methadone maintenance therapy. Methods Participants included 78 patients who had failed to respond to at least 4 months of methadone maintenance plus group counseling with clinic substance abuse counselors, and were enrolled in a study of randomized psychosocial treatment in addition to treatment-as-usual. Several factors that have been implicated in previous studies as well as two affective variables (distress intolerance and coping motives for drug use) were examined. Results Results indicated that when controlling for various risk factors, age was the only significant predictor of dropout, with younger patients more likely to discontinue treatment early. Conclusions This study replicates previous findings in opioid-dependent samples that younger patients are at an increased risk of early treatment dropout. Conclusions and Significance Targeted intervention may be needed to retain young patients in drug abuse treatment. (Am J Addict 2013;22:18-22)
引用
收藏
页码:18 / 22
页数:5
相关论文
共 33 条
[11]   Engagement and Retention in Outpatient Alcoholism Treatment for Women [J].
Graff, Fiona S. ;
Morgan, Thomas J. ;
Epstein, Elizabeth E. ;
McCrady, Barbara S. ;
Cook, Sharon M. ;
Jensen, Noelle K. ;
Kelly, Shalonda .
AMERICAN JOURNAL ON ADDICTIONS, 2009, 18 (04) :277-288
[12]   Characteristics of Opiate Users Leaving Detoxification Treatment Against Medical Advice [J].
Kenne, Deric R. ;
Boros, Alec P. ;
Fischbein, Rebecca L. .
JOURNAL OF ADDICTIVE DISEASES, 2010, 29 (03) :383-394
[13]   Identifying pregnant women at risk for early attrition from substance abuse treatment [J].
Kissin, WB ;
Svikis, DS ;
Moylan, P ;
Haug, NA ;
Stitzer, ML .
JOURNAL OF SUBSTANCE ABUSE TREATMENT, 2004, 27 (01) :31-38
[14]   Anxiety sensitivity: A unique predictor of dropout among inner-city heroin and crack/cocaine users in residential substance use treatment [J].
Lejuez, C. W. ;
Zvolensky, Michael J. ;
Daughters, Stacey B. ;
Bornovalova, Marina A. ;
Paulson, Autumn ;
Tull, Matthew T. ;
Ettinger, Kenneth ;
Otto, Michael W. .
BEHAVIOUR RESEARCH AND THERAPY, 2008, 46 (07) :811-818
[15]   Predictors of Attrition from a National Sample of Methadone Maintenance Patients [J].
Mancino, Michael ;
Curran, Geoffrey ;
Han, Xiaotong ;
Allee, Elise ;
Humphreys, Keith ;
Booth, Brenda M. .
AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE, 2010, 36 (03) :155-160
[16]   A novel method for assessing distress intolerance: Adaptation of a measure of willingness to pay [J].
McHugh, R. Kathryn ;
Hearon, Bridget A. ;
Halperin, Daniella M. ;
Otto, Michael W. .
JOURNAL OF BEHAVIOR THERAPY AND EXPERIMENTAL PSYCHIATRY, 2011, 42 (04) :440-446
[17]   The addiction severity index at 25: Origins, contributions and transitions [J].
McLellan, AT ;
Cacciola, JC ;
Alterman, AI ;
Rikoon, SH ;
Carise, D .
AMERICAN JOURNAL ON ADDICTIONS, 2006, 15 (02) :113-124
[18]   THE 5TH EDITION OF THE ADDICTION SEVERITY INDEX [J].
MCLELLAN, AT ;
KUSHNER, H ;
METZGER, D ;
PETERS, R ;
SMITH, I ;
GRISSOM, G ;
PETTINATI, H ;
ARGERIOU, M .
JOURNAL OF SUBSTANCE ABUSE TREATMENT, 1992, 9 (03) :199-213
[19]   EXPECTATIONS AND MOTIVES FOR SUBSTANCE USE IN SCHIZOPHRENIA [J].
MUESER, KT ;
NISHITH, P ;
TRACY, JI ;
DEGIROLAMO, J ;
MOLINARO, M .
SCHIZOPHRENIA BULLETIN, 1995, 21 (03) :367-378
[20]   Predictors of 3-month retention in a drug treatment therapeutic community [J].
Mulder, Roger T. ;
Frampton, Christopher M. A. ;
Peka, Hatarei ;
Hampton, Gavin ;
Marsters, Tau .
DRUG AND ALCOHOL REVIEW, 2009, 28 (04) :366-371