Relationship of Mental Health and Illness in Substance Abuse Patients.

This study examined the latent structure of a number of measures of mental health (MH) and mental illness (MI) in substance use disorder outpatients to determine whether they represent two independent dimensions, as Keyes (2005) found in a community sample. Seven aspects of MI assessed were assessed - optimism, personal meaning, spirituality/religiosity, social support, positive mood, hope, and vitality. MI was assessed with two measures of negative psychological moods/states, a measure of antisociality, and the Addiction Severity Index's recent psychiatric and family-social problem scores. Correlational and exploratory factor analyses revealed that MH and MI appear to reflect two independent, but correlated, constructs. However, optimism and social support had relatively high loadings on both factors. Antisociality and the family-social problem score failed to load significantly on the MI factor. Confirmatory factor analysis supported the existence of two obliquely related, negatively correlated dimensions. Study findings, although generally supporting the independence of MH and MI, suggest that the specific answers to this question may be influenced by the constructs and assessments used to measure them.

Measurement of mental health in substance use disorder outpatients.

Few studies have examined mental health (MH) attributes of patients with substance use disorder (SUD). This study examines the internal consistency, concurrent validity, and comparative level of MH attributes (i.e., optimism, life attitudes, spirituality/religiousness, social support, positive mood, hope, and vitality) in patients with SUD compared with the instrument development group. The internal consistency of optimism, spirituality/religiousness, positive mood, hope, and vitality were similar in both groups. Some subscales of the social support and life attitude measures had lower internal consistency than was found for the original samples, although internal consistency of more global constructs were comparable. Patients with SUD had higher positive mood, spirituality/religiousness, and hope scores, whereas social support, life attitudes, and optimism scores were lower than in the original sample. Correlations between MH attributes and recent life problems of patients with SUD generally supported the concurrent validity of the MH measures.

Reliability and validity of the alcohol short index of problems and a newly constructed drug short index of problems.

OBJECTIVE: This study evaluated the psychometric properties of the 15-item alcohol Short Index of Problems (SIP) instrument and those of a newly constructed 15-item drug Short Index of Problems (SIP-D) instrument in 277 newly entered substance-abuse patients. METHOD: The SIP is derived from the longer, 50-item Drinker Inventory of Consequences (DrInC), which was designed to assess adverse consequences of alcohol use. The SIP-D was constructed by substituting the term "drug use" for the term "drinking" in each SIP item. A 3-month recall interval was employed. RESULTS: Factor analyses of each of the instruments revealed similar solutions, with only one main factor accounting for the majority of variance. Nonparametric item response theory methods produced the same finding. Internal consistency reliability estimates for the SIP and SIP-D total scores were .98 and .97, respectively. Concurrent validity was demonstrated by examining the correlations of the total scores for each of the instruments with the recent summary indexes of the newly revised Addiction Severity Index (ASI-Version 6): alcohol, drug, medical, economic, legal, family/social, and psychiatric problems. CONCLUSIONS: This study is the first to confirm the psychometric validity of the SIP when used as an independent instrument unembedded within the DrInC. The study also supports the use of the SIP-D as a brief measure of adverse consequences of drug use. The findings strongly support the unidimensional structure of both measures.