A Self-Reported Version of the Measurements in the Addictions for Triage and Evaluation-Q: Concurrent Validity with the MATE 2.1.

INTRODUCTION: Substance abuse treatment centers require reliable and valid instruments to monitor treatment progress, to evaluate treatment effectiveness, and to initiate clinical trials. Currently the Measurements in the Addictions for Triage and Evaluation (MATE) 2.1, an instrument that serves these purposes, is considered quite lengthy and intensive, especially in the case of allocation to milder treatment intensity. Therefore, a self-reported version of the MATE-Q was designed for patients with mild to moderate substance-abuse and co-occurring problems. The aim of the present study was to assess concurrent validity with the interviewer version of the MATE (version 2.1). MATERIALS AND METHODS: Data were collected at 2 locations of a Dutch substance abuse treatment center, one location in a large city and one in a suburban area. A correlational design was employed, where each included participant completed a MATE-Q and a MATE 2.1 within 3 days or less (administered at intake, before treatment initiation). A total of 98 treatment-seeking patients were included (51.0% alcohol as a primary problem, 19.4% cannabis, 14.3% gambling and 6.1% cocaine). Measurements included the MATE-Q and the MATE 2.1. Intraclass correlation coefficients (ICCs) for single measures were calculated, deploying the 2-way mixed procedure with absolute agreement. Descriptives of scores comprise means and Cronbach's alpha for internal consistency. RESULTS: For the majority (15 out of 24) of the scores ICCs were equal or above 0.7. For 93 patients (95%), the primary problem substance or problem behavior was reported correspondingly. Nine MATE-Q mean scores differed significantly from their MATE 2.1 counterparts. DISCUSSION/CONCLUSION: For the majority of scores, the MATE-Q has acceptable concurrent validity for the assessment of patients with mild to moderate substance abuse and co-occurring problems.

Systematic development of a self-help and motivational enhancement intervention to promote sexual health in HIV-positive men who have sex with men.

The objective of this study was to describe the application of a systematic process-Intervention Mapping-to developing a theory- and evidence-based intervention to promote sexual health in HIV-positive men who have sex with men (MSM). Intervention Mapping provides a framework that gives program planners a systematic method for decision-making in each phase of intervention development. In Step 1, we focused on the improvement of two health-promoting behaviors: satisfactory sexual functioning and safer sexual behavior. These behaviors were then linked with selected personal and external determinants, such as attitudes and social support, to produce a set of proximal program objectives. In Step 2, theoretical methods were identified to influence the proximal program objectives and were translated into practical strategies. Although theoretical methods were derived from various theories, self-regulation theory and a cognitive model of behavior change provided the main framework for selecting the intervention methods. The main strategies chosen were bibliotherapy (i.e., the use of written material to help people solve problems or change behavior) and motivational interviewing. In Step 3, the theoretical methods and practical strategies were applied in a program that comprised a self-help guide, a motivational interviewing session and a motivational interviewing telephone call, both delivered by specialist nurses in HIV treatment centers. In Step 4, implementation was anticipated by developing a linkage group to ensure involvement of program users in the planning process and conducting additional research to understand how to implement our program better. In Step 5, program evaluation was anticipated based on the planning process from the previous Intervention Mapping steps.

Risk of Criminal Victimisation in Outpatients with Common Mental Health Disorders.

BACKGROUND: Crime victimisation is a serious problem in psychiatric patients. However, research has focused on patients with severe mental illness and few studies exist that address victimisation in other outpatient groups, such as patients with depression. Due to large differences in methodology of the studies that address crime victimisation, a comparison of prevalence between psychiatric diagnostic groups is hard to make. Objectives of this study were to determine and compare one-year prevalence of violent and non-violent criminal victimisation among outpatients from different diagnostic psychiatric groups and to examine prevalence differences with the general population. METHOD: Criminal victimisation prevalence was measured in 300 outpatients living in Amsterdam, The Netherlands. Face-to-face interviews were conducted with outpatients with depressive disorder (n = 102), substance use disorder (SUD, n = 106) and severe mental illness (SMI, n = 92) using a National Crime Victimisation Survey, and compared with a matched general population sample (n = 10865). RESULTS: Of all outpatients, 61% reported experiencing some kind of victimisation over the past year; 33% reported violent victimisation (3.5 times more than the general population) and 36% reported property crimes (1.2 times more than the general population). Outpatients with depression (67%) and SUD (76%) were victimised more often than SMI outpatients (39%). Younger age and hostile behaviour were associated with violent victimisation, while being male and living alone were associated with non-violent victimisation. Moreover, SUD was associated with both violent and non-violent victimisation. CONCLUSION: Outpatients with depression, SUD, and SMI are at increased risk of victimisation compared to the general population. Furthermore, our results indicate that victimisation of violent and non-violent crimes is more common in outpatients with depression and SUD than in outpatients with SMI living independently in the community.

Treatment outcome of alcohol use disorder outpatients with or without medically assisted detoxification.

OBJECTIVE: Little is known about the incremental effects of medically assisted detoxification on outpatient treatment for alcohol use disorders. The objective of this study was to compare drinking outcomes in a psychosocial treatment program between two groups of heavy drinking patients who had an alcohol use disorder: (a) one group with initial medically assisted detoxification and (b) a second group without initial medically assisted detoxification. METHOD: Analyses were conducted on 262 patients with a more severe alcohol use disorder who completed both an intake assessment and a 9-month follow-up assessment. The effect of medically assisted detoxification was determined using logistic regression analysis with a propensity score to control for possible baseline differences between the two groups. RESULTS: Of the 262 patients, 82 (31.3%) received medically assisted detoxification. These patients were more likely to abstain from alcohol than those without medically assisted detoxification. Abstinence rates in the month before follow-up were 32.9% and 18.9%, respectively (ORadj = 3.48, p = .01, number needed to treat = 7.1). CONCLUSIONS: Medically assisted detoxification may add to the effects of outpatient psychosocial treatment for heavy drinking patients with an alcohol use disorder.

Investigating the structure of craving using structural equation modeling in analysis of the obsessive-compulsive drinking scale: a multinational study.

BACKGROUND: Currently, there is no agreement among researchers on the definition of craving and its underlying theoretical model. The Obsessive-Compulsive Drinking Scale (OCDS) seems to measure certain aspects of craving, but its theoretical basis remains unclear. The aim of this study was to investigate the structure of alcohol craving, using OCDS data. METHODS: OCDS data from four studies were pooled to obtain a large and heterogeneous sample of 505 participants. All participants were treatment-seeking alcoholics meeting DSM-IV criteria for alcohol dependence. The factor structures of the OCDS previously found were evaluated using confirmatory factor analyses. The goodness of fit of these solutions was compared with those of alternative causal models: an obsessive-compulsive disorder model, an inhibition model, and a cognitive-behavioral model. These alternative models were based on modern theories about craving and were tested in the OCDS data, using structural equation modeling. In this way, the current study replaced simple correlational analysis by a more sophisticated causal way of analyzing the underlying structure of the OCDS items. The best fitting model was selected by comparing the mean discrepancy between the implied and observed matrices of the models. RESULTS: The data showed that the previously reported factor structures had to be rejected. Also, the inhibition model and obsessive-compulsive disorder model did not fit the data. The cognitive-behavioral model showed encouraging fit. Optimizing strategies were applied to further improve the fit of this model, which resulted in a model with close fit to the data. CONCLUSIONS: The causal cognitive-behavioral model proved to be superior. It showed that the OCDS contains many items that do not represent the core concept of craving but instead are indicators for the consequences of craving. From this model, it seems that craving, in a narrow sense, can be reliably assessed with only five items of the OCDS.