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Biomedical subjects

D D Simpson

Publications and source records attributed to D D Simpson.

At least 37 records · Page 2Linked to original sources
PubMed1998

Antisocial tendency among drug-addicted adults: potential long-term effects of parental absence, support, and conflict during childhood.

This study examined the relationship between perceptions of parent-child relations in the family of origin and antisocial tendency in a sample of drug-addicted adults. Data included retrospective accounts of childhood family factors, adolescent antisocial tendency, and self-reported hostility and risk-taking prior to treatment entry. A developmental model was tested that included adolescent antisocial tendency as a mediator of the relationship between childhood parenting factors and adulthood antisocial tendency. The effects of parental support and conflict were found to operate primarily through adolescent measures. Specifically, lower levels of parental support and higher levels of conflict with parents predicted greater adolescent antisocial tendency, which in turn predicted more hostility and risk-taking in adulthood. Thus, parental support appears to serve as a buffer against deviant behavior and drug use.

Adolescent↗
PubMed1998

The validity of self-reported cocaine use in a criminal justice treatment sample.

Recent studies comparing self-admitted cocaine use with hair and urine test results have raised concerns about underreporting due to variations across situations and settings. Because of the frequent need for self-report data in conducting treatment evaluations, more information is needed on factors that affect the credibility of this information. The present study examines records of cocaine use collected as part of an evaluation of prison-based treatment (N=396). Specifically, self-reported cocaine use from 6-month postrelease follow-up interviews, completed with treatment graduates and a comparison sample of parolees who were eligible but not sent to treatment, was examined in relation to urine and hair test results. Overall, cocaine use was underreported when compared to hair test results, but underreporting was lower for program graduates than for the untreated comparison group. Furthermore, program graduates originally admitted to prison on a drug-related arrest were the most likely to underreport cocaine use, seemingly due to a heightened concern about potential consequences, such as returning to prison on another drug-related charge. Given that the validity of self-report for high-risk individuals varies greatly and is difficult to predict across studies, future research with criminal justice samples should continue to assess the validity of these measures under specific research conditions and for diverse types of individuals.

Adult↗
PubMed1997

Drug abuse treatment retention and process effects on follow-up outcomes.

After finding that retention in methadone treatment for a year or longer was a highly significant predictor of patient outcomes following discharge, measures of pretreatment motivation and early therapeutic engagement were examined as predictors of program retention. Personal interviews were conducted with a sample of 435 patients 12 months after discharge from three methadone treatment programs. Logistic regression results showed several patient attributes--i.e. over 35, lower injection frequency before admission, and higher motivation for treatment--were each associated with twofold increases in the likelihood of having favorable follow-up outcomes on illicit drug use, alcohol use, and criminal involvement. Patients staying in treatment a year or longer, however, were nearly five times more likely to have better outcomes. Further analyses established that length of treatment stay was predicted by higher patient motivation at intake and early program involvement. The findings suggest that more comprehensive models of patient attributes, therapeutic process, and environmental influences are needed, and that treatment enhancement efforts should focus on such during-treatment measures as interim criteria for improving posttreatment outcomes.

Adult↗
PubMed1997

Maintenance of HIV risk reduction among injection opioid users: a 12 month posttreatment follow-up.

Study objectives were to examine HIV risk behaviors 12 months following methadone maintenance (MM) treatment termination, and to assess the effects of treatment tenure, cocaine use, and gender on posttreatment HIV risk. Injection and sex risk behaviors were measured at treatment entry and 12 months after leaving treatment among 435 injection opioid users. Multi-way contingency tables for treatment tenure and HIV risk at treatment intake and at 12 month follow-up were analyzed using the GSK weighted least-squares estimation procedure. The effects of treatment tenure, gender, and cocaine use on risk behavior at follow-up, while controlling for intake risk and background variables were tested using a series of multiple logistic regression analyses. Results showed that injection and sex risk behaviors were significantly lower at 12 month follow-up than at treatment entry. Additionally, increased tenure was related to risk reductions, while cocaine use was related to increased risk-taking. Gender was generally unrelated to risk changes. These findings support broader use of MM in helping reduce HIV risks among injection drug users and highlight the need to explore ways to encourage treatment compliance in order to reduce risky practices.

Adolescent↗
PubMed1997

Peer, family, and motivational influences on drug treatment process and recidivism for probationers.

Treatment efforts appear to be effective in reducing crime among drug using individuals, but components of the treatment process associated with client improvement need to be identified. Furthermore, these elements of treatment may play an intermediate role in the connection between client background characteristics and later criminal activity. The current study examines a structural equation model including client perceptions of their drug related problems, peer deviance, and family dysfunction as influences upon the formation of therapeutic relationships during treatment and rearrests following treatment. Results showed therapeutic relationships were positively associated with recognition of drug related problems and negatively related to rearrest. Peer deviance also was positively related to rearrest.

Adolescent↗
PubMed1997

Effectiveness of node-link mapping enhanced counseling for opiate addicts: a 12-month posttreatment follow-up.

Drug abuse counseling was enhanced by node-link mapping, a visual representation technique, and evaluated in a posttreatment follow-up study. Clients randomly assigned to receive mapping counseling reported less criminal activity 12 months after treatment than did clients in the standard counseling condition. It was also found that among clients staying less than 6 months in treatment, those in the mapping group had fewer urine samples that tested positive for opiates at follow-up. Thus, mapping-enhanced counseling may be especially beneficial for clients who leave treatment prematurely.

Adult↗
PubMed1997

The role of node-link maps in enhancing counseling efficiency.

Node-link mapping is a counseling tool that helps clients and counselors visualize relationships between ideas, actions, and feelings. Previous research has shown that methadone-maintained clients receiving mapping-enhanced counseling have more positive during-treatment outcomes (e.g., better session attendance and higher probability of clean urines) than those receiving standard counseling. Findings also suggest that mapping enhances the efficiency of counseling sessions by increasing "on task" attention and by reducing communication problems. In this study, mapping counseling was associated with greater coverage of collateral issues (i.e., issues indirectly related to drug use) than standard counseling and lower during-treatment use as indicated by urinalysis results.

Adult↗
PubMed1996

Psychological dysfunction and HIV/AIDS risk behavior.

The relationship between psychological problems and human immunodeficiency virus HIV/AIDS risk-taking behaviors was examined among 834 daily opioid users entering methadone treatment programs. A composite measure of psychological dysfunction was created using depression, anxiety, and hostility scales. This measure was found to be significantly related to needle risk in terms of injecting with used equipment, sharing of drug paraphernalia, and sharing with strangers. Psychological dysfunction was also related to sexual risk taking in terms of number of partners, unprotected sex with other injection drug users, and trading sex. Use of cocaine was significantly related to all measures of injection and sex-related risk taking; use of speedball (heroin and cocaine) was significantly related to use of dirty equipment and sharing of paraphernalia. The implications of study findings for AIDS prevention programming are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Gender, cocaine and during-treatment HIV risk reduction among injection opioid users in methadone maintenance.

HIV risk behavior was examined in relation to gender and cocaine use among a sample of 327 daily opioid users in methadone maintenance treatment. Women and cocaine users tended to be at higher risk than men and non-users prior to treatment entry. Significant reductions in both injection and sex-related risks occurred from intake to months 3 and 6 of treatment; HIV risks were also reduced among the subsample of clients who continued to inject drugs during treatment. The rate of HIV risk reduction was similar for both cocaine and non-cocaine users, but women had lower rates of risk reduction than men in terms of injecting with used equipment and number of sex partners. Measures of risk behavior at month 6 of treatment showed that women used 'dirty works' more often than men, and cocaine users injected more frequently and had more sex partners than non-cocaine users. Study outcomes highlight the need for specialized interventions targeting women and cocaine-using opioid addicts.

Adolescent↗
PubMed1996

Influences of family and friends on client progress during drug abuse treatment.

Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms.

Adult↗
PubMed1996

Effectiveness of a specialized women's intervention in a residential treatment program.

"Time Out! For Me," a specialized psychoeducational treatment found to be effective with women in an outpatient methadone clinic, was tested for generalizability to a residential drug user treatment program. The 6-session module was first given to an experimental group (n = 11) and compared to a control group (n = 10). The treatment was associated with increases in knowledge of human sexuality, assertiveness and communication skills, more positive attitudes toward being assertive and practicing safer sex, and increased self-esteem. Thus, "Time Out" appears to be an effective treatment enhancement for women in residential treatment.

Adult↗
PubMed1995

HIV risks, gender, and cocaine use among opiate users.

HIV risks involving injection and sex behaviors were analyzed in relation to cocaine use and gender among 487 opiate-dependent clients in methadone treatment. Those who also used cocaine were at greater risk than non-cocaine users on HIV risky injection variables. Females were at more risk than males on the HIV risky sex behaviors involving unprotected sex in exchange for money or drugs and with injection users. There were interactions between cocaine use and gender, however, in relation to frequency of injecting with dirty works and sharing dirty works with strangers, as well as having unprotected sex for money or drugs, with injection users, and while intoxicated. HIV risks increased as a direct function of cocaine usage level among males, but not among females; instead, low-to-intermediate levels of cocaine use by females was associated with high-risk behaviors. Implications for HIV risk reduction interventions in drug treatment programs are discussed.

Adult↗
PubMed1995

Client engagement and change during drug abuse treatment.

Previous work has shown length of time in drug abuse treatment is associated with better outcomes, but the role of therapeutic engagement and process needs further examination. In this study, the total number of counseling sessions attended by 557 clients in their first 90 days of community-based outpatient treatment was examined in relation to indicators of treatment delivery and progress. Significant client improvements were found on behavioral criteria and psychosocial functioning during the first 3 months of treatment, and session attendance was positively related to favorable behavioral changes as well as to positive perceptions by clients and counselors of their therapeutic interactions. Client background, treatment motivation, and therapeutic focus of counseling in Month 1 were significant predictors of session attendance in the first 3 months following admission to methadone treatment.

Adult↗
PubMed1995

Heavy drinking in a population of methadone-maintained clients.

OBJECTIVE: The purpose of this study was to clarify the relationship between heavy use of alcohol and response to methadone treatment. METHOD: A sample of clients showing three or more DSM-III-R symptoms (n = 79) were identified and compared with a sample of heavy-drinking clients (n = 108) with less than three alcohol dependency symptoms on admitting characteristics and on tenure in treatment. RESULTS: As expected, clients meeting DSM-III-R dependency criteria were significantly more likely to show evidence of psychological problems and dysfunction of family and peer relations at admission. An unexpected finding was that they were also more likely to remain in treatment longer than drinking clients who did not report dependency. Alcohol dependent clients were significantly more likely to have prior experience with self-help groups, which may reflect less denial and therefore relatively better ability to focus on opiate dependency problems. CONCLUSIONS: Failure to differentiate between alcohol dependent and nondependent groups of drinkers enrolled in methadone treatment may help account for reported differences in treatment outcome studies. Recognizing these different types of drinkers also may help clinicians plan more effective treatments.

Adolescent↗
PubMed1995

Suicidality in a sample of methadone maintenance clients.

Previous work has shown that suicide is a significant cause of death among substance abusers, including methadone-maintained clients, and that the prediction of suicidal ideation and behavior is difficult. Preliminary review of data collected at admission on a population of 438 methadone-maintained clients found 55 expressing some level of suicidal behaviors during the course of treatment. These clients were compared with a randomly selected comparison group of 55 nonsuicide clients matched for gender and race/ethnicity on measures of psychological dysfunction, drug use, family dysfunction, and help-seeking behaviors. Results showed that at time of admission suicidal clients reported: 1) more psychological dysfunction as evidenced by higher levels of depression, social dysfunction, hostility, risk-taking, and previous thoughts of suicide; 2) less family support at the present time and during childhood; and 3) more help-seeking behavior as evidenced by self-referral, number of previous treatment episodes, attendance at self-help meetings, and higher scores on motivational measures of desire for help. Differences in preadmission drug-using behaviors were not found between the two groups.

Adult↗
PubMed1995

Attentional difficulties and the effectiveness of a visual representation strategy for counseling drug-addicted clients.

Three hundred thirty-one opioid-addicted clients in methadone treatment were randomly assigned to counselors who used either mapping-enhanced or standard counseling. Those counseled with mapping had lower percentages of during-treatment urine specimens that were positive for either cocaine or opiates, and they were rated by their counselors as having higher rapport, motivation, and self-confidence. Clients were further classified into those exhibiting either good or poor attention during an intake interview. The results suggest that clients with poor attention are more likely to have positive urines, but that this tendency appears to be reduced under mapping-enhanced counseling.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Psychosocial functioning among adult drug users: the role of parental absence, support, and conflict.

The relationship between perceptions of parental absence, support, and conflict during childhood and psychosocial functioning in adulthood was examined for 411 drug user clients in methadone treatment. History of parental support was related to adult psychosocial functioning and parent-child conflict was related to psychosocial functioning only when parental support was low. Findings indicate parental absence is related to the quality of parental support, which in turn predicts psychosocial functioning in adulthood. Implications for treatment intervention are discussed.

Adolescent↗