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Biomedical subjects

D D Simpson

Publications and source records attributed to D D Simpson.

At least 55 records · Page 3Linked to original sources
PubMed1994

Node-link mapping for counseling cocaine users in methadone treatment.

Treatment engagement problems associated with cocaine-using opioid addicts were addressed using a cognitively enhanced counseling strategy. Analysis of client urines, participation, and counselor ratings of clients over a 6-month period during treatment indicated that the use of node-link mapping--a multipurpose visual representation strategy for communication--produced better results for both low and high cocaine-using opioid addicts in methadone maintenance than those treated without this enhancement.

Adult↗
PubMed1994

Treatment process and relapse to opioid use during methadone maintenance.

A general framework for studying drug abuse treatment process factors is presented, and components are then used to predict relapse to opioid use during treatment in methadone maintenance. Major domains of the treatment process research framework include client variables at entry, program characteristics, treatment events, and client outcomes. The analyses rely on the use of proportional hazards models to identify significant outcome predictors in a sample of 590 methadone maintenance clients from 21 clinics in the Research Triangle Institute/Treatment Outcome Prospective Study (RTI/TOPS) data system who remained in treatment at least 3 months. The analyses were performed on the total sample and separately on clients from three groups of clinics classified on the basis of the distribution of client relapse rates and tenure in treatment. Relapse rates were related to dosage level, client monitoring with urinalyses, and methadone take-home privileges in some clinics, and hence, these time-varying treatment events were important factors in treatment outcomes. Even at entry to treatment, some measures were found to be related to how the client later performed during treatment. Finally, it was also found that the particular area of professional speciality of the staff making client diagnosis at intake and preparing treatment plans was associated with client outcomes.

Adult↗
PubMed1994

The role of node-link mapping in individual and group counseling.

The value of using a visual representation strategy, called node-linking mapping, was evaluated in individual and group drug abuse counseling settings. Methadone maintenance clients were randomly assigned to counselors trained to use mapping techniques (n = 57), and those who used standard counseling (n = 51). Clients in the mapping counseling group had more favorable perceptions of their own therapeutic engagement and progress as indicated by ratings of cognitive-behavioral and motivational attributes than did those in standard counseling. Overall, individual sessions were viewed by clients as being more valuable than group counseling, but the use of mapping increased the helpfulness attributed to group counseling to near the same level as individual counseling.

Adult↗
PubMed1993

Psychosocial correlates of AIDS-risk drug use and sexual behaviors.

Theoretical and empirical research suggests psychosocial functioning is important in drug abuse intervention strategies, especially those focusing on efforts to change AIDS risk behaviors. Self-esteem, depression, anxiety, proneness to risk taking, decision-making confidence, self-assessment of drug use problems, and desire for help with drug problems, along with personal background and health history indicators, were assessed for 194 injection drug users in an AIDS prevention outreach program in New Orleans. Composite index scores for needle risk behaviors were associated with low self-esteem and low decision-making confidence as well as with higher scores on depression, anxiety, drug use problems, and desire for help. However, these psychosocial measures were not significantly related to the composite index for sex risks. Health history measures, represented by previous exposures to hepatitis and sexually transmitted diseases, were significantly related to both needle and sex risk indices. Implications for AIDS intervention efforts are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Employee substance use and on-the-job behaviors.

Substance use and job behaviors were assessed in a sample of municipal employees from a large city in the southwestern United States. Job behaviors included psychological and physical withdrawal, positive work behaviors, and antagonistic work behaviors. Employees who reported substance use at or away from work were found to more frequently engage in withdrawal activities and antagonistic work behaviors than did nonusers, although users and nonusers did not differ on positive work behaviors. We tested hierarchical regression models to determine whether substance use contributed unique variance to the prediction of job behaviors after we controlled for variance associated with personal and job background domains. Substance use added unique variance to the prediction of psychological and physical withdrawal behaviors but not to positive or antagonistic work behaviors.

Adult↗
PubMed1991

Treatment predictors of tenure in methadone maintenance.

Tenure in methadone maintenance treatment was analyzed in terms of treatment process factors using a survival curve regression analysis. The treatment process framework included client variables at entry, program characteristics, treatment events, and client attitudes and satisfaction. The sample consisted of 606 methadone maintenance clients from 21 different clinics. Significant predictors included professional classifications of the diagnosing and treatment-planning staff members, measures of early treatment services, client attitudes and satisfaction, methadone dosage level, and frequency of urine monitoring. The results showed higher tenure rates when specialized professionals diagnosed problems and defined treatment plans, when service needs were addressed, when client attitudes and satisfaction were high, and when methadone dose was higher. Lower tenure rates were found among blacks and clients with lower sociodemographic status. Lower tenure also occurred among those who perceived the program as less accessible or less structured in its procedures.

Black or African American↗
PubMed1991

Depression and decision-making among intravenous drug users.

Two short scales, the TCU Depression Scale and the TCU Decision-making Scale, were psychometrically evaluated in a sample of 145 intravenous drug users. Coefficient alpha reliabilities were .78 for the 6-item TCU Depression Scale and .77 for the 9-item TCU Decision-making Scale. Concurrent validity of the former scale was assessed by correlating scores with those on the Beck Depression Inventory, r = .75. Based on the Beck Depression Inventory Clinical cutoff scores, 83% of the sample showed some depression, with 23% severely depressed, 39% moderately depressed, and 21% mildly depressed. Individuals scoring higher on depression on both tests tended to score lower on decision-making. Significant demographic associations of age, gender, education, and race-ethnicity were found for the depression and decision-making scales. More depression was noted for women, those younger, white, and having less education. Older and more educated intravenous drug users tended to score higher on decision-making. Validity for the depression and decision-making scales was assessed by examining correlations with behaviors. Significant positive correlations were found between depression scores and intravenous use of cocaine only, heroin and cocaine combined, and heroin only. Also, intravenous use of cocaine only and of cocaine and heroin combined were negatively related to decision-making. AIDS sex-risky behavior was positively correlated with depression and negatively correlated with decision-making.

AIDS Serodiagnosis↗
PubMed1991

Unmet service needs in methadone maintenance.

Most drug abuse treatment agencies maintain a wide array of ancillary services, either on-site or through off-site referral resources, for helping meet the diverse social, medical, and psychological needs of clients. The extent to which these needs are met may be an important factor in client retention and outcomes. Perceived unmet service needs and their relationship to client outcomes were therefore studied in relationship to a framework for studying drug abuse treatment process factors. The outcomes in the present study were time in treatment and relapse to opioid use during treatment, and these were examined in relation to perceived need for services and their delivery (whether or not these services were received). The sample consisted of 590 methadone maintenance clients in 21 clinics in the RTI/TOPS data system. The results showed that the measure of unmet needs for services was not significantly related to time to relapse or to time in treatment. However, there appeared to be an indirect effect. There were differences for clinic type and a few significant interactions with other predictor variables used to study treatment process.

Combined Modality Therapy↗
PubMed1990

Alcohol use by heroin addicts 12 years after drug abuse treatment.

Follow-up interviews on a sample of 298 ex-heroin addicts 12 years after they entered treatment were used to examine alcohol use and substitution of alcohol for heroin. Almost one-fourth of the sample were classified as heavy drinkers in Year 12, and half had previously used alcohol in a substitution pattern. Classifications into one of three substitution groups (none, low and high) and multivariate analysis of variance were carried out to identify background and baseline factors related to substitution and long-term behavioral outcomes 12 years after entering treatment. Substitution was found to be related to higher levels of alcohol problems and treatment before addiction, parental alcohol problems, to vulnerability to peer influence in starting drug use and to feelings of rejection by peers during adolescence. In terms of 12-year outcomes, substitution was related to more use of nonopioid drugs, more heavy drinking and alcohol-related problems and more psychological dysfunction symptoms (such as depression). These results showed a strong relationship between substitution and preaddiction as well as postaddiction alcohol abuse. However, to delineate the effects of substitution apart from the effects of previous alcohol abuse, additional analyses were computed in which substitution was examined after controlling for previous alcohol abuse. The results confirmed the validity of substitution as a powerful construct in identifying behavioral differences before and after addition.

Adult↗
PubMed1990

Availability of drugs and psychological proneness in opioid addiction.

The role of drug availability and psychological proneness in opioid addiction was examined using longitudinal data from the Drug Abuse Reporting Program (DARP). The sample included 424 addicts who were followed up and interviewed approximately 12 years after admission to treatment in the DARP, and for whom admission, during-treatment, and 6-year follow-up data were also available. Drug availability and proneness were both found to be important for drug use at any given time--from initial stages of addiction as well as in Year 12 of the follow-up--but proneness was rated as relatively more important for opioid use in the later stages of the addiction career. Proneness measures contributed more to the prediction of long-term drug use outcomes.

Adult↗
PubMed1988

Behavioral changes of adolescents in drug abuse intervention programs.

Reduction of problem behaviors (drug and alcohol use, school problems, and legal involvement) by Mexican-American youth (N = 326) during their first 3 months in drug abuse intervention programs was related negatively to peer drug use during the program and was related positively to the amount of family support available during the program, participation in program activities, and a background of religious involvement. These findings support previous research that has shown the importance of peer influences and commitment to conventional structures of family and religion in relation to adolescent problem behaviors. These findings suggest that two goals that adolescent drug abuse programs should stress are working heavily on developing positive peer relations and family support while they encourage disassociation from deviant friends.

Adolescent↗
PubMed1987

Mortality rates among opioid addicts in a longitudinal study.

Mortality rates and survival curves were estimated for a sample of opioid addicts who had survived to an initial six-year follow-up interview. A total of 52 of the 555 addicts died between the six-year and 12-year follow-up interviews, which corresponds to an average of 13.8 deaths/1,000 person years. This rate is 6.9 times greater than the general population, adjusting for age. Approximately 29 per cent of the deaths were due to violence and 48 per cent to drugs.

Adult↗
PubMed1986

Sex differences in opioid addiction careers.

Differences between the opioid addiction careers of 84 female and 91 male addicts were examined longitudinally. Data were collected from clients participating in methadone maintenance treatment programs between 1969 and 1972 as part of the Drug Abuse Reporting Program (DARP). Clients were interviewed prior to and during treatment, as well as 6 and 12 years after treatment. No differences between male and female addicts were found for demographic characteristics or treatment histories. Further, differences in behavioral outcomes for criminality and employment found at 12-year follow-up were shown to be a function of pretreatment differences, and were not related to differential treatment effects. Males and females did differ, however, in psychological status at 12-year follow-up, and in their reasons for quitting drug use and entering treatments. These differences, along with significantly greater financial and medical needs for females, indicate systematic long-term differences between female and male addiction careers which should be considered in prevention and treatment of opioid addiction.

Adolescent↗
PubMed1984

Influence of family and religion on long-term outcomes among opioid addicts.

This study investigated whether family, religion, and personal background variables were related to long-term follow-up outcomes after treatment for drug abuse. The sample consisted of 1,174 opioid addicts admitted to community treatment agencies during 1972-1973 and who were relocated and interviewed in 1978-1979. The results indicated that family and personal background variables made unique contributions to the prediction of a follow-up composite outcome (representing drug use, employment, and criminality) and a general well-being measure. Religion variables accounted for significant and unique variance only in the general well-being variable. The results favor the inclusion of family and religion variables in the scientific explanation of long-term follow-up outcomes among opioid addicts.

Adult↗