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Biomedical subjects

D K Roszell

Publications and source records attributed to D K Roszell.

At least 19 recordsLinked to original sources
PubMed1993

Outcome of contingency contracting for illicit drug use in a methadone maintenance program.

This study evaluates the outcome of a mandatory, clinic wide, structured contingency contracting system in a methadone maintenance program. The system involved weekly urine screening and placement on written individualized contracts for any of 106 male patients who displayed illicit drug use. Methadone dose decreases were the penultimate and detoxification and discharge the ultimate contingencies for unremitting drug use. Sixty subjects (56.6%) received contracts and 36 (35%) eventually left treatment. The contracts did not decrease the overall number of positive urines for the contract subjects, but opiate use did decrease significantly for subjects on more stringent contracts.

Adult↗
PubMed1993

Dual diagnosis.

Although the problem of patients with dual diagnoses is not new, it has only been in the last few years that their unique and complex problems have begun to be addressed. This recognition coincides with society's concern regarding the magnitude of substance abuse problems in general. Currently, treatment consists of integrating concepts from substance abuse and mental health fields. This integration may improve the therapeutic outcome for these patients. As more experience is gained in this specialty, it is hoped that new treatment concepts will evolve that will more powerfully address the interactive aspect of substance abuse and psychiatric disorders.

Alcoholism↗
PubMed1991

Frequency of symptoms and concurrent psychiatric disorder in Vietnam veterans with chronic PTSD.

The frequency of symptoms of posttraumatic stress disorder within each of three categories--reexperiencing, avoidance or numbing, and physiological arousal--was examined in 116 Vietnam combat veterans with a diagnosis of PTSD. The prevalence of all PTSD symptoms was greater than 50 percent except for flashbacks, psychogenic amnesia, and sense of foreshortened future. Comorbidity in a subgroup of 48 patients was assessed using operational criteria for DSM-III-R mental disorders. Mood disorders, psychoactive substance abuse disorders, and other anxiety disorders frequently co-occurred with PTSD, but psychotic disorders were uncommon. These findings provide empirical validation of the DSM-III-R diagnostic criteria for PTSD.

Adult↗
PubMed1990

Convergent validity of measures of PTSD in Vietnam combat veterans.

The authors evaluated the convergent validity of several widely used psychometric tests of posttraumatic stress disorder (PTSD) symptoms against DSM-III-R criteria for PTSD in 130 Vietnam combat veterans. Significant positive correlations were found between these instruments and the number of DSM-III-R symptoms endorsed, supporting the validity of psychometric instruments as continuous measures of PTSD symptom severity. The various psychometric measures also correlated moderately with one another, suggesting that they assess related but somewhat separate PTSD phenomena. Finally, predicted relationships between stressors and symptoms were supported by significant correlations between degree of traumatic combat exposure and DSM-III-R and psychometric indexes of PTSD.

Adult↗
PubMed1989

Validation of MMPI profile subtypes among opioid addicts who are beginning methadone maintenance treatment.

The purpose of the present research was (1) to examine the stability of MMPI subtypes within a VA drug abusing population; and (2) to provide external validation for these subtypes. The MMPI was administered to 107 male veterans who were entering methadone maintenance treatment. Normal sphere personality characteristics, sociodemographic information, and self- and interviewer ratings were collected by use of the Sixteen Personality Factor Questionnaire (16PF) and the Addiction Severity Index (ASI). Using D2 analysis, each MMPI profile was compared to the mean profile for three MMPI profile clusters obtained by Roszell, Chaney, and Blaes (1983) on a previous sample. Normal, psychoneurotic, and schizoid profiles were found in percentages similar to Roszell et al. The normal cluster was divided into two groups with and without T score elevations above 70 on the clinical scales. The normal group with profile elevations was similar to profile groups labeled as psychopathic in previous research. The four MMPI profile subtypes were compared on the 16PF and the ASI. The psychoneurotic and schizoid groups demonstrated higher levels of emotional distress and psychiatric difficulty than did the normal or psychopathic groups. The psychopathic and schizoid groups had more legal problems than the other two groups; the normal group had less evidence of marital and family problems.

Adult↗
PubMed1988

Interpersonal style differences among drug abusers.

Interpersonal style differences among drug abusers were explored using Ryan's (1977) typological system of FIRO-B interpretation. One hundred eleven male veteran drug abusers were administered the FIRO-B, along with a battery of psychological tests and a structured interview. The drug abusers were more likely to be categorized as "loners," "rebels," and "pessimists" than was the general population sample. The categories within each FIRO-B dimension (inclusion, control, and affection) were collapsed into three larger subtypes based on general patterns of "expressed" and "wanted" scores within each dimension. The construct validity of the Ryan schema was tested by comparing the three larger groups for each dimension on a series of preselected variables for which differences would be hypothesized from FIRO theory. The results of these analyses were consistent with Ryan's (1977) and Schutz's (1978) theories about interpersonal orientation. The findings of the study provide information about the commonality and heterogeneity of interpersonal style among drug abusers. The findings also support the construct validity of Ryan's typological schema for the FIRO-B.

Adult↗
PubMed1986

Alcohol use and psychopathology in opioid addicts on methadone maintenance.

The occurrence of alcohol problems in opiate addicts on methadone maintenance presents a serious challenge for treatment. Dually addicted patients have a higher incidence of medical and psychiatric complications, consume large amounts of staff and treatment resources, and often exit treatment through administrative detoxification. Yet, little is known about differences in psychopathology between this group and other opioid addicts. This paper summarizes data for 166 male opioid addicts receiving methadone treatment. Alcohol problems were identified, and the relationship between dual addiction and psychopathology was explored. In the first phase of the study the MMPI and Brief MAST (Michigan Alcoholism Screening Test) were administered to 91 subjects. Comparison of Brief MAST scores with program counselors' judgments of the presence or absence of an alcohol problem showed a significant relationship. Cluster analysis of MMPI scores generated three groups. The clusters had significantly different mean MAST scores with the normal cluster having the least indication of alcohol problems, the neurotic cluster intermediate, and the schizoid cluster the greatest indication of problematic alcohol consumption. The second phase of the study with another 75 subjects replicated the relationship between cluster membership and MAST score. The Addiction Severity Index (ASI) was also administered to these subjects, and high correlations between Brief MAST and ASI alcohol problem measures were found. Within-treatment outcome data on a number of measures were then collected for 1 year. Problem drinking severity was negatively related to employment status and positively related to number of random urinalyses indicating illicit drug use. Implication of these findings for refining treatment strategies are discussed.

Adult↗
PubMed1986

Personality and demographic characteristics associated with the prescribing of psychoactive medications for methadone maintenance patients.

This study reviews the prescription of psychoactive medications in a methadone maintenance clinic and looks for salient personality and cognitive differences between medication groups based on the administration of a battery of psychological tests. One hundred and nine consecutive admissions to a methadone program were studied, of which 38.5% had received a psychoactive medication in addition to methadone. The data were analyzed comparing results for antianxiety and antidepressant medication groups as well as a methadone-only group. The antianxiety medication group displayed more somatic complaints, worries, and tension and was more timid, impulsive, and pessimistic than the other two groups. There were only small differences between the antidepressant medication and methadone-only groups. There were no significant differences between groups on cognitive measures. Meaningful differences in several demographic variables also emerged. The implications for this research are discussed.

Anti-Anxiety Agents↗
PubMed1986

Methadone dosage: patient characteristics and clinical correlates.

This paper summarizes data for 106 male opioid addicts which give evidence that there are demographic and clinical differences between groups of patients maintained in three ranges of methadone dosage (less than 35 mg, 36-59 mg, greater than 60 mg). At time of admission the Addiction Severity Index was administered. During the first month of treatment a routine battery of psychological tests--including the MMPI-168, 16PF, Shipley Institute of Living Scale, and Trail Making Test--was also administered. High-dose subjects were under greater emotional distress and experienced more anxiety (p less than .05), had more medical hospitalizations (p less than .05), and had been treated more frequently with psychoactive medications (p less than .05). They also had histories of greater use of barbiturates (p less than .001) and amphetamines (p less than .01). While in treatment they more frequently had urinalyses positive for illicit drugs during the first 6 months (p less than .05). Low-dose subjects had fewer friends (p less than .05). The 1-year program retention rates were found to be lower for the medium-dose group (p less than .05).

Adult↗
PubMed1985

Perception of treatment needs: differences between patients and staff of a drug abuse treatment program.

Patients and staff of the Seattle Veterans Administration Drug Dependency Treatment Program were surveyed to elicit their perception of treatment priorities in establishing a series of educationally oriented short-term groups. Comparisons of priorities were made between patients and staff, methadone and polydrug patients, and patients with alcohol problems and those without alcohol problems. After the survey a series of short-term groups was established and attendance was kept. It was found in general that the groups which patients thought had higher priority in their treatment--including drug and medical information, stress management, and money management--were better attended.

Adult↗
PubMed1983

Exploration of the relationship between frequency of illness, attrition from alcohol treatment, neuropsychological status and field dependence.

One hundred thirty-nine male veterans receiving treatment for alcoholism were administered the Cornell Medical Index (CMI), neuropsychological tests comprising the Brain Age Quotient (BAQ) and the Group Embedded Figures Test (GEFT). Patients endorsing items on scale J (frequency of illness) of the CMI comprised a frequently ill group (27%) with the remaining patients comprising an infrequently ill group (73%). The frequently ill group patients were more likely to drop out of treatment, obtain lower BAQ scores and appear more field-dependent on the GEFT. Treatment attrition of frequently ill patients might be less if their individualized treatment plan involved greater structure consistent with their field dependent orientation and impaired neuropsychological status.

Adult↗
PubMed1983

A cognitive behavioral analysis of relaxation training in drug abusers.

The process of autogenic training, a form of relaxation training, was studied in a sample of 23 drug abusers in outpatient treatment. Different theories of drug abuse and treatment generate different predictions of perceived emotional effects of treatment. The relationships among symptomatology and affect as assessed by the three-factor emotionality constructs of pleasure, arousal and dominance were examined to provide information on the relative importance of perceptions of tension-reduction, sense of control and hedonic state to the treatment process. Symptomatology and affect were significantly related and improved over the course of treatment. The euphoria-dysphoria dimension was more salient than perceptions of arousal reduction or increased sense of control. Results suggested the importance of further investigation of patients' perceptions of the desired effects of drug taking on mood in order to optimize the impact of treatment interventions such as relaxation training.

Adult↗
PubMed1982

Relapse in opiate addicts: a behavioral analysis.

Behavioral interviewing was used to study the relapse antecedents and concomitants of 38 opiate addicts on methadone maintenance. Relapse situations were categorized with regard to intra- or interpersonal determinants and implications for behavioral treatment interventions were discussed. Situations were also analyzed within an opponent process theory of motivation framework. Practical and theoretical difficulties with the study of relapse situations in substance abusing populations were highlighted.

Adult↗
PubMed1982

Drug counselors' perceptions of clients: demographic, personality and psychopathology correlates.

Counselors' interpersonal perceptions of their clients in outpatient drug treatment were studied. Factor analysis produced three general factors, interpreted as perceptions of manageability, treatment readiness, and suitability for group treatment. Counselor perception of client interpersonal attractiveness did not emerge as a separate factor, but appeared equally significantly related to each of the first two factors. Correlates of counselor perceptions were sought among measures of client program performance, demographic and drug use history, psychopathology, and counselor background and personality. With one exception, measures of clients' actual program performance were the best predictors of counselors' perceptions of clients. Clinical implications are discussed.

Adult↗
PubMed1982

Autogenic training in a drug abuse program.

The development of a program utilizing autogenic training with opiate-and polydrug-dependent individuals is described. A small cadre of staff were first trained in the procedure, and it was then used in the treatment of 23 patients with stress-related problems. Eleven patients completed the nine training sessions and rated their symptoms as being on the average 52% improved. Several case histories with varying outcome are described. The authors think that although autogenic training is no panacea, it is a useful modality in the drug abuse treatment armamentarium. Implications for further research and treatment are suggested.

Adult↗
PubMed1976

Frequency and magnitude distribution of life change in heroin and alcohol addicts.

A study of the frequency and magnitude of life change in two Veterans Administration Hospital addiction groups was made. Both heroin and alcohol addicts were characterized by a high frequency and magnitude of life change. The life change was highly correlated between the two addictions and there were no significant differences. This kind of evaluation is seen as important in identifying areas in which social disruption is concentrated and as an aid to organizing treatment in a way that is acceptable and nonthreatening to the patient.

Adult↗