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Biomedical subjects

Deni Carise

Publications and source records attributed to Deni Carise.

9 recordsLinked to original sources
PubMed2006

Predicting DSM-IV dependence diagnoses from Addiction Severity Index composite scores.

This study, using data from the Drug Evaluation Network System and a study conducted through the Center for Studies on Addiction of the University of Pennsylvania/Philadelphia Veterans Administration Medical Center, sought to determine the potential of the Addiction Severity Index (ASI) to serve as a screening instrument for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) substance dependence. A significant positive correlation was found between ASI composite scores (CSs) and DSM-IV diagnoses of dependence in both the alcohol (r > .7) and drug (r > .5) domains (p < .01). Receiver operating characteristic analyses were run to predict DSM-IV alcohol and drug dependence diagnoses from the respective ASI CSs. Results showed good to strong prediction; ASI CSs identified dependent clients with approximately 85% sensitivity and 80% specificity. We recommend strategies for using ASI CSs as a diagnostic screening instrument in both research and treatment delivery environments.

Adult↗
PubMed2005

Getting patients the services they need using a computer-assisted system for patient assessment and referral--CASPAR.

The two goals of this technology transfer study were to: (1) increase the number and appropriateness of services received by substance abuse patients, and thereby (2) give clinical meaning and value to research-based assessment information. A software-based Resource Guide was developed to allow counselors to easily identify local resources for referral of their patients to additional clinical and social services. Two hours of training were provided on the use of the guide. It was hoped that this software and training would provide the counselors with a concrete method of linking the Addiction Severity Index (ASI) assessment information on patient problems to appropriate, available community services. We expected improved treatment planning, increased problem services matching, better patient-counselor rapport/satisfaction and better patient-performance during treatment. Data were analyzed from 131 patients of 33 counselors from 9 treatment programs, randomly assigned to 2 groups--Standard Assessment (SA) or Enhanced Assessment (EA). Patients of counselors in the EA group (1) had treatment plans that were better matched to their needs, (2) received significantly more and better-matched services than patients in the SA group, and (3) were less likely to leave treatment against medical advice and more likely to complete the full course of treatment than patients of counselors in the SA group. They did not have higher levels of patient satisfaction or helping alliance scores. These findings are discussed with regard to integrating empirically supported procedures into contemporary, community-based substance abuse treatment.

Computers↗
PubMed2005

Developing CASPAR: a computer-assisted system for patient assessment and referral.

A study was completed on the use of a computer-based system that provided counselors with resources for client referrals to free or low-cost services within the community based on problems identified with an Addiction Severity Index (ASI) assessment. That study, completed in Philadelphia, found that in comparison with clients whose counselors received a standard ASI assessment training, clients whose counselors also received brief training on the simple, easy-to-use computer-based resource guide (RG) had treatment plans that were substantially better-matched to their presenting problems and received significantly more and better-matched services. Because of these favorable results, the current article presents further data on counselor use of the RG and, to facilitate the implementation of these procedures by others, we provide access to the original RG database, describe the steps necessary to develop, and maintain an RG, and provide training suggestions.

Community Mental Health Services↗
PubMed2005

Telescoping of drinking-related behaviors: gender, racial/ethnic, and age comparisons.

OBJECTIVE: To examine demographic differences in alcohol telescoping-the rate of self-reported movement from regular alcohol consumption to the onset of regular heavy drinking-as well as differences in ages of initiation of regular alcohol use and alcohol use to intoxication. METHOD: The present study compared the retrospective reports of 2037 clients (1252 males, 785 females) enrolled in substance user treatment facilities around the country in 1998 and 1999. RESULTS: Overall, the findings support previous research, indicating that women generally move more rapidly than men from initiation of regular alcohol use to problem use (telescoping). The findings also indicate that African-Americans generally begin regular alcohol use later than their Anglo counterparts and move more rapidly from initiation of regular alcohol use to problem use (telescoping). Examining the sample by older vs. younger age groups demonstrates that gender and racial/ethnic differences in the age of initiation of regular alcohol use and in telescoping may be limited by age group, as these patterns appear in the older but not the younger cohort. CONCLUSIONS: These findings suggest that self-reported regular alcohol use, alcohol abuse, and telescoping differences vary dramatically by gender, race/ethnicity, and age cohort. Furthermore, the pattern of findings suggests that these differences are more likely the result of sociocultural than biological differences between the groups under study.

Adult↗
PubMed2004

Identifying United States substance abuse treatment programs: a test in one mid-sized city.

An accurate national listing of substance abuse treatment programs is essential for reporting data about the nation's treatment system and the clients entering that system. The National Survey of Substance Abuse Treatment Services (NSSATS) is thought to provide the most comprehensive list of treatment providers. Therefore, we report a partial test of the concurrent validity of the NSSATS in a single mid-sized city. Using operational definitions of "substance abuse treatment" and "substance abuse treatment programs" derived from prior work by the Center for Substance Abuse Treatment; and working within the defined geographic boundaries of a single, mid-sized city, we compared the NSSATS list with an independently developed compilation of programs from 5 sources: (1) the Yellow Pages; (2) the Internet Infospace Directory; (3) a State directory of licensed substance abuse treatment services; (4) the Office of Applied Studies Directory; (5) the National Master Facility Inventory. With all sources, including NSSATS, we identified 96 separate listings that met the operational definition of adult treatment within the geographic bounds of the city. The NSSATS identified 70 of those 96 programs (73%), the 5-source compilation identified a sample of 83 (86%). While these findings from a single city cannot be considered a full test of the validity of the NSSATS, the data presented offer at least one partial but promising indication that the NSSATS may be a valid national listing and may serve as satisfactory national frame.

Adolescent↗
PubMed2002

A successful researcher-practitioner collaboration in substance abuse treatment.

The best efforts to improve substance abuse treatment come from the integration of practice and research. The purpose of this article is to discuss factors that contribute to fruitful research-practice collaborations using the example of our recent successful partnership between a group of treatment researchers and a group of substance abuse recovery houses operated by Fresh Start. The research effort was the Drug Evaluation Network System, a computer assisted method of integrating clinical research and policy relevant information into a standard admission interview. The article discusses several factors that were important in integrating this research effort into the treatment system. These factors included adequate advance preparation of clinical and research staff to employ the new system, overcoming bilateral biases, and determining the degree to which the clinicians' and researchers' missions are matched. The paper also discusses a range of general factors to consider in implementing and maintaining successful research-to-practice integrations.

Humans↗
PubMedDate not supplied

The Addiction Severity Index at 25: origins, contributions and transitions.

The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented.

Adult↗