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Biomedical subjects

Maryann Amodeo

Publications and source records attributed to Maryann Amodeo.

12 recordsLinked to original sources
PubMed2006

How do treatment repeaters use the drug treatment system? An analysis of injection drug users in Massachusetts.

This study explored common drug treatment utilization patterns in the first four types of treatments entered by injection drug users (IDUs) with multiple admissions. A Massachusetts longitudinal database with all entries to all licensed drug treatment programs was used. Treatment repeaters' admission patterns varied considerably. For the years 1997-2001, there were 2,500-3,000 IDUs new to the system each year who became treatment repeaters and who had more than 250 utilization patterns. Only approximately half of these repeaters followed the 10 most common utilization patterns. The most common pattern (for 30% of the population each year) was only entering detoxification two to four times; the only other common pattern (involving 4-8% of the population) was having entered methadone maintenance twice or having entered detoxification then methadone maintenance. Studies are needed to identify the extent to which the absence of a systematic pattern is caused by client, payment, or treatment setting and systems issues. A key implication is the need to develop policies that provide support for states to develop continuum-of-care models for their drug treatment systems.

Adult↗
PubMed2006

Racial differences in social support: kin versus friends.

Social support was examined among 290 Black and White women recruited from the community. We hypothesized that (1) social support, adjusted for social class, would not vary by race and (2) social support would be related to well-being. Standardized measures were administered, examining support provided by friends versus kin separately. Multivariate models showed that Black women reported similar numbers of kin and fewer friends than Whites, while satisfaction with support did not vary by race. Measures of social support were generally associated with well-being. These findings question earlier reports that Black women have stronger kin support than White women, suggesting that clinicians should not assume that Blacks can rely on kin for social support.

Adult↗
PubMed2006

Introducing evidence-based practices into substance abuse treatment using organization development methods.

BACKGROUND: Dissemination of evidence-based practices (EBPs) in addiction settings is a national priority. We tested Organization Development (OD) methods for dissemination. METHODS: Using OD in two addiction treatment programs we developed an organization-specific treatment plan using employee work teams with the goals of changes in organizational policies and procedures and improvement in practitioner skills. RESULTS: OD was effectively applied, but EBPs were premature for these addiction programs because they first needed to address more fundamental aspects of client-clinician interaction and agency treatment philosophy. CONCLUSION: The OD approach in addiction treatment is complementary to other technology transfer efforts by being: (a) "organization-centered," engaging practitioners at all levels; (b) "needs-focused," addressing concerns of the particular organization; (c) flexible in its responsiveness to readiness for change; and (d) relatively affordable. However, before absorbing EBPs, substance abuse treatment organizations must develop strengths in delivering fundamental aspects of care.

Evidence-Based Medicine↗
PubMed2006

Childhood sexual abuse among Black women and White women from two-parent families.

Differences in childhood sexual abuse (CSA) between Black women and White women are explored in a community sample of 290 women raised in two-parent families.A self-administered questionnaire and a face-to-face interview assessed CSA characteristics, aftermath, and prevalence as well as family structure and other childhood variables. Siblings served as collateral informants for the occurrence of CSA. Overall, comparisons of the nature, severity, and aftermath of CSA showed similarities by race; some differences, for example, in age of onset, are potentially relevant for the planning of prevention programs. Logistic regression models examined effects of childhood variables on CSA prevalence. Initial analyses showed a higher CSA prevalence among Black women (34.1% [45] of Black women vs. 22.8% [36] of White women) that was attenuated when family structure (e.g., living with two biological parents throughout childhood or not) and social class were considered. Of interest, differences in family structure remained important even among these two-parent families. Understanding the dynamics of abuse by race and family structure will facilitate the design of more targeted CSA prevention programs.

Adolescent↗
PubMed2005

Predicting long-term outcomes for women sexually abused in childhood: contribution of abuse severity versus family environment.

OBJECTIVE: Child sexual abuse (CSA) has been associated with adverse adult psychosocial outcomes, although some reports describe minimal long-term effects. The search for explanations for the heterogeneous outcomes in women with CSA has led to an examination of a range of CSA-related factors, from the severity of individual CSA incidents to the childhood family environment. This study compares three factors for predicting adult outcomes: a multidimensional CSA Severity Scale, the presence or absence of CSA, and family environment. METHODS: The effect of CSA on adult outcomes was examined among 290 community-dwelling women raised in intact families. Standardized measures and a focused interview were used to collect data, with siblings as collateral informants. RESULTS: Comparison of a multidimensional CSA Severity Scale to a dichotomous measure of the presence or absence of CSA showed that the Severity Scale did not have greater predictive value for adult outcomes than the dichotomous measure, nor was it as parsimonious. Childhood family environment scales added significantly to the predictive ability of the dichotomous measure. CONCLUSION: The specific characteristics of a CSA experience may be less important than the occurrence of CSA and the family environment of women for predicting long-term outcomes.

Adult↗
PubMed2005

Mental health status, drug treatment use, and needle sharing among injection drug users.

This study examined the relationship among mental health symptoms, drug treatment use, and needle sharing in a sample of 507 injection drug users (IDUs). Mental health symptoms were measured through the ASI psychiatric scale. A logistic regression model identified that some of the ASI items were associated with needle sharing in an opposing direction. Specifically, anxiety was significantly and positively associated with needle sharing. Using psychotropic medication was significantly and negatively associated with sharing needles. Those who had higher levels of drug injecting were more likely to share needles and those with an HIV-positive status were less likely to share needles. Finally, IDUs who reported high levels of drug treatment use (in the 75th percentile in terms of number of treatment admissions) were also more likely to share needles. Results suggest that treating mental health problems in IDUs who are not drug free could reduce HIV risk behaviors. The results also suggest the need to develop new intervention methods for high-level drug treatment users who may be "cycling" through treatment with low levels of treatment completion.

Adult↗
PubMed2004

Use of mental health and substance abuse treatment services by female injection drug users.

This article examines whether female injection drug users (IDUs) who have a history of using mental health services (i.e., one or more psychiatric hospitalizations or counseling) enter types of drug treatment different from those of female IDUs who do not have a history of using mental health services. Data used for this exploration originate from a statewide drug-treatment database covering all women who entered drug treatment in the state of Massachusetts from 1996 to 2001. A total of 7776 women were included in the study. Through the use of logistic regression analysis, the study determined that those female IDUs who had a mental health service history, compared with female IDUs who had no such history, were about two-thirds more likely to enter substance abuse treatment other than detoxification only. Specifically, women with a mental health service history were about 66% more likely to enter substance abuse treatment modalities such as drug-free outpatient counseling, methadone maintenance, and/or long-term residential services rather than detoxification alone. This is a positive result, indicating that female IDUs who have mental health problems and therefore have high needs for effective substance abuse treatment are entering the more intensive and/or longer term modalities likely to lead to better outcomes. Possible factors accounting for this, including the referral process within detoxification centers, the role of community referral agents, and the experience women gain as a consequence of receiving services in more than one service system, are discussed.

Adolescent↗
PubMed2003

Parental status of women injection drug users and entry to methadone maintenance.

This article examines patterns of methadone maintenance treatment entry among 9018 adult women injection drug users (IDUs), with special attention to parental-status differences. The data originate from a statewide drug-treatment database covering all women IDUs who entered drug treatment in the State of Massachusetts over a four-year period. Through the use of logistic regression analysis, the study found that among these women IDUs, those who resided with their children were significantly more likely to enter methadone maintenance than women who were mothers but did not reside with their children. Mothers residing with their children were 73% more likely to enter methadone maintenance than mothers who do not reside with their children. The authors discuss specific programmatic and policy implications including the need to determine whether methadone maintenance should be promoted as an alternative drug treatment option in order to preserve family unification or promote family reunification.

Adolescent↗
PubMed2002

MSWs with and without long-term substance abuse training: agency, community, and personal outcomes.

Behavioral outcomes in agency, community, and personal arenas were examined for 81 social workers with Masters degrees (MSWs) who completed a clinical postgraduate substance abuse (SA) training program (trainees) and a matched group of 78 MSWs not enrolled in such a program (comparison subjects). Subject self-report data was collected via telephone interviews of 30-40 min. With little or limited prior SA training, trainees took this clinical training to a broader level: they were significantly more likely than comparison subjects to provide agency SA training, receive SA training and supervision outside the agency, engage in SA community service, present SA papers at conferences, and intervene with their SA-troubled significant others. With more MSW students now receiving SA training in their graduate programs, the impact of such postgraduate education is likely to be even greater.

Community Mental Health Services↗
PubMed1999

Integrating Substance Abuse Content into Social Work Courses: Effects of Intensive Faculty Training.

An evaluation was conducted in a graduate school of social work to assess the integration of substance abuse content into basic and advanced courses by instructors with and without specialized substance abuse training. Students in these courses completed questionnaires that asked about the amount, type, and usefulness of substance abuse content presented during the semester. Instructors with and without specialized substance abuse training completed questionnaires that examined their perceptions of the amount, type, and usefulness of the substance abuse content they had taught. Results showed that (1) faculty with specialized substance abuse training were more likely than faculty without such training to integrate substance abuse content; (2) courses taught by trained faculty received higher ratings from students on the quality of the content; (3) both groups of faculty (trained and untrained) perceived that more substance abuse content had been taught than their students perceived; and (4) neither faculty nor students perceived that too much substance abuse content had been taught. This approach could be useful to social work programs and other disciplines interested in measuring the effects of changes in course content.

Journal Article↗
PubMedDate not supplied

Mediating factors for the long-term effects of parental alcoholism in women: the contribution of other childhood stresses and resources.

The primary aim of this study was to identify the stresses and resources in childhood that mediate the relationship between parental alcoholism and adult outcomes in women. Adult outcomes included alcohol problems and measures of psychosocial adjustment. Standardized measures and a face-to-face interview were used to collect data on 290 community-dwelling women, with siblings as collateral informants. Mediation analysis showed that the effect of parental alcoholism on several adult outcomes was indirect, mediated by the other stresses and resources examined. Contextual models such as those presented here are helpful in understanding the long-term effects of childhood environment on women.

Adult↗