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Biomedical subjects

Quyen Tiet

Publications and source records attributed to Quyen Tiet.

6 recordsLinked to original sources

Self-efficacy, therapeutic alliance, and alcohol-use disorder treatment outcomes.

OBJECTIVE: High abstinence self-efficacy reliably predicts better treatment outcomes for patients with alcohol use disorders, but little is known about aspects of treatment that may be particularly beneficial for patients who enter treatment with low self-efficacy. This study examines whether the relationship between self-efficacy and treatment outcomes is influenced by the quality of the therapeutic alliance in Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a multisite clinical trial of three treatments for alcohol use disorders. METHOD: Information on 785 patients in the outpatient sample of Project MATCH was used to test for an interaction between baseline self-efficacy and therapeutic alliance in relation to 1-year alcohol use outcomes. RESULTS: A significant interaction was found between self-efficacy and the therapists' perception of the therapeutic alliance predicting I1year drinking outcomes. Patients with low self-efficacy who established a strong treatment alliance, as judged by the therapist, experienced I1year outcomes that were superior to those of patients with low self-efficacy with poorer treatment alliance and comparable with those of patients with high self-efficacy. Therapeutic alliance was not strongly related to the outcomes of patients with high baseline self-efficacy. CONCLUSIONS: In patients who are treated for alcohol-use disorders, a positive therapeutic alliance may counteract the negative impact of a low baseline self-efficacy. Potential reasons why the therapist's perception of the alliance may be particularly important for patients with low self-efficacy are discussed.

Adolescent↗

Chronic PTSD patients' functioning before and after the September 11 attacks.

This study examined how treatment-seeking veterans with preexisting posttraumatic stress disorder (PTSD) (n = 178) were affected by vicarious exposure to the September 11 terrorist attacks. Participants were surveyed 0 to 5 months prior to 9/11 and resurveyed 6 months after the attacks. Half the patients reported that thoughts and feelings about 9/11 impaired their functioning some (37%) or most or all of the time (13%). However, there was little evidence that vicarious exposure to 9/11 altered the course of these patients' functioning. Mean symptom, substance use, and role functioning outcomes were unchanged from pre-9/11 levels. Time spent following media coverage of 9/11 events was weakly associated (r = .17 to .18, p < .05) with only two of eight functioning outcomes.

Adaptation, Psychological↗

Abstinence self-efficacy and abstinence 1 year after substance use disorder treatment.

To better understand the relationship between abstinence self-efficacy and treatment outcomes in substance use disorder patients, experts in the field need more information about the levels of abstinence self-efficacy most predictive of treatment outcomes. Participants (N = 2,967) from 15 residential substance use disorder treatment programs were assessed at treatment entry, discharge, and 1-year follow-up. A signal detection analysis compared the ability of different measures of self-efficacy to predict 1-year abstinence and identified the optimal cutoffs for significant predictors. The maximal level of abstinence self-efficacy (i.e., 100% confident) measured at discharge was the strongest predictor of 1-year abstinence. Treatment providers should focus on obtaining high levels of abstinence self-efficacy during treatment with the goal of achieving 100% confidence in abstinence.

Adolescent↗

Recent suicide attempt and the effectiveness of inpatient and outpatient substance use disorder treatment.

BACKGROUND: The present study investigated whether or not the effect of treatment setting (inpatient or outpatient) on 6-mo follow-up substance use varied for suicidal and non-suicidal patients. In particular, the study tested the hypothesis that treatment setting would have no differing effect for non-suicidal participants, but for suicidal participants, inpatient setting would be more closely associated with positive outcomes than the outpatient setting. METHODS: A national sample of patients presenting for treatment of substance use disorders in the Veterans Administration health care system was selected to participate in the study. A total of 1,289 participants provided complete data on psychiatric and substance-related problems at baseline and 6-mo follow-up. RESULTS: At baseline, 4% (n=53) of the sample reported having made a suicide attempt within the past 30 days. Those who reported a suicide attempt were no more likely to have been treated in an inpatient setting than in an outpatient setting. A significant interaction between baseline suicide attempt and treatment setting was found, such that non-suicidal patients reported similar patterns of substance use when treated in inpatient or outpatient settings, but suicidal patients were significantly more likely to have better substance-related outcomes at 6-mo follow-up if they were treated in inpatient compared with outpatient settings. CONCLUSIONS: Suicidal patients displayed substantial improvement after substance use disorders treatment and seem particularly responsive to treatment in inpatient settings.

Adult↗

Outcomes of substance use disorder treatment in suicidal and nonsuicidal male patients.

OBJECTIVE: Numerous studies report high rates of substance-related problems and psychopathology in substance use disorder (SUD) patients with a history of a suicide attempt. However, little is known about the response of suicidal SUD patients to treatment. This study examined the treatment outcomes of suicidal and nonsuicidal SUD patients who were followed for 5 years. METHOD: A total of 2099 male SUD patients were recruited from 15 Department of Veterans Affairs residential alcohol and drug treatment programs and were assessed at four points (treatment entry, discharge, and 1 and 5 years later). Approximately 7% (n = 156) of the patients reported a suicide attempt in the 3 months prior to the start of treatment. RESULTS: Although patients with a recent suicide attempt reported severe patterns of alcohol use and elevated psychiatric symptoms at baseline, they showed significant improvements in both of these domains at discharge from residential treatment, and these improvements were still evident at 1-year and 5-year follow-ups. Suicidal SUD patients were no more likely to leave treatment early than were nonsuicidal patients, and they received slightly longer and more individualized treatment. CONCLUSIONS: Despite a more severe pattern of alcohol use and psychiatric symptoms at baseline, suicidal SUD patients benefitted substantially from residential SUD treatment. These findings imply that suicidal SUD patients can be treated effectively within SUD treatment settings.

Adult↗

Factors associated with adolescent utilization of alcohol treatment services.

OBJECTIVE: This study examined factors associated with adolescents' use of alcohol treatment services. METHOD: Data on adolescents (aged 12-17) from the 1994 National Household Survey on Drug Abuse (NHSDA, N = 4,698), a large representative sample of the U.S. population, were used in this study. Information obtained from the survey included adolescent alcohol use, drinking patterns, alcohol abuse/dependent problems, and service use for alcohol-related problems. In addition, socio- demographics, health insurance, mental and behavioral problems, and other drug use were also included in the analysis. RESULTS: The findings indicate that many adolescents with alcohol problems did not receive treatment. White adolescents were more likely to receive alcohol treatment services than nonwhites. Among alcohol-related problems, alcohol causing problems at home, school, or other settings predicted entry into alcohol treatment. Drug use and poor health status were also associated with receiving alcohol treatment services. CONCLUSIONS: This study calls for an improved service delivery system to meet service needs of adolescents with alcohol-related problems, especially among minorities, and those with alcohol-related problems but without yet experiencing significant negative social consequences.

Adolescent↗