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Biomedical subjects

W Fals-Stewart

Publications and source records attributed to W Fals-Stewart.

At least 37 records · Page 2Linked to original sources
PubMed1996

Behavioral couples therapy for male substance-abusing patients: effects on relationship adjustment and drug-using behavior.

Married or cohabitating substance-abusing patients (N = 80) who were entering individual outpatient treatment, most of whom were referred by the criminal justice system (n = 68; 85%), were randomly assigned to a no-couples-treatment control group (n = 40) or to 12 weekly sessions of adjunctive behavioral couples therapy (BCT; n = 40). Drug use and relationship adjustment measures were collected at pretreatment, posttreatment, and at 3-, 6-, 9-, and 12-month follow-ups. Couples who received BCT as part of individual-based treatment had better relationship outcomes, in terms of more positive dyadic adjustment and less time separated, than couples in which husbands received individual-based treatment only. Husbands in the BCT condition also reported fewer days of drug use, longer periods of abstinence, fewer drug-related arrests, and fewer drug-related hospitalizations through the 12-month follow-up period than husbands receiving individual-based treatment only. However, some of the drug use and relationship adjustment differences between these groups dissipated over the course of the follow-up period.

Adaptation, Psychological↗
PubMed1995

The relationship of patients' cognitive status and therapists' ratings of psychological distress among psychoactive substance users in long-term residential treatment.

Patients in a long-term residential substance abuse treatment program (N = 168) were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), a brief inventory that measures psychological distress in nine symptom areas. Using the Symptom Checklist-90 Analogue (SCL-90 Analogue), which allows raters to assess patients along the same dimensions measured by the SCL-90-R, therapists also estimated the degree of psychological distress they observed in their patients. Significantly larger discrepancies were found between therapists' ratings of their patients and patients' ratings of themselves when patients were cognitively impaired (N = 57) than when patients did not display these decrements (N = 111). Furthermore, these patient-therapist assessment differences were negatively related to measures of patients' participation in treatment and length of stay in the program. Clinical and research implications of these findings are discussed.

Adaptation, Psychological↗
PubMed1995

The effect of defensive responding by substance-abusing patients on the Million Clinical Multiaxial Inventory.

This study explored the effect of defensive (i. e., fake-good) responding by substance-abusing patients on the scale scores of the Millon Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Patients asked to respond honestly (N = 62) had significantly higher scores on most of the scales than patients who were instructed to respond defensively (N = 62) and forensic subjects suspected of abusing psychoactive substances (N = 54). Significantly fewer subjects in the defensive responding simulation and the forensic group had elevated the Drug Dependence and Alcohol Dependence scales compared to the honestly responding patients. These results indicate that most drug-abusing individuals can conceal the presence of a substance-related disorder, as reflected by scale scores on the MCMI-II, if motivated to do so.

Adolescent↗
PubMed1995

Maximizing internal and external validity in MMPI malingering research: a study of a military population.

The authors investigated the effectiveness of various commonly used Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) indices of exaggeration and malingering in detecting suspected malingering in a military sample of 121 enlisted men. To maximize external validity, only men undergoing psychological evaluation were used as participants. Forty-one participants were identified as suspected malingerers through multiple criteria and were contrasted with schizophrenic-spectrum and clinic outpatient groups. To improve internal validity, the 41 suspected malingering participants were asked to retake the test without exaggerating. Results revealed that there were many false positives and fewer, but nonetheless many, false negatives with standard malingering indices. It appeared that the Gough Dissimulation scale (Gough, 1947) might hold the most promise as a measure of malingering, but other scales are also useful. Individual comparisons between different samples and implications for MMPI-2 (Butcher et al., 1989) are presented.

Journal Article↗
PubMed1994

Behavioral group therapy with obsessive-compulsives: an overview.

During the last two decades, effective psychotherapeutic interventions have been developed and proven successful in treating patients with Obsessive-Compulsive Disorder (OCD). Behavior therapy, using exposure to anxiety-evoking stimuli and response prevention directed toward rituals, provides lasting benefit for most patients who engage in and comply with treatment. A recent study indicated that, for certain OCD patients, these interventions could be applied successfully in a group therapy context. This article describes the general procedures used in this study to treat obsessive-compulsives with exposure and response prevention in a group context.

Behavior Therapy↗
PubMed1994

Obsessive-compulsive disorder among patients entering substance abuse treatment. Prevalence and accuracy of diagnosis.

Patients (N = 217) admitted to two community-based substance abuse outpatient treatment programs participated in a structured clinical interview to determine the comorbidity of obsessive-compulsive disorder. Twenty-four patients (11.1%) met the diagnostic criteria for obsessive-compulsive disorder, which is significantly higher than the general population prevalence of this disorder. However, only eight of these patients were accurately diagnosed with this condition by their primary counselors. Clinical implications of these findings are discussed.

Adolescent↗
PubMed1994

A treatment outcome study of community-based residential care.

OBJECTIVE: The authors describe two psychosocially oriented community residential facilities for patients with persistent and severe mental disorders and multiple failures at community tenure, and they report a retrospective study designed to evaluate treatment outcomes of program residents. METHODS: The study employed a retrospective single-group repeated-measures design to evaluate 104 patients who completed the one-year follow-up. One-year mean number of admissions to and days in a hospital or crisis center during the two years before program entry were compared with mean admissions and days for the follow-up year; employment status, living status, and Global Assessment of Functioning (GAF) Scale scores at program entry and at one-year follow-up were also compared. Thirteen sociodemographic and clinical variables were individually tested for association with outcome. RESULTS: Hospital and crisis center admissions and days were significantly reduced during the follow-up year. At one-year follow-up, a significantly greater proportion of patients were employed and living independently, and fewer were homeless. GAF scores were significantly higher. No significant correlations between outcome and sociodemographic and clinical variables were found. CONCLUSIONS: Despite design limitations of the study, the findings suggest that psychosocial residential treatment models can offer cost-effective and clinically efficacious care to persistently mentally ill patients.

Adult↗
PubMed1994

The personality of marital distress: an empirical typology.

Couples seeking marital therapy (N = 102) completed the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943). Cluster analytic procedures were performed on partners' MMPI validity and clinical scales. Five distinct types of couples were identified: Conflicted, Depressed, Dissatisfied Wives, Dysphoric, and Domestic Calm. The resulting cluster solution was successfully replicated with a separate sample of dissatisfied couples. With reference to additional measures of marital adjustment, a description of each couple type is provided, along with implications for future research.

Adaptation, Psychological↗
PubMed1993

A comparison of behavioral group therapy and individual behavior therapy in treating obsessive-compulsive disorder.

Outpatients with a primary DSM-III axis I diagnosis of obsessive-compulsive disorder (OCD: N = 93) were randomly assigned to one of three treatment groups: One group (N = 30) received 24 sessions of behavioral group therapy over a 12-week period; a second group (N = 31) received 24 individual behavior therapy sessions over the same treatment interval; and members of a control group (N = 32) received 24 individual sessions of progressive muscle relaxation. The Yale-Brown Obsessive-Compulsive Scale was administered before treatment at 2-week intervals during treatment, and at 6-month follow-up to measure changes in distress caused by OCD symptoms. The Beck Depression Inventory and the Self-Rating Anxiety Scale were also administered at pretreatment, posttreatment, and 6-month follow-up. Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed.

Adult↗
PubMed1993

MMPI correlates of psychotherapy compliance among obsessive-compulsives.

The purpose of this investigation was to examine the relationship between compliance with a behavior therapy program and personality characteristics of obsessive-compulsive disorder (OCD) outpatients (n = 169), as measured by the Minnesota Multiphasic Personality Inventory (MMPI). Compliance was defined as the number of scheduled behavior therapy sessions canceled or missed by patients. Standard multiple regression analysis revealed that higher scores on scales 8 (Schizophrenia), 2 (Depression), and 0 (Social Introversion) contributed significantly to the prediction of compliance among OCD patients engaged in behavior therapy.

Adult↗
PubMed1992

The relationship between length of stay in drug-free therapeutic communities and neurocognitive functioning.

The relationship between neurocognitive functioning and length of stay in drug-free therapeutic communities (TCs) was investigated. The Wechsler Adult Intelligence Scale (WAIS) was administered to 495 patients admitted to a therapeutic community. It was hypothesized that Digit Symbol and Block Design, which have been found to be more sensitive to diffuse neuropsychological impairment than other WAIS subtests, would be significant predictors of length of stay. A hierarchical regression analysis was performed, and both subtests were found to be predictive of time-in-residence. These findings are congruent with recent investigations that have found a relationship between cognitive impairment and treatment process and outcome in substance abuse treatment.

Adolescent↗
PubMed1992

The treatment of substance abusers diagnosed with obsessive-compulsive disorder: an outcome study.

Sixty substance abusers dually diagnosed with obsessive-compulsive disorder (OCD) and voluntarily admitted to a drug-free therapeutic community were randomly assigned to one of three treatment conditions. One group received a combined intervention that addressed their obsessive-compulsive symptoms and substance abuse; a second group received only substance abuse treatment; and an attention control group received treatment for their substance abuse and training in progressive muscle relaxation. Patients who received treatment for their OCD and substance abuse stayed in treatment longer, showed greater reductions in OCD symptom severity, and had higher overall abstinence rates at 12-month follow-up.

Adult↗
PubMed1992

Personality characteristics of substance abusers: an MCMI cluster typology of recreational drug users treated in a therapeutic community and its relationship to length of stay and outcome.

The purpose of this investigation was to define homogeneous personality subtypes among substance abusers treated in a long-term, inpatient, drug-free therapeutic community and to determine how the resulting typology was related to length of stay and treatment outcome. A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 235 admissions to a therapeutic community. Five cluster types emerged, which were similar to typologies found in studies with alcoholic inpatients. A concordant solution evolved when a different clustering algorithm was used with the same sample and when clustering was done with a different group of substance abusers. As hypothesized, clusters of patients with average MCMI elevations that indicated avoidant, schizoid, and antisocial qualities tended to stay in treatment fewer days and relapsed earlier during the 1-year follow-up. The implications for substance abuse treatment are discussed.

Adult↗
PubMed1992

Using subtests of the Brain Age Quotient to screen for cognitive deficits among substance abusers.

The subtests of the Brain Age Quotient, a brief neuropsychological battery, were used to screen for cognitive impairment in a sample of 112 substance abusers. Each of the subtests was scored, using newly developed T scores corrected for age, education, and gender, for which a mean battery score of T less than 40 indicates general cognitive impairment. The chance-corrected agreement in finding cognitive dysfunction between this battery and the Average Impairment Rating T score from the Halstead-Reitan battery was adequate, kappa = .81. This result suggests that, for discerning global cognitive impairment, this relatively brief neurodiagnostic screening device may be an attractive alternative to the more time-consuming Halstead-Reitan battery.

Adolescent↗
PubMed1992

A dimensional analysis of the Yale-Brown Obsessive Compulsive Scale.

A principal axis factor analysis with a Promax rotation was performed on the Yale-Brown Obsessive Compulsive Scale. Although the scale has separate obsession and compulsion indices, only one factor was extracted. The psychometric implications of this finding are discussed.

Adult↗
PubMedDate not supplied

An MCMI cluster typology of obsessive-compulsives: a measure of personality characteristics and its relationship to treatment participation, compliance and outcome in behavior therapy.

The two-fold purpose of this investigation was to (a) define personality subtypes among patients diagnosed with obsessive-compulsive disorder (OCD) and (b) examine the relationship between the resulting typology and treatment participation, compliance and outcome of OCD patients treated with behavior therapy, using exposure and response prevention. A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 137 OCD patients seeking outpatient treatment; four cluster types emerged. Patients' OCD symptom severity was assessed at pretreatment, posttreatment, and 6-month follow-up using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Patients with no evident personality pathology and those with dependent qualities demonstrated the best overall outcome. Patients whose personalities indicated particular difficulties with interpersonal interaction were most likely to refuse behavior therapy and, among these patients who engaged in treatment, evidenced no reduction in OCD symptoms at posttreatment and follow-up. Patients with histrionic/borderline traits showed symptom reductions at posttreatment, but did not maintain their treatment gains at follow-up. The clinical implications of these findings are discussed.

Adult↗