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Participation and outcome in a residential treatment and work therapy program for addictive disorders: the effects of race.

OBJECTIVE: The authors examined differences in program participation and outcome between black and white veterans with addictive disorders who participated in an intensive Department of Veterans Affairs (VA) residential work therapy program. METHOD: Data on 962 veterans treated in the VA Compensated Work Therapy/Transitional Residence Program were gathered. Multivariate analyses were used to compare black and white veterans on admission characteristics, program participation, and 3-month outcome. RESULTS: The black subjects were younger than the white veterans and had more severe drug abuse problems, less severe alcohol and psychiatric problems, and more extensive social support networks. There were no differences between groups in 11 of 13 measures of program participation, although the blacks felt more positively about the therapeutic milieu and worked more hours per month in the work therapy program than the whites. The black veterans also showed more improvement in alcohol use and housing. The proportion of black participants at the site level had no impact on measures of program participation or outcome among black participants with one exception: blacks were more likely to achieve sobriety at 3 months when treated in programs with higher proportions of black participants. CONCLUSIONS: Detailed data on program participation and outcome in a large study group showed no evidence of less program participation or worse outcome among black patients.

Adult↗

Temperamental and environmental risk factors for borderline personality disorder among inner-city substance users in residential treatment.

Borderline Personality Disorder (BPD) is widely considered the result of biological vulnerability and environmental adversity. Despite growing evidence for the role of several temperamental and environmental risk factors in the development of BPD, the unique contribution of each to the development of this disorder remains unclear. Furthermore, the extent to which these factors are associated with BPD among underserved and diverse populations is unknown. The current study examined the temperamental and environmental factors uniquely associated with BPD among a sample of 93 inner-city individuals receiving residential substance use treatment. Results indicate that BPD was associated with higher impulsivity and emotional instability/vulnerability, lower well-being, and several interpersonal manifestations of positive and negative temperament (i.e., greater alienation and lower achievement and social closeness). BPD was also associated with several forms of childhood maltreatment, including emotional and physical abuse and neglect. However, only emotional instability or vulnerability, impulsivity, and emotional abuse emerged as unique predictors of BPD status.

Adult↗