Open Access
Addiction treatment dropout: exploring patients’ characteristics
(Wiley, 2012) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua
This study explored the characteristics associated with treatment dropout in substance dependence patients. A sample of 122 addicted patients (84 treatment completers and 38 treatment dropouts) who sought outpatient treatment was assessed to collect information on socio-demographic, consumption (assessed by EuropAsi), psychopathological (assessed by SCL-90-R) and personality variables (assessed by MCMI-II). Completers and dropouts were compared on all studied variables. According to the results, dropouts scored significantly higher on the EuropAsi variables measuring employment/support, alcohol consumption and family/social problems, as well as on the schizotypal scale of MCMI-II. Because most of significant differences were found in EuropAsi variables, three clusters analyses (2, 3 and 4 groups) based on EuropAsi mean scores were carried out to determine clinically relevant information predicting dropout. The most relevant results were obtained when four groups were used. Comparisons between the four groups derived from cluster analysis showed statistically significant differences in the rate of dropout, with one group exhibiting the highest dropout rate. The distinctive characteristics of the group with highest dropout rate included the presence of an increased labour problem combined with high alcohol consumption. Furthermore, this group had the highest scores on three scales of the MCMI-II: phobic, dependent and schizotypal. The implications of these results for further research and clinical practice are discussed.
Open Access
Efectividad del tratamiento de la violencia contra la pareja en pacientes drogodependientes
(Colegio Profesional de Psicólogos de Costa Rica, 2014) Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; López-Goñi, José Javier; Psicología y Pedagogía; Psikologia eta Pedagogia
En este artículo se analiza la efectividad de los programas de tratamiento psicológico para drogodependientes, que presentan conductas violentas contra la pareja. Para ello, se revisan, en primer lugar, los estudios que valoran la influencia del tratamiento habitual sobre las adicciones y la reducción de las conductas violentas contra la pareja. En segundo lugar, se analizan los resultados de los programas de intervención conjunta que se han desarrollado hasta la fecha, en el ámbito internacional, en los centros de tratamiento para la adicción con drogodependientes que ejercen, además, violencia contra la pareja. Los resultados muestran, por una parte, que la intervención con pacientes adictos produce una disminución importante en la tasa de violencia contra la pareja asociada a la adicción. Por otra parte, los programas de intervención con adicciones constituyen un marco de gran utilidad para aplicar, de forma conjunta, tratamientos específicos para aquellos adictos con un problema asociado de violencia contra la pareja. Los resultados de estos programas de intervención muestran los mejores datos en la reducción de la tasa de violencia contra la pareja de los pacientes adictos. Se comentan las implicaciones de todo ello para la práctica clínica y para las investigaciones futuras.
Open Access
Predictive validity of the EuropAsi: clinical diagnosis or composite scoring?
(Elsevier, 2012) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia
This study assessed the correlation between the areas of the Interviewer Severity Rating (ISR) and the areas of the Composite Scores (CS) of the EuropAsi. It evaluated the predictive validity of both types of scoring with regard to completion of treatment. For this purpose, 252 patients were interviewed using the EuropAsi. 38.9% of patients discontinued treatment. Results indicated a high correlation between various areas of the ISR and the CS, except the legal and family-others scales. Regarding predictive results, patients with a score greater than 3 in the ISR family area were more likely to quit the programme compared to patients with a score lower than 3. Patients with a CS score that was greater than 0.34 in the alcohol-use area were more likely to drop-out of treatment. When both ISR and CS scores were included in the prediction model, the ISR family area was a better predictor.
Open Access
Profile of addicted patients who re-enter treatment programmes
(Taylor & Francis, 2014) López-Goñi, José Javier; Fernández-Montalvo, Javier; Cacho Fernández, Raúl; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua, 359/2012
Objective. This study explored the differential profile of addicted patients who re-enter treatment programmes. Method. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Data regarding socio-demographic factors, drug consumption factors (assessed using the EuropAsi), psychopathological factors (assessed using the Symptom Checklist 90 Revised [SCL-90-R]), and personality variables (assessed using the Millon Clinical Multiaxial Inventory II [MCMI-II]) were collected. Results. 65.9% (n=166) of drug-addicted patients were re-admitted into treatment programmes. All of the variables for which we collected data were compared between these treatment repeaters and patients who were admitted for the first time. Significant differences between the two groups of patients were found for some of the variables that we examined. Treatment repeaters were generally older and had a poorer employment situation than first-time admits. Treatment repeaters were also more likely to report poly-consumption and to have sought treatment for alcohol abuse. Moreover, some of the scores for several EuropAsi, SCL-90-R, and MCMI-II variables were statistically significantly different from those of the first-time admits. Conclusions. According to these results, patients who re-enter treatment programmes often present with more severe addiction problems. The implications of these results for further research and clinical practice are discussed.
Open Access
Differential profile of addicted patients depending on violent behaviours and/or criminal acts
(Taylor & Francis, 2015) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Cacho Fernández, Raúl; Psicología y Pedagogía; Psikologia eta Pedagogia
This study explored the prevalence of violent and/or criminal behaviours in drug-addicted patients. A sample of 252 drug-addicted patients who sought treatment was assessed. Information on violent behaviours, criminal acts, socio-demographic factors, consumption factors, psychopathological factors and personality variables was collected. The sample was divided into four groups according to the presence of violence and/or criminal behaviours. There were significant differences between the groups on some variables. In general, patients associated with both violence and criminal behaviours showed a greater severity in drug consumption and maladjustment variables, as well as a higher rate of treatment dropout and re-entry.
Open Access
Violent behaviours in drug addiction: differential profiles of drug-addicted patients with and without violence problems
(SAGE Publications, 2012) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia
This study explored the prevalence of violent behaviours in patients who are addicted to drugs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Information on violent behaviours, socio-demographic factors, consumption factors (assessed by the EuropAsi), psychopathological factors (assessed by SCL-90-R) and personality variables (assessed by MCMI-II) was collected. Drug-addicted patients who were associated with violent behaviours were compared on all variables to patients who were not associated with violent behaviours. The rate of drug-addicted patients with violent behaviours in this sample was 39.68% (n=100). There were significant differences between the numbers of patients who did and did not demonstrate violence on some variables. Patients with violence problems were younger than those without violence problems and were more likely to report having been a victim of abuse. Moreover, they were significantly more likely to have experienced an overdose and showed a significantly higher score on several EuropAsi, SCL-90-R and MCMI-II variables. According to these results, patients with violence control problems present with both a more severe addiction and several comorbid problems. The implications of these results for further research and clinical practice are discussed.
Open Access
Suicidal attempts among patients with substance use disorders who present with suicidal ideation
(Elsevier, 2019) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Ciencias de la Salud; Osasun Zientziak
Background and aims: Patients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the speciﬁc risk characteristics for suicidal attempts in patients with addiction pro- blems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and o explore the diﬀerential characteristics for suicide ideators with and without suicide attempts. Methods: A sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed. Measurements: Information concerning socio-demographic characteristics, addiction severity, and psycho- pathological symptoms was obtained. Results: In total, 39.6% of the patients had attempted suicide (95% Conﬁdence Interval: 32.1%–47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction proﬁle and more maladjustment to ev- eryday life than patients with only suicidal ideation. Speciﬁcally, three psychopathological variables were re- lated to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium. Conclusions: According to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition.
Open Access
Therapeutic progression in abused women following a drug-addiction treatment program
(SAGE Publications, 2017) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Cacho Fernández, Raúl; Azanza Álvarez, Paula; Psicología y Pedagogía; Psikologia eta Pedagogia
This study explored the prevalence of victims of abuse and the therapeutic progression among women who sought treatment for drug addiction. A sample of 180 addicted Spanish women was assessed. Information was collected on the patients’ lifetime history of abuse (psychological, physical and/or sexual), socio-demographic factors, consumption variables and psychological symptoms. Of the total sample, 74.4% (n = 134) of the addicted women had been victims of abuse. Psychological abuse affected 66.1% (n = 119) of the patients, followed by physical abuse (51.7%; n = 93) and sexual abuse (31.7%; n = 57). Compared with patients who had not been abused, the addicted women with histories of victimisation scored significantly higher on several EuropASI and psychological variables. Specifically, physical abuse and sexual abuse were related to higher levels of severity of addiction. Regarding therapeutic progression, the highest rate of dropout was observed among victims of sexual abuse (63.5%; n = 33), followed by victims of physical abuse (48.9%; n = 23). Multivariate analysis showed that medical and family areas of the EuropASI, as well as violence problems and suicide ideation, were the main variables related to physical and/or sexual abuse. Moreover, women without abuse and with fewer family problems presented the higher probability of treatment completion. The implications of these results for further research and clinical practice are discussed.
Open Access
Gender differences in treatment progress of drug-addicted patients
(Taylor & Francis, 2017) Fernández-Montalvo, Javier; López-Goñi, José Javier; Azanza Álvarez, Paula; Arteaga Olleta, Alfonso; Cacho Fernández, Raúl; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua
This study explored the differences in treatment progress between men and women who were addicted to drugs. The differential rate of completion of/dropout from treatment in men and women with substance dependence was established. Moreover, comparisons between completers and dropouts, accounting for gender, were carried out for several variables related to treatment progress and clinical profile. A sample of 183 addicted patients (96 male and 87 female) who sought outpatient treatment between 2002 and 2006 was assessed. Information on socio-demographic, consumption and associated characteristics was collected. A detailed tracking of each patient's progress was maintained for a minimum period of eight years to assess treatment progression. The treatment dropout rate in the whole sample was 38.8%, with statistically significant differences between women (47.1%) and men (31.3%). Women who dropped out of treatment presented a more severe profile in most of the psychopathologic variables than women who completed it. Moreover, women who dropped out from treatment presented a more severe profile than men who dropped out. According to these results, drug-addicted women showed worse therapeutic progress than men with similar histories. Thus, women must be provided with additional targeted intervention to promote better treatment outcomes.
Open Access
Gender differences in unidirectional and bidirectional intimate partner violence in addictions
(Taylor & Francis, 2019) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Ciencias de la Salud; Osasun Zientziak
Background: Few studies have analyzed the specific characteristics related to uni/bidirectional intimate partner violence (IPV) in patients with addiction problems. Knowing the specific profiles of these patients would allow the development of effective tailored interventions. Objective: This study assessed gender differences in unidirectional and bidirectional IPV among patients undergoing drug addiction treatment. Method: We sampled 122 patients (91 male and 31 female) who sought treatment in an addiction treatment center, and collected cross-sectional self-reported data on violent behaviors (physical, sexual and psychological violence), sociodemographic factors, distorted thoughts about women and violence, impulsiveness, and anger. Results: Ninety-one percent of participants reported experience of IPV (any type and any direction). Sixty-three percent of participants reported bidirectional violence, which was more common among women (83.9%) than men (56.1%). Unidirectional (perpetration only) IPV was reported in 28.7% of participants, and it was more common among men (34.1%) than women (12.9%). No one reported unidirectional (victimization-only) IPV. When only physical and/or sexual violence was considered, bidirectional violence affected 32.0% of the sample; 23.8% were only victims, and 3.3% were only perpetrators (all of them men). Participants who reported bidirectional violence had higher scores for impulsiveness, anger, and distorted thoughts. Conclusions: Bidirectional IPV is commonly reported among patients seeking treatment for addiction, particularly among women, and should be considered in future research and clinical practice.