Open Access
Prevalence and differential profiles of people with adverse childhood experiences in treatment for substance use disorder
(Cambridge University Press, 2025-04-07) Leza González, Leire; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.
Open Access
Therapeutic difficulties in dealing with suicidal behaviour in treatment addiction programmes
(Springer, 2025-06-16) López-Goñi, José Javier; Leza González, Leire; Sánchez Torres, Ana María; Campos, Lucía; Arteaga Olleta, Alfonso; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa; Gobierno de Navarra / Nafarroako Gobernua
Suicidal behaviour is a therapeutic target in the treatment of substance use disorders (SUDs) because of its high prevalence. As such, it is expected that clinicians are confident in addressing suicidal behaviour. However, there is a paucity of research examining clinicians¿ perspectives on suicidal behaviour interventions. The aim of this study was to assess the knowledge, difficulties, and needs perceived by professionals dealing with SUD in the Navarre region. A sample of 47 professionals completed the scales to assess knowledge and attitudes towards suicidal behaviour and perceived difficulties in intervening. The results showed that professionals had a low level of knowledge about suicide, but in general, they did not report prejudiced or stigmatized attitudes towards suicidal behaviour. Most professionals had been in contact with patients who had made one or more lifetime suicide attempts (n = 44, 95.7%), had experienced the suicide of one of their patients (n = 23, 52.3%), or had worked with patients at risk of suicide under their supervision (n = 42, 89.4%). Most clinicians reported that they had received inadequate training in how to address suicidal behaviour (n = 46, 97.9%), and thirty-two (68.1%) expressed a need for specific training on suicide. Among the specific professional difficulties reported by clinicians, technical difficulties were most often perceived as frequent. These results highlight the need for specific training in intervention strategies for understanding and managing suicidal behaviour, considering that clinicians working with patients with SUD have to address suicidal behaviour at some point in their professional practice.
Open Access
Gender differences in risk factors related to suicidal ideation among callers to telephone helplines in Spain
(Taylor & Francis, 2018) Villanueva Irure, Pedro; Arteaga Olleta, Alfonso; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak
The main goals of this study were to determine the prevalence rate of suicidal ideation among callers to a Spanish telephone general crisis helpline (Teléfono de la Esperanza) and to identify gender-based characteristics and risk factors related to suicidal ideation. A sample of 10,765 (6,868 men and 3,897 women) callers to this telephone helpline was assessed. ATENSIS, an assessment tool designed to collect information related to suicidal ideation among callers to telephone helplines, was used. Comparisons between men and women with suicidal ideation were carried out in all variables studied: sociodemographics, telephone call timing, risk factors, and suicidality. Of the total sample, 1.87% (n = 201) presented suicidal ideation, with a higher prevalence in women (2.80%) than in men (1.34%). Moreover, significant gender-based differences among callers with suicidal ideations were observed in some variables: women were older than men and showed a greater prevalence of chronic disease with pain; men showed a greater prevalence of depression, alcohol/drug abuse, helplessness, and lack of hope for the future. This study showed that telephone helplines can be used to identify suicidal ideation among callers. Moreover, gender-based differential characteristics among suicide ideators have been found. The implications for further research are discussed.
Open Access
Suicidal behaviours in people seeking treatment for substance use disorder
(Elsevier, 2025-03-13) Leza González, Leire; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Sánchez Torres, Ana María; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Little is known about the specific characteristics of suicidal behaviour in people receiving treatment for substance use disorder (SUD). The aim of this study was to describe the number and types of suicide attempts and the methods used by 215 patients with SUD, according to sex. A face to face interview (Columbia Scale Severity Rate) was conducted. Lifetime suicidal ideation was reported by 48.8 % (n = 105) of the patients, and lifetime suicide attempts by 28.4 % (n = 61). Forty-five patients reported actual suicide attempts (20.9 %), and overdose was the most common method used (52.5 %; n = 32). Women had more aborted attempts than men did. Most of the participants who attempted suicide made only one attempt (n = 34; 55.7 %). The projection of these figures is alarming. These results justify the need to integrate suicide prevention interventions into addiction treatment programmes.
Open Access
Suicidal ideation and attempts among patients with lifetime physical and/or sexual abuse in treatment for substance use disorders
(Taylor & Francis, 2019) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Ciencias de la Salud; Osasun Zientziak
Background: Several studies indicate that lifetime abuse is a relevant risk factor for suicidal ideation and/or attempts. However, little is known about this phenomenon in patients seeking treatment for substance use disorder. The prevalence rate of suicidal ideation and/or suicide attempts was explored among lifetime physically and/or sexually abused patients receiving treatment for drug addiction. The differential characteristics between these patients and those without suicidal behaviours were studied. Method: Three hundred and seventy-five patients were assessed. Socio-demographic characteristics, addiction severity, lifetime abuse, suicidal ideation and attempts, and psychopathological symptoms were explored. Results: Eighty-two patients (21.9%) presented with a history of lifetime abuse and were included in the study (37 men and 45 women). Sixty-two per cent of them presented with lifetime suicidal ideation (12.2% in the last month), and 30.5% with suicide attempts (1.2% in the last month). Patients with suicidal ideation or attempts showed a more severe addiction profile (assessed by the EuropASI) and more psychopathological symptoms (assessed by the SCL-90-R). Conclusion: This study highlights the relationship between previous traumatic experiences and suicidal behaviours. According to these results, systematic screening of suicidal risk in patients seeking treatment in addiction centres with histories of abuse is recommended.
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
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
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
Comparative psychometric properties of the short versions of the SCL-90-R for patients with substance use disorder
(Elsevier, 2025-11-01) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Leza González, Leire; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Background: The prevalence of comorbid psychopathological disorders and associated problems is high among patients with substance use disorder (SUD). The Symptom Checklist 90-R (SCL-90-R) is one of the most widely used self-report instruments to assess psychopathology. This study examined the psychometric properties of the SCL-90-R and its short-form versions for patients with SUD. Method: The values of the short versions were calculated a posteriori based on the SCL-90-R scores. Confirmatory factor analysis (CFA) was conducted using the diagonally weighted least squares estimator to assess construct validity. Reliability was assessed via the ordinal alpha coefficient, McDonald’s omega coefficient and intraclass correlation coefficient (ICC). Results: The SCL-90- R showed acceptable model fit (χ2 /df = 1.916, CFI = 0.940, TLI = 0.938, RMSEA = 0.035). Among the short versions, the BSI-53, SA-45, SCL-27, HSCL-25, and BSI-18 demonstrated good to excellent fit. The depression scale showed the highest reliability across the versions. Pearson correlations and ICCs revealed strong associations between the SCL-90-R and its short forms, although the agreement declined with shorter versions. Despite the excellent fit of the SCL-6, it had lower reliability. Conclusion: These results provide evidence of the psychometric robustness of short versions of the SCL-90-R and support their use to assess comorbid psychopathology in people with SUD.
Open Access
Tratamiento de agresores contra la pareja en programas de atención a drogodependientes: un reto de futuro
(Sociedad Científica Española de Estudios sobre el Alcohol, el Alcoholismo y las otras Toxicomanías, 2011) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia
Existe una relación muy estrecha entre el consumo de sustancias (alcohol y otras drogas) y la violencia hacia la pareja. Los estudios llevados a cabo con hombres maltratadores y con pacientes adictos muestran una alta comorbilidad entre ambos fenómenos. Sin embargo, hasta la fecha han sido muy escasos los programas de intervención con maltratadores que se han aplicado en el ámbito de las drogodependencias. En este artículo se propone, en primer lugar, la necesidad de detectar los casos de violencia contra la pareja que aparecen camuflados bajo un problema de consumo de drogas. En este sentido, es necesario llevar a cabo estudios que determinen la tasa de prevalencia de agresores contra la pareja entre los usuarios de los programas de tratamiento para el abuso de sustancias, así como conocer las características específicas de este tipo de pacientes. En segundo lugar, una vez detectados los agresores, se podrían desarrollar programas específicos para el tratamiento simultáneo de ambas problemáticas (adicción y violencia hacia la pareja). Se han llevado a cabo algunos estudios con tratamientos conjuntos de la adicción y de la violencia de pareja. Los resultados obtenidos son esperanzadores y muestran que los programas de intervención con adicciones pueden ser un marco útil para aplicar también, en los casos necesarios, un tratamiento específico para aquellos adictos con un problema asociado de violencia contra la pareja. Se comentan las implicaciones de todo ello para la práctica clínica y para las investigaciones futuras.