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Erschienen in: Journal of Urban Health 4/2007

01.07.2007

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

verfasst von: Hortensia Amaro, PhD, Jianyu Dai, Sandra Arévalo, Andrea Acevedo, Atsushi Matsumoto, Rita Nieves, Guillermo Prado

Erschienen in: Journal of Urban Health | Ausgabe 4/2007

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Abstract

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.
Fußnoten
1
Effect sizes reported are for the 12-month postbaseline assessment (unless otherwise noted).
 
Literatur
1.
Zurück zum Zitat Kessler R. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61(Suppl 5):4–12.PubMed Kessler R. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61(Suppl 5):4–12.PubMed
2.
Zurück zum Zitat Najavits LM, Weiss RD, Shaw SR. The link between substance abuse and posttraumatic stress disorder in women: a research review. Am J Addict. 1997;6:273–283.PubMedCrossRef Najavits LM, Weiss RD, Shaw SR. The link between substance abuse and posttraumatic stress disorder in women: a research review. Am J Addict. 1997;6:273–283.PubMedCrossRef
3.
Zurück zum Zitat Brown JR, Hill HM, Lambert SF. Traumatic stress symptoms in women exposed to community and partner violence. J Interpers Violence. 2005;20:1478–1494.PubMedCrossRef Brown JR, Hill HM, Lambert SF. Traumatic stress symptoms in women exposed to community and partner violence. J Interpers Violence. 2005;20:1478–1494.PubMedCrossRef
4.
Zurück zum Zitat Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.PubMed Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.PubMed
5.
Zurück zum Zitat Hidalgo RB, Davidson JR. Posttraumatic stress disorder: epidemiology and health-related considerations. J Clin Psychiatry. 2000;61:5–13.PubMed Hidalgo RB, Davidson JR. Posttraumatic stress disorder: epidemiology and health-related considerations. J Clin Psychiatry. 2000;61:5–13.PubMed
6.
Zurück zum Zitat Davidson JR. Trauma: the impact of post-traumatic stress disorder. J Psychopharmacol. 2000;14:S5–S12.PubMed Davidson JR. Trauma: the impact of post-traumatic stress disorder. J Psychopharmacol. 2000;14:S5–S12.PubMed
7.
Zurück zum Zitat Stevens SJ, Murphy BS, McKnight K. Traumatic stress and gender differences in relationship to substance abuse, mental health, physical health, and HIV risk behavior in a sample of adolescents enrolled in drug treatment. Child Maltreat. 2003;8:46–57.PubMedCrossRef Stevens SJ, Murphy BS, McKnight K. Traumatic stress and gender differences in relationship to substance abuse, mental health, physical health, and HIV risk behavior in a sample of adolescents enrolled in drug treatment. Child Maltreat. 2003;8:46–57.PubMedCrossRef
8.
Zurück zum Zitat Claus RE, Kindleberger LR. Engaging substance abusers after centralized assessment: predictors of treatment entry and dropout. J Psychoactive Drugs. 2002;34:25–31.PubMed Claus RE, Kindleberger LR. Engaging substance abusers after centralized assessment: predictors of treatment entry and dropout. J Psychoactive Drugs. 2002;34:25–31.PubMed
9.
Zurück zum Zitat Amaro H, Nieves R, Johannes SW, Cabeza NML. Substance abuse treatment: critical issues and challenges in the treatment of Latina women. Hisp J Behav Sci. 1999;21:266–282.CrossRef Amaro H, Nieves R, Johannes SW, Cabeza NML. Substance abuse treatment: critical issues and challenges in the treatment of Latina women. Hisp J Behav Sci. 1999;21:266–282.CrossRef
10.
Zurück zum Zitat Thompson MP, Kingree JB. The frequency and impact of violent trauma among pregnant substance abusers. Addict Behav. 1998;23:257–262.PubMedCrossRef Thompson MP, Kingree JB. The frequency and impact of violent trauma among pregnant substance abusers. Addict Behav. 1998;23:257–262.PubMedCrossRef
11.
Zurück zum Zitat Barrowclough C, Haddock G, Tarrier N, et al. Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psych. 2001;158:1706–1713.CrossRef Barrowclough C, Haddock G, Tarrier N, et al. Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psych. 2001;158:1706–1713.CrossRef
12.
Zurück zum Zitat Ouimette PC, Brown PJ, Najavits LM. Course and treatment of patients with both substance use and posttraumatic stress disorders. Addic Behav. 1998;23:785–795.CrossRef Ouimette PC, Brown PJ, Najavits LM. Course and treatment of patients with both substance use and posttraumatic stress disorders. Addic Behav. 1998;23:785–795.CrossRef
13.
Zurück zum Zitat Brown PJ, Stout RL, Gannon-Rowley J. Substance use disorders-PTSD comorbidity: patient’s perceptions of symptom interplay and treatment issues. J Subst Abuse Treat. 1998;15:445–448.PubMedCrossRef Brown PJ, Stout RL, Gannon-Rowley J. Substance use disorders-PTSD comorbidity: patient’s perceptions of symptom interplay and treatment issues. J Subst Abuse Treat. 1998;15:445–448.PubMedCrossRef
14.
Zurück zum Zitat Ouimette P, Brown PJ. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, D.C.: American Psychological Association; 2002. Ouimette P, Brown PJ. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, D.C.: American Psychological Association; 2002.
15.
Zurück zum Zitat Najavits LM, Sullivan TP, Schmitz M, Weiss RD, Catherine SN, Lee BA. Treatment utilization by women with PTSD and substance dependence. Am J Addict. 2004;13:215–224.PubMedCrossRef Najavits LM, Sullivan TP, Schmitz M, Weiss RD, Catherine SN, Lee BA. Treatment utilization by women with PTSD and substance dependence. Am J Addict. 2004;13:215–224.PubMedCrossRef
16.
Zurück zum Zitat Hellerstein DJ, Rosenthal RN, Miner CR. Integrating services for schizophrenia and substance abuse. Psychiatr Q. 2001;72:291–306.PubMedCrossRef Hellerstein DJ, Rosenthal RN, Miner CR. Integrating services for schizophrenia and substance abuse. Psychiatr Q. 2001;72:291–306.PubMedCrossRef
17.
Zurück zum Zitat Najavits L, Weiss R, Shaw S, Muenz L. “Seeking safety”: outcome of a new cognitive-behavioral psychotherapy for women with post-traumatic stress disorder and substance dependence. J Trauma Stress. 1998;22:437–456.CrossRef Najavits L, Weiss R, Shaw S, Muenz L. “Seeking safety”: outcome of a new cognitive-behavioral psychotherapy for women with post-traumatic stress disorder and substance dependence. J Trauma Stress. 1998;22:437–456.CrossRef
18.
Zurück zum Zitat Rach Beisel J, Scott J, Dixon L. Co-occurring severe mental illness and substance use disorders: a review of recent research. Psychiatr Serv. 1999;50:1427–1434. Rach Beisel J, Scott J, Dixon L. Co-occurring severe mental illness and substance use disorders: a review of recent research. Psychiatr Serv. 1999;50:1427–1434.
19.
Zurück zum Zitat McCaul ME, Svikis DS, Moore RD. Predictors of outpatient treatment retention: patient versus substance use characteristics. Drug Alcohol Depend. 2001;62:9–17.PubMedCrossRef McCaul ME, Svikis DS, Moore RD. Predictors of outpatient treatment retention: patient versus substance use characteristics. Drug Alcohol Depend. 2001;62:9–17.PubMedCrossRef
20.
Zurück zum Zitat Ziedonis DM, Stern R. Dual recovery therapy for schizophrenia and substance abuse. Psychiatr Ann. 2001;31:255–264. Ziedonis DM, Stern R. Dual recovery therapy for schizophrenia and substance abuse. Psychiatr Ann. 2001;31:255–264.
21.
Zurück zum Zitat Drake RE, Yovetich NA, Rebout RR, Harris M, McHugo GJ. Integrated treatment for dually diagnosed homeless adults. J Nerv Ment Dis. 1997;185:298–304.PubMedCrossRef Drake RE, Yovetich NA, Rebout RR, Harris M, McHugo GJ. Integrated treatment for dually diagnosed homeless adults. J Nerv Ment Dis. 1997;185:298–304.PubMedCrossRef
22.
Zurück zum Zitat Amaro H, Larson MJ, Gampel J, Richardson E, Savage A, Wagler D. Racial/ethnic differences in social vulnerability among women with co-occurring mental health and substance abuse disorders: implications for treatment services. J Community Psychol. 2005;33:495–511.CrossRef Amaro H, Larson MJ, Gampel J, Richardson E, Savage A, Wagler D. Racial/ethnic differences in social vulnerability among women with co-occurring mental health and substance abuse disorders: implications for treatment services. J Community Psychol. 2005;33:495–511.CrossRef
23.
Zurück zum Zitat Hser YI, Anglin MD, Chou C. Evaluation of drug abuse treatment. Repeated measures design assessing methadone maintenance. Eval Rev. 1998;12:547–570.CrossRef Hser YI, Anglin MD, Chou C. Evaluation of drug abuse treatment. Repeated measures design assessing methadone maintenance. Eval Rev. 1998;12:547–570.CrossRef
24.
Zurück zum Zitat Hohman MM, Galt DH. Latinas in treatment: comparisons of residents in a culturally specific recovery home with residents in non-specific recovery homes. J Ethn Cult Divers Soc Work. 2001;9(3/4):93–109.CrossRef Hohman MM, Galt DH. Latinas in treatment: comparisons of residents in a culturally specific recovery home with residents in non-specific recovery homes. J Ethn Cult Divers Soc Work. 2001;9(3/4):93–109.CrossRef
25.
Zurück zum Zitat Mora J. Latinas in cultural transition: addiction, treatment and recovery. In: SLA Straussner, S Brown, eds, The Handbook of Addiction Treatment for Women: Theory and Practice. San Francisco, CA: Jossey Bass; 2002:323–347. Mora J. Latinas in cultural transition: addiction, treatment and recovery. In: SLA Straussner, S Brown, eds, The Handbook of Addiction Treatment for Women: Theory and Practice. San Francisco, CA: Jossey Bass; 2002:323–347.
26.
Zurück zum Zitat Ashley OS, Marsden ME, Brady TM. Effectiveness of substance abuse treatment programming for women: a review. Am J Drug Alcohol Abuse. 2003;29:19–53.PubMedCrossRef Ashley OS, Marsden ME, Brady TM. Effectiveness of substance abuse treatment programming for women: a review. Am J Drug Alcohol Abuse. 2003;29:19–53.PubMedCrossRef
27.
Zurück zum Zitat Herman JL. Trauma and Recovery. New York: Basic Books; 1992. Herman JL. Trauma and Recovery. New York: Basic Books; 1992.
28.
Zurück zum Zitat van der Kolk BA, Pelcovitz D, Roth S, Mandel FS, McFarlane A, Herman JL. Dissociation, somatization, and affect dysregulation: the complexity of adaptation to trauma. Am J Psychiatry. 1996;153(Suppl 7):83–93.PubMed van der Kolk BA, Pelcovitz D, Roth S, Mandel FS, McFarlane A, Herman JL. Dissociation, somatization, and affect dysregulation: the complexity of adaptation to trauma. Am J Psychiatry. 1996;153(Suppl 7):83–93.PubMed
29.
Zurück zum Zitat van der Kolk BA, Hostetler A, Herron N, Fisler RE. Trauma and the development of borderline personality disorder. Psychiatr Clin North Am. 1994;17:715–730.PubMed van der Kolk BA, Hostetler A, Herron N, Fisler RE. Trauma and the development of borderline personality disorder. Psychiatr Clin North Am. 1994;17:715–730.PubMed
30.
Zurück zum Zitat Briere JN. Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Newbury Park, CA: Sage Publications; 1992. Briere JN. Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Newbury Park, CA: Sage Publications; 1992.
31.
Zurück zum Zitat Malinowsky-Rummell R, Hansen DJ. Long-term consequences of childhood physical abuse. Psychol Bull. 1993;114:68–79.CrossRef Malinowsky-Rummell R, Hansen DJ. Long-term consequences of childhood physical abuse. Psychol Bull. 1993;114:68–79.CrossRef
32.
Zurück zum Zitat Levitan RD, Parkh SV, Lesage AD, et al. Major depression in individuals with a history of childhood physical or sexual abuse: relationship to vegetative features, mania, and gender. Am J Psychiatry. 1998;155:1746–1752.PubMed Levitan RD, Parkh SV, Lesage AD, et al. Major depression in individuals with a history of childhood physical or sexual abuse: relationship to vegetative features, mania, and gender. Am J Psychiatry. 1998;155:1746–1752.PubMed
33.
Zurück zum Zitat Shalev AY. Discussion: treatment of prolonged posttraumatic stress disorder—learning from experience. J Trauma Stress. 1997;10:415–423.PubMed Shalev AY. Discussion: treatment of prolonged posttraumatic stress disorder—learning from experience. J Trauma Stress. 1997;10:415–423.PubMed
34.
Zurück zum Zitat Resick PA, Schnicke MK. Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992;60:748–756.PubMedCrossRef Resick PA, Schnicke MK. Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992;60:748–756.PubMedCrossRef
35.
Zurück zum Zitat Fallot R, Harris M. Trauma Recovery and Empowerment Model (TREM): conceptual and practical issues in a group intervention for women. Community Ment Health J. 2002;38:475–485.PubMedCrossRef Fallot R, Harris M. Trauma Recovery and Empowerment Model (TREM): conceptual and practical issues in a group intervention for women. Community Ment Health J. 2002;38:475–485.PubMedCrossRef
36.
Zurück zum Zitat McHugo GJ, Kammerer N, Jackson EW, et al. Women, Co-occurring Disorders, and Violence Study: evaluation design and study population. J Subst Abuse Treat. 2005;28:91–107.PubMedCrossRef McHugo GJ, Kammerer N, Jackson EW, et al. Women, Co-occurring Disorders, and Violence Study: evaluation design and study population. J Subst Abuse Treat. 2005;28:91–107.PubMedCrossRef
37.
Zurück zum Zitat Amaro H, McGraw S, Larson MJ, Lopez L, Nieves R, Marshall B. Boston Consortium of Services for Families in Recovery: a trauma-informed intervention model for women’s alcohol and drug addiction treatment. Alcohol Treat Q. 2004;22:95–119.CrossRef Amaro H, McGraw S, Larson MJ, Lopez L, Nieves R, Marshall B. Boston Consortium of Services for Families in Recovery: a trauma-informed intervention model for women’s alcohol and drug addiction treatment. Alcohol Treat Q. 2004;22:95–119.CrossRef
38.
Zurück zum Zitat McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index. J Subst Abuse Treat. 1992;9:199–213.PubMedCrossRef McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index. J Subst Abuse Treat. 1992;9:199–213.PubMedCrossRef
39.
Zurück zum Zitat Derogatis LR. BSI: Brief Symptom Inventory (BSI): Administration, Scoring and Procedures Manual (4th edn.). Minneapolis: National Computer Systems, Inc; 1993. Derogatis LR. BSI: Brief Symptom Inventory (BSI): Administration, Scoring and Procedures Manual (4th edn.). Minneapolis: National Computer Systems, Inc; 1993.
40.
Zurück zum Zitat Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychol Assess. 1997;9:445–451.CrossRef Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychol Assess. 1997;9:445–451.CrossRef
41.
Zurück zum Zitat Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress. 1993; 6:459–473.CrossRef Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress. 1993; 6:459–473.CrossRef
42.
Zurück zum Zitat Harris M. Trauma Recovery and Empowerment: a Clinician’s Guide for Working with Women in Groups. New York: The Free Press; 1998. Harris M. Trauma Recovery and Empowerment: a Clinician’s Guide for Working with Women in Groups. New York: The Free Press; 1998.
43.
Zurück zum Zitat Cohen J. Statistical Power Analysis for the Behavioral Sciences (2nd edn.). Hillsdale, NJ: Lawrence Earlbaum Associates; 1988. Cohen J. Statistical Power Analysis for the Behavioral Sciences (2nd edn.). Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.
44.
Zurück zum Zitat Morrissey JP, Ellis AR, Gatz M, et al. Outcomes for women with co-occurring disorders and trauma: program and person-level effects. J Subst Abuse Treat. 2005a; 28:121–133.PubMedCrossRef Morrissey JP, Ellis AR, Gatz M, et al. Outcomes for women with co-occurring disorders and trauma: program and person-level effects. J Subst Abuse Treat. 2005a; 28:121–133.PubMedCrossRef
45.
Zurück zum Zitat Morrissey JP, Jackson EW, Ellis AR, Amaro H, Brown VB, Najavits LM. 12-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatr Serv. 2005b;56:1213–1222.PubMedCrossRef Morrissey JP, Jackson EW, Ellis AR, Amaro H, Brown VB, Najavits LM. 12-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatr Serv. 2005b;56:1213–1222.PubMedCrossRef
46.
Zurück zum Zitat Cocozza J, Jackson E, Hennigan K, et al. Outcomes for women with co-occurring disorders and trauma: program-level effects. J Subst Abuse Treat. 2005;28:109–119.PubMedCrossRef Cocozza J, Jackson E, Hennigan K, et al. Outcomes for women with co-occurring disorders and trauma: program-level effects. J Subst Abuse Treat. 2005;28:109–119.PubMedCrossRef
47.
Zurück zum Zitat Dumain M. Meta-analysis of interventions with co-occurring disorders of severe mental illness and substance abuse: implications for social work practice. Res Soc Work Pract. 2003;13:142–165.CrossRef Dumain M. Meta-analysis of interventions with co-occurring disorders of severe mental illness and substance abuse: implications for social work practice. Res Soc Work Pract. 2003;13:142–165.CrossRef
48.
Zurück zum Zitat Messman-Moore TL, Long PJ. Alcohol and substance use disorders as predictors of child to adult sexual revictimization in a sample of community women. Violence Vict. 2002;17:319–340.PubMedCrossRef Messman-Moore TL, Long PJ. Alcohol and substance use disorders as predictors of child to adult sexual revictimization in a sample of community women. Violence Vict. 2002;17:319–340.PubMedCrossRef
49.
Zurück zum Zitat Ouimette PC, Moos RH, Finney JW. Two-year mental health service use and course of remission in patients with substance use and posttraumatic stress disorders. Addict Behav. 2000;23:785–795.CrossRef Ouimette PC, Moos RH, Finney JW. Two-year mental health service use and course of remission in patients with substance use and posttraumatic stress disorders. Addict Behav. 2000;23:785–795.CrossRef
Metadaten
Titel
Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment
verfasst von
Hortensia Amaro, PhD
Jianyu Dai
Sandra Arévalo
Andrea Acevedo
Atsushi Matsumoto
Rita Nieves
Guillermo Prado
Publikationsdatum
01.07.2007
Erschienen in
Journal of Urban Health / Ausgabe 4/2007
Print ISSN: 1099-3460
Elektronische ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-007-9160-z

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