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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-05-2008 | Original Paper

Targeting Trauma-related Interventions and Improving Outcomes for Women with Co-occurring Disorders

Authors: Karen J. Cusack, Joseph P. Morrissey, Alan R. Ellis

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 3/2008

Abstract

National attention to the effects of interpersonal trauma has led mental health systems to adopt policies on trauma-related services; however, there is a lack of clarity regarding targeting of these services. Data from the Women, Co-occurring Disorders and Violence Study (WCDVS) were reanalyzed by grouping women on their baseline PTSD and substance abuse presentation and assessing the differential response to an integrated mental health/substance abuse intervention. Treatment effects were largest for subgroups characterized by high levels of PTSD, whereas the effects for those in the low symptom group were near zero. These findings underscore the need for clinicians to conduct careful assessments of trauma-related symptoms and to target the most intensive trauma-related interventions to individuals with PTSD symptoms.

Back, S. E., Sonne, S. C., Killeen, T., Dansky, B. S., & Brady, K. T. (2003). Comparative profiles of women with PTSD and comorbid cocaine or alcohol dependence. The American Journal of Drug and Alcohol Abuse, 29(1), 169–189.PubMedCrossRef

Beck, J. C., & van der Kolk, B. A. (1987). Reports of childhood incest and current behavior of chronically hospitalized psychotic women. American Journal of Psychiatry, 144, 1474–1476.PubMed

Becker, M. A., Noether, C. D., Larson, M. J., Gatz, M., Brown, V., Heckman, J. P., et al. (2005). Characteristics of women engaged in treatment for trauma and co-occurring disorders: Findings from a multisite study. Journal of Community Psychology, 33(4), 429–443.CrossRef

Binder, R. L., McNiel, D. E., & Goldstone, R. L. (1996). Is adaptive coping possible for adult survivors of childhood sexual abuse? Psychiatric Services, 47, 186–188.PubMed

Bisson, J. I., Ehlers, A., Mattews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 190, 97–104.PubMedCrossRef

Brady, K. T., Back, S. E., Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science, 13(5), 206–209.CrossRef

Breslau, N., Davis, G. C., Peterson, E. L., & Schultz, L. R. (2000). A second look at comorbidity in victims of trauma: The posttraumatic stress disorder-major depression connection. Biological Psychiatry, 48, 902–909.PubMedCrossRef

Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55(7), 626–632.PubMedCrossRef

Briere, J., Woo, R., McRae, B., Foltz, J., & Sitzman, R. (1997). Lifetime victimization history, demographics, and clinical status in female psychiatric emergency room patients. Journal of Nervous and Mental Disease, 185, 95–101.PubMedCrossRef

Carmen, E., Rieker, P. P., & Mills, T. (1984). Victims of violence and psychiatric illness. American Journal of Psychiatry, 141, 378–383.PubMed

Cascardi, M., Mueser, K. T., DeGirolomo, J., & Murrin, M. (1996). Physical aggression against psychiatric inpatients by family members and partners: A descriptive study. Psychiatric Services, 47, 531–533.PubMed

Chilcoat, H. D., & Breslau, N. (1998). Posttraumatic stress disorder and drug disorders: Testing causal pathways. Archives of General Psychiatry, 55, 913–917.PubMedCrossRef

Cocozza, J. J., Jackson, E. W., Hennigan, K., Morrissey, J. P., Reed, B. G., Fallot, R., et al. (2005). Outcomes for women with co-occurring disorders and trauma: Program-level effects. Journal of Substance Abuse Treatment, 28, 109–119.PubMedCrossRef

Craine, L. S., Henson, C. E., Colliver, J. A., & MacLean, D. G. (1988). Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system. Hospital and Community Psychiatry, 39, 300–304.PubMed

Cusack, K. J., Grubaugh, A. L., Knapp, R., & Frueh, B. C. (2006). Trauma and PTSD in public mental health consumers with serious mental illness. Community Mental Health Journal, 42, 487–500.PubMedCrossRef

Derogatis, L. (1993). A brief form of the SCL-90-R: A self-report symptom inventory designed to measure psychological stress: Brief Symptom Inventory (BSI). Minneapolis: National Computer Systems.

Domino, M. E., Morrissey, J. P., Chung, S., Huntington, N., Larson, M. J., & Russel, L. A. (2005a). Service use and costs for women with co-occurring mental and substance use disorders and a history of violence. Psychiatric Services, 56, 1223–1232.PubMedCrossRef

Domino, M., Morrissey, J. P., Nadlicki-Patterson, T., & Chung, S. (2005b). Service costs for women with co-occurring disorders and trauma. Journal of Substance Abuse Treatment, 28(2), 135–143.PubMedCrossRef

Drake, R. E., & Mueser, K. T. (2001). Managing comorbid schizophrenia and substance abuse. Current Psychiatry Reports, 3, 418–422.PubMedCrossRef

Elhai, J. D., North, T. C., & Frueh, B. C. (2005). Health service use predictors among trauma survivors: A critical review. Psychological Services, 2, 3–19.CrossRef

Fallot, R. D., & Harris, M. (2002). The trauma recovery and empowerment model (TREM): Conceptual and practical issues in a group intervention for women. Community Mental Health Journal, 38(6), 475–485.PubMedCrossRef

Foa, E. B., Keane, T. M., & Friedman, M. J. (2000). Effective treatments for PTSD: Practice guidelines from the international society for traumatic stress studies. New York: Guilford.

Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.CrossRef

Frueh, B. C., Cusack, K. J., Hiers, T. G., Monogan, S., Cousins, V. C., & Cavenaugh, S. D. (2001). Improving public mental health services for trauma victims in South Carolina. Psychiatric Services, 52(6), 812–814.PubMedCrossRef

Goodman, L. A., Dutton, M. A., & Harris, M. (1995). Physical and sexual assault prevalence among episodically homeless, seriously mentally ill women. Violence and Victims, 11, 159–174.

Gray, M. J., & Litz, B. T. (2005). Behavioral interventions for recent trauma: Empirically informed practice guidelines. Behavior Modification, 29(1), 189–215.PubMedCrossRef

Hair, J. F. Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis. Upper Saddle River, NJ: Prentice-Hall.

Hanson, R. F., Saunders, B., Kilpatrick, D., Resnick, H., Crouch, J. A., & Duncan, R. (2001). Impact of childhood rape and aggravated assault on adult mental health. American Journal of Orthopsychiatry, 71(1), 108–119.PubMedCrossRef

Hartigan, J. A. (1975). Clustering algorithms. New York: Wiley.

Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: A review of the literature. American Journal of Psychiatry, 158, 1184–1190.PubMedCrossRef

Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.PubMedCrossRef

Jennings, A. (2004). Models for developing trauma-informed behavioral-health systems and trauma-specific services. National Association of Mental Health Program Directors, National Technical Assistance Center for State Mental Health Planning.

Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 13, 164–180.CrossRef

Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Study. Archives of General Psychiatry, 52(12), 1048–1060.PubMed

Kilpatrick, D. G., Resnick, H. S., Saunders, B. E., & Best, C. L. (1998). Rape, other violence against women, and posttraumatic stress disorder. In B. P. Dohrenwend (Ed.), Adversity, Stress, and Psychopathology. New York: Oxford Press.

McCaffrey, D. F., Ridgeway, G., & Morral, A. R. (2004). Propensity score estimation with boosted regression for evaluating causal effects in observational studies. Psychological Methods, 9(4), 403–425.PubMedCrossRef

McHugo, G. J., Caspi, Y., Kammerer, N., Mazelis, R., Jackson, E. W., Russell, L., et al. (2005a). The assessment of trauma history in women with co-occurring substance abuse and mental disorders and a history of interpersonal violence. Journal of Behavioral Health Services & Research, 32(2), 113–127.CrossRef

McHugo, G. J., Kammerer, N., Jackson, E. W., Markoff, L. S., Gatz, M., Larson, M. J., et al. (2005b). Women, co-occurring disorders, and violence study: Evaluation design and study population. Journal of Substance Abuse Treatment, 28(2), 91–107.PubMedCrossRef

McLellan, A., Luborsky, L., O’Brien, C. P., & Woody, G. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disease, 168, 26–33.PubMedCrossRef

Morrissey, J. P., Ellis, A. R., Gatz, M., Amaro, H., Reed, B. G., Savage, A., et al. (2005a). Outcomes for women with co-occurring disorders and trauma: Program and person-level effects. Journal of Substance Abuse Treatment, 28(2), 121–134.PubMedCrossRef

Morrissey, J. P., Jackson, E. W., Ellis, A. R., Amaro, H., Brown, V. B., & Najavits, L. M. (2005b). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56(10), 1213–1222.PubMedCrossRef

Muenzenmaier, K., Meyer, I., Struening, E., & Ferber, J. (1993). Childhood abuse and neglect among women outpatients with chronic mental illness. Hospital and Community Psychiatry, 44, 666–670.PubMed

Mueser, K. T., Goodman, L. B., Trumbetta, S. L., Rosenberg, S. D., Osher, F. C., Vidaver, R., et al. (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 66, 493–499.PubMedCrossRef

Mueser, K. T., Noordsy, D. L., Drake, R. E., & Fox, L. (2003). Integrated treatment for dual disorders. New York: Guilford Press.

Mueser, K. T., Rosenberg, S. D., Goodman, L. A., & Trumbetta, S. L. (2002). Trauma, PTSD, and the course of severe mental illness: An interactive model. Schizophrenia Research, 53, 123–143.PubMedCrossRef

Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women: A research review. American Journal of Addictions, 6, 273–283.CrossRef

Pimlott-Kubiak, S., & Cortina, L. M. (2003). Gender, victimization, and outcomes: Reconceptualizing risk. Journal of Consulting and Clinical Psychology, 71(3), 528–539.PubMedCrossRef

R Development Core Team (2004). R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing.

Rauch, S. A., Hembree, E. A., & Foa, E. B. (2001). Acute psychosocial preventive interventions for posttraumatic stress disorder. Advances in Mind-Body Medicine, 17(3), 187–190.PubMed

Rosenbaum, P. R., & Rubin, D. B. (1984). Reducing bias in observational studies using subclassification on the propensity score. Journal of the American Statistical Association, 79, 516–524.CrossRef

Saladin, M. E., Brady, K. T., & Kilpatrick, D. G. (1995). Understanding comorbidity between PTSD and substance use disorders: Two preliminary investigations. Addictive Behaviors, 20(5), 643–655.PubMedCrossRef

Surrey, J., Swett C. Jr., Michaels, A., & Levin, S. (1990). Reported history of physical and sexual abuse and severity of symptomatology in women psychiatric outpatients. American Journal of Orthopsychiatry, 60, 412–417.PubMedCrossRef

Switzer, G. E., Dew, M. A., Thompson, K., Goycoolca, J. M., Derricott, T., & Mullins, S. D. (1999). Posttraumatic stress disorder and service utilization among urban mental health center clients. Journal of Traumatic Stress, 12, 25–39.PubMedCrossRef

Tjaden, P., & Thoennes, N. (2000). Prevalence and consequences of male-to-female and female-to-male intimate partner violence as measured by the National violence against women survey. Violence Against Women, 6(2), 142–161.CrossRef

U.S. Department of Health and Human Services. (1999). Mental health. A Report of the Surgeon General..

Wolfe, J., & Kimerling, R. (1997). Gender issues in the assessment of posttraumatic stress disorder. In J.P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 192–238). New York: Guilford.

Title: Targeting Trauma-related Interventions and Improving Outcomes for Women with Co-occurring Disorders
Authors: Karen J. Cusack
Joseph P. Morrissey
Alan R. Ellis
Publication date: 01-05-2008
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 3/2008
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-007-0150-y

Keynote webinar | Spotlight on medication adherence

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Targeting Trauma-related Interventions and Improving Outcomes for Women with Co-occurring Disorders

Abstract

Keynote webinar | Spotlight on medication adherence

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