Addiction Recovery Blog

Addictionland - Addiction Recover Blog

  • Home
    Home This is where you can find all the blog posts throughout the site.
  • Login
    Login Login form

Study: Substance Abuse Treatment Reduces Violence Risk In Severely Mentally Ill

Posted by on in Drug Addiction
  • Font size: Larger Smaller
  • Hits: 2720
  • Print


“The perception that mental illness and psychiatric symptomatology uniformly lead to aggression and violence is a

major source of stigma for the severely mentally ill.”

(Zhuo, Bradizza and Maisto, 2014)

PsychCentral reports that a study conducted under the auspices of the University of Buffalo found that substance abuse is a stronger predictor of violence than severe mental illness and that  treating the substance abuse disorders in  dually diagnosed patients illness can reduce their risk of future violence. The study appears in the current issue of the Journal of Substance Abuse Treatment (47 (2014) 353–361).

The investigators,   Yue Zhuo,  Clara M. Bradizza, and  Stephen A. Maisto, identified 278  patients of a publicly-funded community mental health center in Buffalo, New York who were diagnosed with both a severe mental illness (a schizophrenia-spectrum or bipolar disorder) and a substance use disorder. These subjects not only met criteria for current alcohol dependence (97%) or alcohol abuse (3%) but also  had high rates of comorbid drug use disorders. 86% met  DSM-IV criteria  for at least one drug use disorder (76% cocaine abuse/dependence, 46% marijuana, 23% opiates, 16% sedatives/hypnotics and 9% amphetamines). The research team followed these subjects over a 6-month period following their admission to an outpatient dual diagnosis treatment program. Then they analyzed the data they obtained  to  study the association between subjects’ attendance at treatment and subsequent displays of aggression.

For the purposes of this study, “treatment utilization was defined as the number of days during the first 4 months following treatment enrollment that participants either received outpatient treatment and/or were in attendance at a self-help group meeting (e.g., Alcoholic Anonymous, Narcotics Anonymous,  or Double Trouble in Recovery).” Aggression was assessed by querying subjects monthly  about how often the following events happened as a result of their drinking or drug use:  (a)  arguments with family and friends; (b) physical fights when under the influence; (c) arrests due to behavior when they were drunk or high; (d) infliction of injury to someone else; and (e) damage to  property or breaking things. These questions, along with assessments  of drug and alcohol use and treatment utilization were administered for the previous 12 months at baseline and monthly after the initiation of the study.

Analyses revealed that dual diagnosis treatment was associated with lower levels of subsequent aggression. However, a thorough examination of the data held some surprises for the investigators.

 They observed that, “In our model, severity of psychiatric symptoms did not predict severity of later aggression; instead, aggression was more closely associated with severity of substance use ” and thorough analyses of data indicated that “greater treatment involvement was associated with reduced substance use, which was associated with lower levels of aggression”.  The research team concluded that “substance use was found to mediate the relationship between dual diagnosis treatment and aggression” and that “targeting substance use reduction in treatment may have the additional benefit of reducing the risk of later aggression among dual diagnosis patients.

Very interestingly, the authors of this study also found that while psychiatric symptoms were not directly associated with aggression,  individuals with worse initial psychiatric symptoms received less treatment, and that “attending less treatment was associated with greater aggression both directly and via greater substance use”.

Read more about addiction and the family in Dr. Wood’s books: Children of Alcoholism: The Struggle for Self and Intimacy in Adult Life and Raising Healthy Children in an Alcoholic Home

Barbara Wood is a licensed psychologist who practices in Bethesda, Maryland and specializes in the treatment of addictions and trauma. She is the author of two books that explain the impact of alcoholism on families and describe a path toward recovery for family members. Her first book, Children of Alcoholism: The Struggle for Self and Intimacy in Adult Life wa an alternate selection of the Psychotherapy and Social Sciences Review in 1987, and is identified in the current New York Review of Books Reader’s Catalog as one of the best books in print. The Journal of Contemporary Psychology described it as "compelling from intellectual and emotional standpoints" and said that it was "highly recommended to a general clinical readership.” Dr. Wood's second book, Raising Healthy Children in an Alcoholic Home" is a book written for parents in recovery from alcoholism, co-dependence, and other addictive problems. It helps them to become “therapeutic ” parents—active and compassionate listeners and sensitive guides to children in crisis. A reviewer from the Harvard Medical School described it as" an impressive contribution for everyone who grapples with this issue in their own lives as well as for practitioners helping their clients to become therapeutic parents.”

Dr. Wood also performs forensic evaluations and provides expert testimony in cases where plaintiffs or defendants have been affected by traumatic events and/or substance abuse disorders. Washingtonian Magazine has identified her as one of the top 123 psychotherapists in the Washington D.C. Metropolitan area. She lectures widely on her work.

website by | © Addictionland LLC