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Gender Differences in Physical/Sexual Abuse in Outpatients with SUDs:
Correlates with Medical and Psychiatric Symptoms
L.
1
Islam ,
1Virginia
A.
1
Sepulveda ,
A.
2
Alvanzo ,
T.
3
Reickman ,
M.
2
Stitzer ,
and D.
1
Svikis
2Johns
Commonwealth University, Richmond, VA;
Hopkins School of Medicine, Baltimore, MD;
3Oregon Health and Science University, Portland, OR
Demographics (N = 628)
Introduction
• Unemployment is a chronic problem in drug dependent
individuals.1,2,3
• Job Seekers’ Workshop (JSW) program was developed
specifically for drug dependent individuals and has demonstrated
efficacy across several well-designed studies1,2,3
• Through the NIDA CTN, the efficacy of JSW was studied in a
much larger and more heterogeneous sample of drug dependent
individuals.
• Since rates of physical and sexual abuse in persons with
Substance Use Disorders (SUD) vary greatly across studies, this
study offers a large, relevant sample to examine.
Purpose
•
L.
1
Keyser-Marcus ,
To examine prevalence rates in a diverse sample of men and
women with SUDs and their medical/psychiatric correlates with
the goal of informing clinical practice.
Method
• Participants were recruited from 6 drug free, psychosocial
treatment (PT) and 5 methadone maintenance (MM) programs
(N = 628) participating in a NIDA Clinical Trials Network (CTN)
randomized clinical trial (RCT) of an employment intervention.
Variable
Gender
(% female)
Race
(% white)
Age
(mean yrs)
Disability
(%)
MM
(N=301)
p-value
46.2
60.8
0.01
54.7
25.9
0.01
38.8
43.7
0.01
8.6
23.3
(47.9%) abuse (lifetime) than men (24.7% and 12.5%,
respectively, both p<.001).
• Men and women with physical abuse were more likely to
report recent depression (.008<p<.001); lifetime depression
(.002<p<.001) and trouble controlling violent behavior
(lifetime) (p<.001).
• Men with physical abuse were more likely to report chronic
medical problems (73%) than men without abuse (51%)
(p<.001).
• Chronic medical problem rates were comparable for women
with and without abuse.
Variable
PT
(N=327)
MM
(N=301)
p-value
Alcohol
83.8
54.5
0.01
Marijuana
64.5
41.2
0.01
Stimulants
33.0
10.3
0.01
Opiates
39.5
96.4
0.01
• Similar patterns were seen for men and women with and
without a sexual abuse history. Those with sexual abuse
reported higher rates of recent and lifetime depression and
trouble controlling violence (lifetime).
• Rates of chronic medical problems were comparable for
all groups.
Discussion
Reported Lifetime Abuse
• Women with SUDs report physical and sexual abuse at rates
double those of men with SUDs.
• History of physical and sexual abuse was associated with
increased rates of depression and trouble controlling violence in
both genders.
• Men with physical abuse were more likely to present for
treatment with a chronic medical problem.
• The constellation of problems suggests both men and women
with histories of abuse would benefit from psychiatric evaluation
and ancillary intervention services.
Inclusion Criteria
• Inclusion criteria:
This research was supported by a grant from the National
Institute on Drug Abuse (NIDA) Clinical Trials Network
(CTN) (Mid-Atlantic Node).
0.01
Substance Use Disorders (N = 628)
• Males and females with and without physical and sexual abuse
(lifetime) were compared on a variety of medical & psychiatric
measures with chi-square analyses.
Acknowledgements
• Women reported higher rates of physical (60.9%) and sexual
PT
(N=327)
• All subjects completed Addiction Severity Index (Lite) as part
of baseline.
- 18 years of age or older
- Met DSM-IV criteria for Substance Abuse/Dependence
(lifetime)
- Reported unemployment or < 20 hrs work in any week of
prior month
- Completed at least 30 days of treatment at baseline
assessment
Statistical Summary
Chronic Medical Problems
References
1Hall,
SM, Loeb, P, Coyne, K, et al. (1981). Increasing employment
in ex-heroin addicts I: Criminal justice sample. Behavior Therapy,
12, 443-452.
2Hall, SM, Loeb, P, LeVois, M, et al. (1981). Increasing employment
in ex-heroin addicts II: Methadone maintenance sample. Behavior
Therapy, 12, 453-460.
3Hall, SM, Loeb, P, and Norton, J. (1977). Improving vocational
placement in drug treatment clients: A pilot study. Addictive
Behaviors, 2, 227-234.