Jerome J. Platt

Risk characteristics associated with chronic unemployment in methadone clients

Relatively few methadone programs emphasize vocational skills training in their service delivery protocols. As a result, this study was conducted to determine the contribution of background demographic, vocational and clinical characteristics in differentiating chronically unemployed methadone clients from those regularly or intermittently employed over a 3-year period of time. Three-hundred eighty heroin addicts, from five urban methadone treatment programs, participated in the study. Using the multiple logistic regression approach, nine variables were found to be significantly related to unemployment risk.

AIDS in Africa: Emerging trends

This paper reviews the literature on AIDS in Africa. By 29 February, 1988, 9760 cases of AIDS had been reported in Africa. This review addresses the currently accepted belief in the African origin of AIDS, the distribution (cluster) of AIDS in Africa, identified modes of transmission, and changing sexual and drug use behaviors in Africa. There is no conclusive evidence to show that the AIDS virus originated in Africa. Even if the progenitor virus had a habitat in central Africa, certain high-risk sexual behaviors which were introduced in the 60s and 70s may have initiated the infectious process. The distribution pattern does not suggest a transcontinental spread; rather, it suggests a contigual and transatlantic spread. The primary mode of transmission is heterosexual activity. This paper raises a number of questions relating to heterosexual behaviors. Other issues addressed include drug use behavior, homosexuality, and high-risk sexual activities of Africans and foreigners in Africa. Other modes of transmission are transfusion of contaminated blood and blood products, use of nonsterile needles, and perinatal transmission. It is not likely that traditional (folk) medicine will contribute to the spread of AIDS. Traditional doctors use fresh razor blades for cuts and not hollow instruments such as needles. The impact of the political and socioeconomic climate in most of Africa during the 60s and early 70s is evaluated. Finally, we make suggestions for future direction, which include confirmatory testing of HIV Positive samples, conducting clinical epidemiology and social science-based research, and developing innovative education programs that are culturally relevant.

Family Therapy for Dutch Drug Abusers: Replication of an American Study

This paper presents the results of an evaluation study conducted in The Netherlands in which an attempt was made to determine the efficacy of family therapy treatment for drug abusers in that country. The theory underlying the approach, as formulated most prominently by Stanton and Todd, is outlined. This study is an attempt to replicate Stanton and Todds finding that significantly more drug abusers who underwent family therapy would abstain than would clients who received methadone treatment. Stanton and Todds findings were partly confirmed. As in their study, nearly two-thirds of the clients abstained from heroin and 75% of the clients abstained from illegal use of nonopiates. No significant differences were found, however, between the experimental and the control group in the Dutch study.

Family Therapy for Dutch Drug Users: The Relationship between Family Functioning and Success

This article reports treatment outcome in families with drug problems after a family therapy intervention. An attempt is made to determine what changes occur in family functioning in the course of treatment with family therapy, and how these changes relate to prolonged abstinence and improvement in social functioning in drug misusers. The results indicate that, overall, most families, one year after the start of family therapy, changed in the predicted direction as determined by an observation instrument. Furthermore, success in treatment for the drug misuser was most likely to occur in families in which the parents communicated with each other in a predominantly negative way at the beginning of therapy, and when, in the course of therapy, a significant change occurred toward a more positive supportive manner of communicating.

Psychopathology in Dutch and American heroin addicts

The Beck Depression Inventory (BDI) and the Symptom Check List-90 (SCL-90) were administered to 47 Dutch and 121 American White male heroin addicts receiving methadone. A one-way MANOVA indicated that the Dutch and American samples displayed comparable SCL-90 profiles, but that the Dutch had more symptom complaints than the Americans. The mean BDI total score of the Dutch was higher than that of the Americans, and this mean difference reflected more severe cognitive and affective symptoms in the Dutch than in the Americans. There was no difference between the samples with respect to somatic and performance symptoms. Furthermore, the mean levels of symptoms distress for the nine SCL-90 subscales reported by both the Dutch and the American heroin addicts were comparable to those of American psychiatric outpatients.

Cognitive-Behavioral Theory and Interventions for Crime and Delinquency

The purpose of this chapter is severalfold. First, it is intended to provide the reader with some of the theoretical bases for the cognitive-behavioral interventions that have been applied recently to delinquent and criminal populations. Second, it briefly outlines some of the recent work by those cognitive-behavioral psychologists who have begun to apply their interventions to the prevention and treatment of delinquent and criminal behavior. Third, it attempts to describe the cognitive-behavioral approach in terms of target skills and/or abilities that have been identified as associated with—in some cases as underlying—other skills in which delinquent and adult offenders are deficient. As to this last point, the chapter will present some data concerning the role played by interpersonal cognitive problem-solving skills in the adjustment process of youthful offenders.

Types of self-reported psychopathology in Dutch and American heroin addicts

One-hundred Dutch and 100 American heroin addicts receiving methadone were administered the Symptom Check List-90 (SCL-90), and a Modal Profile Analysis was performed to determine whether or not the mean profiles of the nine SCL-90 subscales were comparable for these two White male samples. Three profile-shape components correctly classified over 85% of both groups and reflected (1) Anxious-depressed, (2) Hostile and (3) Paranoid syndromes. The relationships of the SCL-90 profiles to selected psychosocial characteristics were also studied. For example, marijuana use was associated with the Paranoid shape component in both samples. The implications of these SCL-90 profiles for identifying common aspects of self-reported psychopathology in both Dutch and American heroin addicts were discussed.