Seana Golder

An integrated relapse prevention and relationship safety intervention for women on methadone: testing short-term effects on intimate partner violence and substance use.

This study tests the feasibility, safety, and short-term preliminary effects of a relapse prevention and relationship safety (RPRS) intervention in reducing drug use and the experience of intimate partner violence (IPV) among women on methadone. For this randomized controlled trial, 34 women who met IPV and drug use criteria were randomly assigned to either the RPRS condition (n = 16) or a one-session informational control (IC) condition (n = 18). RPRS participants were more likely than IC participants to report a decrease in minor physical or sexual IPV (OR = 7.1, p = .05), minor psychological IPV (OR = 5.3, p = .03) and severe psychological IPV (OR = 6.07, p = .03) at the 3month follow-up. Data suggest that RPRS participants were also more likely than IC participants to report a decrease in any drug use at 3 months (OR = 3.3, p = .08). This study provides preliminary evidence that the RPRS intervention is effective in reducing IPV and drug use among women on methadone.

Psychological Distress and Substance Use Among Community-Recruited Women Currently Victimized by Intimate Partners A Latent Class Analysis and Examination of Between-Class Differences

Latent class analysis was used to examine patterns of victimization among a community sample of 212 women experiencing intimate partner violence (IPV). Results identified three classes of women characterized by victimization history (recent IPV, childhood victimization); classes were further differentiated by IPV-related posttraumatic stress disorder symptoms, other indicators of psychological distress, and substance use. Differentiating levels of victimization and their associated patterns of psychosocial functioning can be used to develop intervention strategies targeting the needs of different subgroups of women so that mental health and substance use problems can be reduced or prevented altogether. Implications for treatment and future research are presented here.

Adapting Motivational Interviewing Strategies to Increase Posttreatment 12-Step Meeting Attendance

Abstract Recent twelve-step (TS) program research has suggested a dose threshold consisting of minimum weekly TS meeting attendance that is necessary to derive substantial benefit. Unfortunately, other research has observed the vast majority of patients do not attend meetings or attend sporadically in the period following treatment. As another example of research advancing our understanding of recovery processes, numerous studies have refined adaptations of Motivational Interviewing (MI) into a change theory with proven practice methods. This paper reviews related literature and provides rationale for the use of a brief motivational intervention to increase TS program attendance. The paper concludes by addressing two possible problems to implementing such an intervention: (1) Resistance within the culture of the addiction counseling field and (2) a lack of objective and normative TS program feedback data. We respond to this latter gap in the literature by advancing possible specimen feedback data.

Substance Use Among Victimized Women on Probation and Parole

Victimized women within the criminal justice system are an important group and understanding their substance use is critical. Substance use was examined among 406 victimized women on probation and parole in an urban community from 2010 to 2013. Ninety-three percent reported lifetime use of an illicit substance, whereas 58% and 45% reported use of at least one illicit substance in the past 2 years and 12 months, respectively. Among probationers, having been in a controlled environment was associated with a higher prevalence of illicit substance use as compared to parolees. Implications for practice, policy, and future research are discussed.

Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women.

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women’s engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.

Development of a Brief Abstinence Self-Efficacy Measure.

This study compared the 40-item Alcohol Abstinence Self-Efficacy (AASE) scale with domains of confidence and temptation to a new 12-item version developed by the authors consisting of the same domains. There were 126 participants who completed the survey. Psychometric analysis demonstrated high reliability and validity consisting of high correlations between domains of confidence (α = .92) and temptation (α = .88) in the 40-item version of the scale compared to the briefer version. The 12-item version appears to provide a clinically reliable and valid measure of AASE domains of confidence and temptation, providing a more efficient tool for clinical practice.

Posttreatment 12-Step Program Affiliation and Dropout: Theoretical Model and Qualitative Exploration

ABSTRACT Treatment outcome research has repeatedly demonstrated that involvement in twelve-step (TS) programs (e.g., Alcoholics Anonymous or Narcotics Anonymous) following treatment is associated with improved substance use outcomes. Treatment providers widely encourage TS program attendance during treatment and for aftercare; yet, evidence suggests that minimal and sporadic attendance or complete dropout is the more common occurrence. Providers would benefit from knowledge that would contribute to a greater understanding of factors that influence posttreatment TS program affiliation or dropout to guide treatment strategies. This article reviews the literature on TS affiliation, advances theory and a model to explain affiliation, and reports findings from a qualitative research study focused on understanding what people in TS facilitative treatment report as good (the pros) and not so good (the cons) about TS program involvement. Results suggest that unresolved ambivalence as well as socio-cultural barriers to support contribute to poor TS program utilization.

Nonmedical prescription opioid use among victimized women on probation and parole.

BACKGROUND Nonmedical prescription opioid use (NPOU) is a major public health concern and few studies have described this phenomenon among victimized women involved in the criminal justice system. OBJECTIVE This study will describe the relationship between victimization, psychological distress, health status and NPOU among the vulnerable population of victimized women on probation and parole. METHODS A sample of 406 women on probation and parole responded to items assessing victimization history, self-reported health status, physical pain, psychological distress, and post-traumatic stress disorder. Multiple logistic regression analysis was utilized to differentiate NPOUs versus nonusers. RESULTS Overall, 169 (41.6%) women reported lifetime NPOU, and 20% reported use in the past year. Compared to women who did not report NPOU, NPOUs were more likely to be White, have poorer general health, and more severe psychological distress across nine symptom domains. In multiple logistic regression models, each year of age reduced the odds of NPOU by 4%; White women were twice as likely as women of other races to report NPOU; each unit increase in the measure for physical pain was associated with a 30% increase in the odds of NPOU; and participants who met diagnostic criteria for PTSD were 60% more likely to report NPOU compared to individuals who did not. CONCLUSION Victimized women on probation and parole report high rates of NPOU and comorbid mental and physical health problems. The criminal justice system should routinely screen for NPOU, as well as untreated or poorly managed physical pain and psychological distress, which may increase risk of NPOU.

Childhood Victimization, Attachment, Psychological Distress, and Substance Use Among Women on Probation and Parole

The present analysis was guided by a gendered pathways-based theoretical model and examined relationships between childhood victimization and current attachment, psychological distress, and substance use among 406 women with histories of victimization who were on probation and parole in an urban Kentucky county. Structural equation modeling examined relationships among childhood victimization, attachment, psychological distress, and substance use. Additionally, we examined the mediational role that attachment plays in relationships between childhood victimization and both psychological distress and substance use. The data fit the models properly. Psychological distress was significantly predicted by childhood victimization, and adult attachment partially mediated this relationship. Childhood victimization did not significantly predict substance use; however, attachment did. The findings suggest that attachment may be an important factor to further understand and address in relation to psychological distress and substance use among women with histories of victimization who are involved in the criminal justice system.

Lifetime victimization and psychological distress: cluster profiles of out of treatment drug-involved women

K-means clustering techniques were used to identify four cluster profiles characterized by unique patterns of victimization and psychological distress and further differentiated by distinct patterns of risk and protection across multiple life domains among a sample of 149 crack-using women. Results of this study suggest that important differences exist in patterns of victimization and psychological distress among drug-involved women. Identification of this variation can be used to tailor intervention strategies to the particular needs of different subgroups within the population of crack-using women.