Search PubMed⌕ Search

Biomedical subjects

R H Moos

Publications and source records attributed to R H Moos.

230 records · Page 13Linked to original sources
PubMedDate not supplied

Difficulty of follow-up and posttreatment functioning among depressed patients.

Evaluations of treatment outcome may obtain positively biased findings by failing to reassess patients who are difficult to follow and who may also be functioning more poorly than those who are successfully followed. We consider whether difficulty of follow-up is related to pre- and posttreatment functioning by reassessing 95% of a sample of 424 depressed patients after a 12-month interval. In contrast to earlier findings with other patient populations (e.g., alcoholic patients), there was no strong or consistent tendency for depressed patients who were more difficult to follow to be functioning more poorly after treatment. Moreover, poor functioning at treatment intake was not predictive of later difficulty of follow-up. However, patients who were younger, single, and of lower occupational level were somewhat more difficult to follow.

Adaptation, Psychological↗
PubMedDate not supplied

Two pathways out of drinking problems without professional treatment.

This 3-year longitudinal study examined two recovery pathways among 135 problem drinking individuals who never received professional treatment. Almost half (48.3%) of those individuals for whom outcome could be clearly determined became moderate drinkers or stably abstinent. At baseline, individuals who subsequently became abstinent (n = 28) were of low socioeconomic status, had severe drinking problems, and believed their drinking was a very serious problem. Once they began their recovery, they relied heavily on Alcoholics Anonymous as a maintenance factor. In contrast, individuals who became moderate drinkers (n = 29) had higher socioeconomic status and more social support at baseline than did individuals who became abstinent or continued to have drinking problems. A logistic regression on baseline data showed that it was possible to predict which natural recovery pathway an individual drinker would follow. The implications of these findings for alcoholism treatment and policy are discussed.

Adult↗
PubMedDate not supplied

Recovering substance abuse staff members' beliefs about addiction.

This study of 329 substance abuse treatment staff assessed how recovery status, in combination with other variables, influences beliefs about the causes and treatment of substance abuse. About 15% (n = 47) of participants were "in recovery" from substance abuse problems; these staff members were not significantly different than nonrecovering staff members on education, age, race/ethnicity, years of clinical experience, or amount of client contact. When examined in a multiple regression equation that also included age, education, and treatment program goals and activities, staff members' recovery status was not associated with endorsement of disease and psychosocial models of substance abuse. However, being in recovery was associated with endorsing an eclectic approach to substance abuse treatment. The importance of recognizing the diversity of beliefs about substance abuse among recovering staff and of acknowledging that multiple influences affect all staff members viewpoints on treatment is discussed.

Adult↗
PubMedDate not supplied

Participation in community residential treatment and substance abuse patients' outcomes at discharge.

OBJECTIVE: The study sought to identify patient characteristics that predict participation in substance abuse treatment in community residential facilities (CRFs) and to examine the association between patient characteristics, participation in treatment, and outcomes at discharge from CRFs. METHODS: A sample of 2,794 patients with substance abuse disorders was assessed at entry into and discharge from a representative set of 88 CRFs nationwide. RESULTS: In general, patients' psychological distress, motivation for treatment, prior involvement in self-help, and social resources predicted more engagement in CRF services and activities; prior inpatient treatment and the history of a psychiatric disorder predicted less engagement. These patient characteristics also predicted outcomes at discharge; more important, participation in treatment was positively and independently associated with such discharge outcomes as completion of the program and moving into stable residence. In addition, there was some evidence that participation in treatment counteracted the negative effects of high-risk patient characteristics on outcome. CONCLUSIONS: Participation in treatment is as important a predictor of outcomes at discharge from CRFs as are patient characteristics at intake to treatment. Suggestions are made about how providers can enhance patients' motivation to participate and remain in treatment.

Adult↗
PubMedDate not supplied

During treatment changes in substance abuse patients with posttraumatic stress disorder. The influence of specific interventions and program environments.

Male substance abuse patients with posttraumatic stress disorder (PTSD) (SA-PTSD; N = 140) were compared to patients with only substance use disorders (SA-only; N = 1,262), and those with other Axis I diagnoses (SA-PSY; N = 228) on changes during substance abuse treatment. Diagnoses were determined by chart review, and patients completed questionnaires assessing coping, cognitions, and psychological distress. Although SA-PTSD patients improved on outcomes during treatment, they showed less benefit relative to SA-only patients. At discharge, SA-PTSD patients reported less use of effective coping styles, and endorsed more positive beliefs about substance use than SA-only patients. They had more psychological distress than SA-only and SA-PSY patients. More counseling sessions devoted to substance abuse and family problems, and increased involvement in 12-step activities partially counteracted the negative effects of having a PTSD diagnosis on several outcomes. SA-PTSD patients reported fewer psychological symptoms at discharge in programs that were high in support and order/organization.

Adaptation, Psychological↗
PubMedDate not supplied

Assessing life stressors and social resources: applications to alcoholic patients.

A growing body of evidence points to the importance of life stressors and social resources in the development and course of alcoholism and other substance abuse disorders. This article describes the Life Stressors and Social Resources Inventory (LISRES), which provides an integrated assessment of life stressors and social resources in eight domains: physical health, home/neighborhood, financial, work, spouse/partner, children, extended family, and friends. The indices were developed on data obtained at two points in time 18 months apart from four demographically comparable groups: alcoholic patients, depressed patients, arthritic patients, and non-problem-drinking adults. As expected, alcoholic patients reported more acute and chronic stressors and fewer social resources than did non-problem-drinking adults. More important, the indices were predictively related to changes in alcohol consumption, drinking problems, depression, and self-confidence. Procedures such as the LISRES have some potential clinical and research applications and may be helpful in examining the process of recovery and relapse in substance abuse disorders.

Adult↗
PubMedDate not supplied

Negative affect and plasma testosterone: a longitudinal human study.

The association between mood and plasma testosterone was investigated. Every second day for 2 months, a Multiple Affect Adjective Checklist was filled out by 20 young men. Blood samples taken at the same time were analyzed for testosterone concentration. Relationships between hostility, anxiety, and depression and plasma testosterone levels were tested both within and across individuals. Intrasubject correlation coefficients between affects and hormone were fairly evenly distributed between positive and negative values, some significant on either side. Intersubject correlation coefficients were all positivie. Between depression and testosterone, the correlation was significant only at the 10% level; between the other two affects and testosterone, the correlations were not significant.

Adult↗
PubMedDate not supplied

Perimenstrual symptoms: prevalence and risk factors.

This article provides an overview of information on the prevalence of perimenstrual symptoms. Overall, at least 40% of women experience some cyclical perimenstrual symptoms. Although most women rate their symptoms as mild, approximately 2%-10% report severe symptoms. Prospective studies of perimenstrual symptoms indicate that retrospective reports are reasonably accurate among women who experience moderate to severe symptoms. However, among the majority of women with few or minimal symptoms, retrospective reports may amplify the cyclicity of variation in comparison to concurrent reports. A variety of risk factors are associated with patterns of symptom reporting and may provide clues to the etiology of perimenstrual symptoms and help to identify women most vulnerable to them. A woman's age and cycle characteristics are predictors of the type and severity of perimenstrual symptoms she experiences. In addition, a history of affective illness may be associated with increased reporting of perimenstrual symptoms. Future research should focus on developing new diagnostic criteria for subtypes of perimenstrual syndromes, exploring positive symptoms and experiences associated with the menstrual cycle, and formulating holistic treatment approaches that view perimenstrual syndromes as psychosomatic conditions.

Adolescent↗
PubMedDate not supplied

Evaluating and improving VA substance abuse patients' care.

The VA has implemented a nationwide evaluation program to monitor process and outcome of care for substance abuse patients. This program focuses on the changing characteristics of VA substance abuse patients and treatment services and involves outcome-based evaluations of major VA substance abuse treatment modalities. Initial findings show that VA substance abuse patients, including patients with concomitant psychiatric disorders, improve substantially from treatment intake to a 1-year follow-up and that community residential facilities are an important part of the continuum of substance abuse care. Moreover, within broad limits, there is a dose-response relationship between the continuity of outpatient mental health care and better 1-year substance use and psychosocial outcomes. These findings are placed into context as part of an evidence-based initiative to improve the quality of VA mental health care.

Adult↗