The effects of personality disorders on treatment response and outcome among cocaine-dependent outpatients.
Item
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Title
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The effects of personality disorders on treatment response and outcome among cocaine-dependent outpatients.
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Identifier
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AAI9908353
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identifier
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9908353
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Creator
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Rhum, Madeline.
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Contributor
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Adviser: Steven Tuber
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Date
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1998
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical
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Abstract
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This study examined the effects of comorbid Axis II personality disorders on the treatment response and outcome of treatment-seeking cocaine-dependent outpatients who were enrolled in controlled clinical trials at the New York State Psychiatric Institute in New York City. The subjects were 51 patients some of whom were diagnosed with the comorbid Axis I disorders of attention deficit hyperactivity disorder (ADHD; n = 17) or depression ("dep"; n = 19), and a group who were not diagnosed with any additional non-substance related Axis I disorder (N/C; n = 15). It was hypothesized that Axis II diagnoses would be evenly distributed among the three subgroups of study patients. It was also hypothesized that each subgroup of patients would be differently effected by the presence of any Axis II comorbidity. Specifically, it was hypothesized that the ADHD subgroup would not be negatively effected by any Axis II comorbidity; and, that the treatment response and outcome of the "dep" and N/C subgroups would be adversely effected by Axis II comorbidity. Furthermore, it was hypothesized that any patients whose only comorbid diagnosis in addition to cocaine dependence was antisocial personality disorder (ASP), would do less well in treatment than patients who were diagnosed with ASP and any additional Axis I (i.e. ADHD or depression) and/or any additional Axis II diagnoses.;Patients were treated with either an active medication or placebo, and an individual cognitive-behavioral intervention, Relapse Prevention (RP), which focused directly on thoughts, feelings and behaviors associated with the patients' drug use. Patients' Axis II diagnoses were determined using the Millon Clinical Multiaxial Inventory, third edition (MCMI-III; Millon 1994). Treatment response and outcome were measured through several means including: urine toxicology screens for evidence of cocaine; changes in self-reports of cocaine craving; changes on scores of the drug and psychological severity scales of the Addiction Severity Index, fifth edition (McLellen et al. 1992); and, length of time subject remained in treatment.;No statistically significant results were found between those patients who had a comorbid personality disorder and those who did not. Several factors may have contributed to these findings including: the lack of diagnostic precision of the MCMI-III with this population; and, the effectiveness of the psychotherapeutic intervention (RP) in ameliorating pathological aspects of patients' Axis II disorders.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
