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Dual diagnosis among veterans in the United States
- Authors:
- CRANE Cory A., SCHLAUCH Robert C., EASTON Caroline J.
- Journal article citation:
- Advances in Dual Diagnosis, 8(1), 2015, pp.4-17.
- Publisher:
- Emerald
Purpose: Over the course of their service, veterans are exposed to elevated levels of chronic stress that contribute to a greater prevalence of mental illness than observed in the general population. When mental illness is present, comorbidity is normative. Convergent evidence suggests that co-occurring substance use and mental illness is among the most prevalent forms of comorbidity within veteran samples. The purpose of this paper is to explore issues associated with dual diagnoses among veterans in the USA. Design/methodology/approach: Research on dual diagnoses among veterans was reviewed and consolidated for presentation into three substantive content areas consisting of prevalence, associated conditions, and treatment of dual diagnoses. Findings: Dually diagnosed veterans represent a group at particularly high risk for myriad adverse biopsychosocial and treatment outcomes, including poor health, suicidality, violence or aggressive behaviour, arrest, homelessness, and unemployment. A comprehensive strategy has been implemented within the Veterans Health Administration to address dual diagnosis and related problems. Additional research is required to more readily identify co-occurring substance use and mental illness and to refine integrated intervention approaches to minimize burden while improving treatment outcomes for veterans and their families. Originality/value: The current review includes a wide range of research spanning more than two decades and describing dual diagnosis among combat veterans of all modern eras. Areas in need of further research (e.g. dual diagnosis among female veterans; early detection of psychopathology and fully integrated care among returning veterans) are identified and discussed. (Publisher abstract)
Co-occurring mental health problems among substance dependent offenders of intimate partner violence
- Author:
- EASTON Caroline J.
- Journal article citation:
- Advances in Dual Diagnosis, 5(2), 2012, pp.86-93.
- Publisher:
- Emerald
This study investigated the differences between substance dependent men who were arrested for intimate partner violence (IPV) with and without concurrent psychiatric problems. Sixty three participants from Connecticut, United States, were randomly assigned to manual-guided group Substance Abuse-Domestic Violence (SADV) therapies or drug counselling and assessed after 12 weeks of treatment. Twenty three per cent reported prior mental health treatment. SADV participants with co-occurring mental health were different than SADV participants without co-occurring mental health symptoms on both baseline and post-treatment time periods. SADV participants with co-occurring mental health symptoms had more pre-treatment impairments, more drug use during treatment, a trend for more problems with aggressive behaviours throughout treatment and significantly more impairments in anger control subscales at post treatment compared to SADV participants without co-occurring mental health symptoms. The authors concluded that there was a need to target and treat co-occurring psychiatric symptoms and distress among SADV offenders.
Avatar and technology assisted platforms in the treatment of co-occurring addiction and IPV among male offenders
- Authors:
- EASTON Caroline J., BERBARY Cassandra M., CRANE Cory A.
- Journal article citation:
- Advances in Dual Diagnosis, 11(3), 2018, pp.126-134.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to review the research on the use of technology in mental health and addiction treatment, focusing on the use of technology-assisted treatment. Although initial research investigating technology-assisted treatment for substance use has demonstrated promising results, this paper highlights the need for treatment to address co-occurring substance use and intimate partner violence (IPV). This paper defines the benefits associated with the use of behavioural health avatar coaches in mental health treatment targeting substance use and IPV as well as providing preliminary research results regarding the use of avatar coaches in clinical settings. Design/methodology/approach: A literature review of the research relating to the use of technology in mental health and addiction treatment is provided. Additionally, a preliminary study aimed to develop an interactive therapy platform that utilizes virtual avatars as therapy coaches to help clients with substance abuse and IPV is presented. In this preliminary study, male participants were shown videos of various technology-based coaches matched on length, gestures and content. Researchers investigated whether patients preferred a virtual reality health coach, a cartoon health coach or a human health coach; as well as patient satisfaction and preference between two versions of the avatar. Findings: A review of the relevant literature suggests that a majority of research has focused on using technology to replace face-to-face therapy with little research focusing on technology-assisted or augmented mental health and addiction treatment. Although initial research investigating avatar-assisted treatment for substance use has demonstrated promising results, research suggests a high prevalence of co-occurring substance use and IPV, suggesting the need for treatment to address co-occurring substance use and IPV. A preliminary research study was conducted to obtain patient feedback for personalizing avatar development into behavioural health interventions that target addiction and IPV. Research limitations/implications: Although results of the preliminary study combined with previous research on avatar-assisted treatment for substance use has demonstrated promising results, theory-based research needs to be expanded to focus on randomized controlled trials of avatar-assisted treatment for co-occurring substance use and IPV. Practical implications. This paper provides an overview of the use of technology-assisted treatment for co-occurring substance use and IPV. The preliminary results regarding patient satisfaction led to the development of additional avatars for use in interactive therapy. Originality/value: This paper is one of the first to explore the use of avatar-assisted treatment for male offenders with co-morbid substance use and IPV. (Edited publisher abstract)