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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)
Physical health conditions and intimate partner violence perpetration among offenders with alcohol use diagnoses
- Authors:
- CRANE Cory A., EASTON Caroline J.
- Journal article citation:
- Journal of Interpersonal Violence, 32(11), 2017, p.1678–1691.
- Publisher:
- Sage
Intimate partner violence (IPV) is prevalent among samples with diagnosed alcohol use disorders (AUDs), but few studies have evaluated the factors that account for this increased risk, and none have systematically evaluated the risk posed by comorbid physical health conditions. The present study evaluated the likelihood of perpetrating IPV among alcohol diagnosed offenders with medical health problems relative to healthy counterparts. Physical health and partner violence data provided by 655 criminal offenders with AUDs diagnosed during a court-ordered substance abuse evaluation were examined. One third of participants (35.3%) endorsed a physical health condition, and 46.4% reported perpetrating physical IPV. The odds of perpetrating IPV among participants with a physical health condition were 2.29 times larger than among healthy participants. Specific conditions emerged as risk factors for IPV, including brain injury, cardiac issues, chronic pain, liver issues, gastrointestinal symptoms, hepatitis, and recent injury. Findings highlight the importance of identifying and managing physical health conditions that may complicate IPV treatment efforts. Integrated behavioural and medical health treatment approaches may increase treatment compliance and reduce the risk of future partner violence among offenders with co-occurring issues, such as mental illness, addiction, and physical health conditions. (Edited publisher abstract)
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)