Gender Differences in Substance Use, Consequences, Motivation to Change, and Treatment Seeking in People With Serious Mental Illness

Abstract

Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender.

RÉSUMÉ

Différences dans les modèles et conséquences de la dépendance aux substances, dans la recherche de traitements et dans la motivation de vouloir changer selon les sexes.

Différences dans les modèles et conséquences de la dépendance aux substances, dans la recherche de traitements et dans la motivation de vouloir changer selon les sexes. Deux échantillons ont été examines: un échantillon comprenait des gens avec des maladies mentales graves et l’autre échantillon comprenait des gens avec des troubles liés à l’usage de substances. Un des échantillons comprenait des gens dans la communauté qui ne recherchaient pas présentement de traitements pour la dépendance aux substances (N = 175) et l’autre échantillon comprenait des gens qui recherchaient un traitement (N = 137). Dans les deux groupes, les femmes et les hommes ont démontrées plus de similarités que de différences dans les modèles et sévérité d’utilisation de leurs substances. Par contre, les femmes qui recherchaient un traitement ont démontrées une facilité plus importante à changer leurs dépendances aux substances. Les problèmes de maladies mentales et les expériences traumatiques pourraient faire en sorte que les gens faisant partie de ses deux groupes sont incites à entrer dans un traitement d’abus de substances indépendamment de leur sexe.

RESUMEN

Diferencias de género de su uso de sustancia, consecuencias, el motivo para cambiar, y buscando-tratamiento en personas con trastornos mentales crónico/grave

Diferencias de género en pautas y consecuencias del uso de sustancia, buscando-tratamiento, y el motivo para cambiar fueron examinado en dos muestras de personas con trastornos mentales crónico/grave (TMC) y comorbilidad de trastornos por uso de sustancias (TUS): una muestra de la comunidad cual presentemente no está buscando tratamiento de abuso de sustancia (N = 175) y una muestra buscando tratamiento (N = 137). En ambos grupos, las mujeres y los hombres demostraron más similitudes que diferencias en la pauta y la severidad de su uso de sustancia. Sin embargo, mujeres cual buscaron-tratamiento mostraron la prontitud más grande para cambiar su uso de sustancia. Los problemas de la salud mental y experiencias traumáticas pueden incitar a personas con TMC y TUS a entrar tratamiento de abuso de sustancia, a pesar de género.

Keywords :

• dual diagnosis
• serious mental illness
• gender differences
• motivation to change
• treatment-seeking

THE AUTHORS

Amy Drapalski, Ph.D., is Administrative Core Manager at the Veterans Affairs (VA) Capital Health Care Network Mental Illness, Research, Education and Clinical Center (MIRECC). Her research has primarily focused on identifying barriers and facilitators of recovery and developing, evaluating, and implementing psychosocial treatments for individuals with serious mental illness and their families. Her current research is aimed at understanding the impact of self-stigma and other related factors on recovery and developing interventions aimed at reducing internalized stigma and its effects in people with serious mental illness.

Melanie Bennett, Ph.D., is a Clinical Associate Professor in the Department of Psychiatry at the University of Maryland, School of Medicine. Her primary research focus has been on the assessment and treatment of substance use disorders in people with serious mental illness. Her current research focuses on developing behavioral treatment programs to alcohol, drug, and nicotine dependence in people with schizophrenia and other forms of serious mental illness. She is also interested in ways to improve treatment engagement and outcome via motivational enhancement strategies that are adapted for individuals with serious mental illness.

Alan S. Bellack, Ph.D., A.B.P.P., received his Ph.D. from the Pennsylvania State University in 1970. He currently is Professor of Psychiatry and Director of the Division of Psychology at the University of Maryland School of Medicine and Director of the VA Capital Health Care Network Mental Illness Research, Education, and Clinical Center (MIRECC). He was formerly Professor of Psychiatry and Director of Psychology at the Medical College of Pennsylvania and Professor of Psychology and Director of Clinical Training at the University of Pittsburgh. He is a Past President of the Association for Advancement of Behavior Therapy and of the Society for a Science of Clinical Psychology. He is a Diplomate of the American Board of Behavior Therapy and the American Board of Professional Psychology and a fellow of the American Psychological Association, the American Psychological Society, the Association for Clinical Psychosocial Research, and the American Psychopathological Association. He was the first recipient of the American Psychological Foundation Gralnick Foundation Award for his lifetime research on psychosocial aspects of schizophrenia and was the first recipient of the Ireland Investigator Award from NARSAD. He received an National Institute of Mental Health (NIMH) MERIT award and has had continuous funding from NIH since 1974 for his work on schizophrenia, depression, social skills training, and substance abuse. He chaired the VA Recovery Transformation Workgroup and is Chair of the VA National Recovery Advisory Committee. He is founding Coeditor of the journals Clinical Psychology Review and Behavior Modification and serves on a number of other editorial boards and a VA Merit review study section.

Dr. Bellack has published 175 journal articles and 52 book chapters. He is Coauthor or Coeditor of 31 books, including Bellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (2004). Social Skills Training for Schizophrenia: A Step-by-Step Guide (Second Edition). New York: Guilford Press, and Bellack, A. S., Bennett, M. E., & Gearon, J. S. (2007). Behavioral Treatment for Substance Abuse in People With Serious and Persistent Mental Illness. New York: Taylor and Francis.