Substance Abuse Administrators' Attitudes Regarding Psychosocial Functioning of Persons with Single Diagnoses Versus Severe Dual Diagnoses

ABSTRACT

This study assessed whether administrators of substance abuse agencies would rate the psychosocial functioning of clients with either of two substance dependence diagnoses (alcohol dependence, illicit drug dependence) or either of two serious psychiatric diagnoses (schizophrenia, major depression) as different than the functioning of clients with selected dual diagnoses (either alcohol or illicit drug dependence with either schizophrenia or major depression). A short case description, an assessment inventory, and a demographic questionnaire were mailed to a randomly selected, nationwide sample of 470 clinical directors of American substance abuse treatment agencies (response rate = 45%; responding n = 212). Consistent with research indicating more impaired functioning by persons with dual diagnoses, case descriptions of clients with single diagnoses typically were rated as having higher overall functioning, as more capable of functioning independently and responsibly, and as less likely to injure themselves or others.

KEYWORDS:

• Dual diagnosis
• schizophrenia
• major depression
• alcohol dependence
• drug dependence
• stigmatization

This article is based on the Masters thesis of the first author conducted in collaboration with and under the supervision of the second author. We wish to acknowledge the helpful suggestions of Stuart Keeley and Anne Gordon during the design and analysis phases of the project.

Notes

^a Item 1: Improvement with treatment did not load strongly on any factor and was treated as a separate dependent measure.

^a t values and df's for Independence and Low Dangerousness are based on results that corrected for unequal variances given significance of heterogeneity of variance tests; mean of remaining items substituted for occasional missing values.