RESUMEN

OBJECTIVES: To evaluate the prevalence of reported physical and sexual abuse among youths with substance use problems, to explore whether youths report relying on substances to cope with the abuse, and to examine whether individual factors related to substance use were associated with the outcome measures of reported physical abuse, sexual abuse, and using substances to cope. METHOD: We assessed 287 male and female youths (age 14 to 24 years) who presented for help for substance use problems, using a semistructured interview that focused on substance use, history of previous sexual and physical abuse, and coping strategies. RESULTS: One-half of the female youth substance abusers reported having been sexually abused (50.0%), while male youth substance users reported a significantly lower rate (10.4%). Similarly, one-half of the female youths had a history of physical abuse (50.5%), and males again had a lower rate (26.0%). Of those who endorsed a history of abuse, more females (64.7%) than males (37.9%) reported using substances to cope with the trauma. Specific associations between the outcome measures and substance use variables were found for youths in both sexes. CONCLUSION: These findings underscore the importance of why clinicians should explore abuse issues with substance-using youth of both sexes. Identifying concurrent factors will help provide better intervention strategies. Suggestions for assessing sexual and physical abuse in youths with substance use disorders are provided.

Asunto(s)

Abuso Sexual Infantil/psicología , Trastornos Relacionados con Sustancias/etiología , Violencia/psicología , Adaptación Psicológica , Adolescente , Adulto , Ira , Distribución de Chi-Cuadrado , Abuso Sexual Infantil/estadística & datos numéricos , Familia/psicología , Femenino , Humanos , Masculino , Conducta Materna/psicología , Padres/psicología , Prevalencia , Distribución por Sexo , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Violencia/estadística & datos numéricos

RESUMEN

This article describes an integrated treatment program for individuals with concurrent mental health and substance use disorders. Principles of dialectical behaviour therapy (DBT), originally developed by Linehan (l993a ; 1993b) for chronically suicidal individuals with borderline personality disorder, provided the framework for the organization of a program of specialized treatment services in the following areas ; substance use and borderline personality disorder, substance use and anger, and substance use and eating disorders. An overview of DBT and the rationale for founding a concurrent disorder program upon this approach is discussed. A description of our treatment protocols for the three subgroups of concurrent disordered patients is provided with attention to the similarities and differences from the standard DBT protocol. The principal elements of the program are highlighted.