Physical and XXXX history and addiction treatment outcomes.

@entity1 @entity458
OBJECTIVE: Prior research on @entity1 with substance use disorders has shown that lifetime physical or @entity458 is associated with more impaired functioning at treatment intake. The present study sought to determine whether physical or @entity458 also predicted treatment response (posttreatment outcomes) of individuals with substance use disorders. METHOD: Male (n = 19,989) and female (n = 622) veterans with substance use disorders were assessed with the Addiction Severity Index (ASI) early in treatment and reassessed an average of 12 months later. Treatment outcomes were compared for @entity1 who did and did not report prior physical or @entity458 in the initial ASI interview. RESULTS: Lifetime physical or @entity458 predicted worse outcomes in six of seven domains of functioning, after controlling for baseline functioning, psychiatric diagnoses and demographic variables. Although @entity1 were more likely than @entity1 to report being abused, the effect of abuse on treatment outcomes was similar for both genders. Psychiatric problems at baseline mediated the effect of abuse history on outcomes. Abuse history moderated the effect of treatment intensity (contacts per month) on outcomes: More frequent treatment contacts were more beneficial for abused @entity1 than for nonabused @entity1 . CONCLUSIONS: Individuals with substance use disorders who have a history of physical or @entity458 may have higher risk for problematic treatment outcomes as a result of greater psychiatric problems, deficits in social support and possible difficulties in establishing treatment alliance. Clinicians may consider increasing the duration and intensity of treatment to temper the negative effects of abuse on later functioning.
