As more addiction treatment programs treat comorbidity it seems likely that client confusion about treatment approach will increase.  Comorbidity is here defined as having both a mental health disorder (such as anxiety or depression) as well as an addictive disorder.  Client confusion might arise because CBT (cognitive behavior therapy) has become the treatment of choice for many mental health disorders, but 12-step based treatment remains the most widely available treatment for addictive disorders.  Clients receiving CBT for their mental disorders can be confused when they compare the self-empowering strategies of CBT with the emphasis on powerlessness in a 12-step approach.  Although 12-step treatment now often incorporates relapse prevention and other CBT components, there remains a ...

Cluster B personality disorders (e.g., borderline personality disorder) and substance use disorders (SUD) are both marked by impulsivity and poor behavioral control. Previous studies (e.g., Taylor, 2005) have found evidence that symptoms of cluster B personality disorder and SUD are significantly and positively correlated. Because of accumulating evidence which suggests that personality disorders are prevalent in opioid dependent populations, along with evidence linking cluster B personality disorder characteristics and SUD severity, Murray et. al. hypothesized that opioid dependent patients with cluster B personality characteristics would have elevated methadone dose prescriptions (2008). Such a finding would have immediate implications for the doses of methadone, and possibly other me...

Many studies present evidence that antisocial personality disorder (ASPD) is highly associated with substance use disorders (SUD). The DSM-IV defines ASPD as “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” Characteristics of individuals with ASPD may include persistent lying, superficial charm, lack of remorse, impulsivity, poor behavioral controls, and disregard for social norms and rules. Mariani et. al. examined the rates of different antisocial syndromes among cocaine-dependent and cannabis-dependent individuals seeking drug treatment (2008). Conduct Disorder A true diagnosis of ASPD must include the childhood component of antisocial behavior known as conduct disorder (CD). C...

In Spain, alcohol dependence affects up to 10 percent of the population and a major public health problem. Previous studies have suggested that personality disorders affect from 2.8 and 11 percent of the population, and studies of personality disorders among alcoholics suggest that the prevalence of personality disorders ranges from 24 to 78 percent among alcohol-dependent individuals. There have been discrepancies in studies of personality disorders among alcohol-dependent individuals, but the literature nevertheless suggests that personality disorders are more prevalent in this group than in the general population. Thus, the possibility of personality disorders should be explored in alcohol treatment and alcohol recovery. A team of researchers in Spain set out to discover the most fre...

A recent study suggests that depression, obesity, and alcohol use disorder are interrelated conditions among young adult women but not among men. A better understanding of the relationship between these interrelated conditions would help young women in alcohol recovery. A team of Washington University researchers collected data from young adults at the ages of 24, 27, and 30 (McCarty et. al., 2009). Nearly half of the 776 participants met the criteria for depression, obesity, or alcohol use disorder at each time point.   Alcohol Use Disorder Stats From The Study The study found that women with an alcohol use disorder (AUD) at age 24 were more than three times more likely to be obese at age 27. Women who were obese at age 27 were more than twice as likely to be depressed whe...

Because alcohol use disorders are common among driving-while-intoxicated (DWI) offenders, a DWI arrest may serve as an opportunity for psychological screening and subsequent alcohol treatment. Holt et. al. examined the Beck Depression Inventory (BDI) as a tool for predicting intervention outcomes in first-time DWI offenders. The BDI is a multiple-choice self survey consisting of 21 questions. It is the most widely used questionnaire for measuring the severity of depression. Survey questions are related to affective depressive symptoms such as pessimism, guilt, self-dislike, suicidal thoughts, and feelings of worthlessness, as well as physical symptoms such as anhedonia (loss of pleasure), crying, agitation, loss of energy, change in sleep patterns, change in appetite, difficulty conc...

Do you feel anxious when you’re in the spotlight or under scrutiny? According to a recent study from researchers at Yale University and Florida State University, social anxiety – and fear of scrutiny, specifically – appears to serve as a risk factor for alcohol use disorders (Buckner & Schmidt, 2009). Future research into how observation anxiety can lead to excessive alcohol use will likely provide useful guidance for alcohol recovery. For now, it appears that individuals with both observation anxiety and excessive alcohol use will likely need to learn to manage their observation anxiety in order to achieve a stable alcohol recovery. Social anxiety disorder (SAD) and alcohol use disorders (AUD) are highly comorbid. According to one study, 48 percent of individuals with a lifet...

Social anxiety disorder (SAD) and alcohol use disorders (AUD) tend to co-occur at high rates. The National Epidemiologic Survey on Alcohol and Related Conditions (Grant et al., 2005) found that 48 percent of participants with a lifetime diagnosis of SAD also met criteria for a lifetime diagnosis of AUD. In instances of alcohol use and comorbid social anxiety disorder, the two disorders may lead to greater impairment than either condition alone. For example, research suggests that patients seeking alcohol treatment who have a lifetime diagnosis of SAD are more likely to have major depressive episodes, severe alcohol dependence, less peer social support, and lower occupational status when compared to AUD patients without SAD (Thevos, Thomas, & Randall, 1999; Thomas et al., 1999). Mot...

Alcohol treatment clinics commonly treat individuals with comorbid disorders. In fact, an individual with “pure” alcoholism is rare in alcohol treatment clinics. Comorbid anxiety disorders, including generalized anxiety as well as phobic disorders, are extremely common in alcohol treatment clinics. For instance, the 1994 National Comorbidity Study found social phobia in 19.3 percent of alcohol-dependent participants. According to the self-medication hypothesis, individuals with anxiety use alcohol to decrease anxiety symptoms, and this promotes excessive use. Researchers in Amsterdam and the Netherlands set out to answers three questions regarding comorbid phobic disorders: (1) What are the clinical characteristics of treatment-seeking alcohol-dependent patients with a comorbid phobic d...