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Examining differential effects of psychosocial treatments for cocaine dependence: an application of latent trajectory analyses.

Abstract：

BACKGROUND:The NIDA Collaborative Cocaine Treatment Study yielded different efficacies for different psychosocial treatments for cocaine dependence. However, substantial heterogeneity of patient outcomes was evident. Longitudinal data analysis techniques can be helpful in examining differential effects of psychosocial interventions on specific subpopulations of patients. METHODS:Overall drug and cocaine use of 346 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions were assessed monthly during 6-month treatment. Growth mixture models were used to identify patient subgroups based on typical patterns of change in substance use during treatment and to evaluate differential treatment effects within these subgroups. RESULTS:Three patient subgroups following different change patterns in cocaine and overall drug use were identified irrespective of the treatment type: (a) those with moderate baseline severity of drug use and very rapid reduction of drug use during treatment, (b) those with moderate baseline severity of drug use and moderate reduction of drug use during treatment, and (c) those with severe levels of baseline drug use with moderate reduction of drug use during treatment. Patient baseline characteristics enabled discrimination between these subgroups. Individual drug counseling was most efficacious among those patients with moderate baseline severity and moderate treatment response. There were no differential treatment effects in the two other patient subgroups. CONCLUSIONS:The population of treatment-seeking cocaine dependent individuals is heterogeneous. Research on patient subgroups with different change patterns revealed its potential to enable classifications of patients that indicate which treatment is most effective for which type of patient.

journal_name

Drug Alcohol Depend

journal_title

Drug and alcohol dependence

authors

Stulz N,Gallop R,Lutz W,Wrenn GL,Crits-Christoph P

doi

10.1016/j.drugalcdep.2009.08.009

subject

Has Abstract

pub_date

2010-01-15 00:00:00

pages

164-72

issue

2-3

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(09)00328-7

journal_volume

106

pub_type

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Examining differential effects of psychosocial treatments for cocaine dependence: an application of latent trajectory analyses.