A clinical tool for rating response to civil commitment for substance abuse treatment. 1997

D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
Minneapolis Veterans Affairs Medical Center, Minnesota 55417, USA.

OBJECTIVE The objectives of this study were to develop a measure to assess patients' response to civil commitment, to test this measure on two groups of dually diagnosed patients (medically ill alcoholics and patients with dual mental and substance use disorders), and to identify patient characteristics associated with a positive response to commitment. METHODS The outcome of 38 male veterans civilly committed to inpatient substance abuse treatment for an average of six months was rated by their treating clinicians. Raters used the Commitment Response Form (CRF), a scale anchored to behavioral descriptions that was developed for the study and that measures outcome in five areas: patients' attitude toward recovery, substance use, medical condition, engagement in substance abuse treatment, and independence of functioning. Each patient's medical records were reviewed by two clinical staff members who made independent retrospective ratings and a joint rating using the CRF. They also made independent and joint dichotomous ratings of whether the patient was a positive responder or a nonresponder to civil commitment. RESULTS The CRF showed superior reliability when compared with the dichotomous rating of outcome. The scale demonstrated reasonable psychometric properties. Mean scale scores did not differ significantly by patient group; slightly more than half were rated as having a good to excellent overall response. Better outcome was associated with longer periods of previous abstinence from alcohol and a higher level of education. CONCLUSIONS Use of a scale anchored to behavioral descriptions improved reliability of outcome determinations by clinical staff. Civil commitment resulted in good to excellent outcome in many but not all committed patients.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010043 Outcome and Process Assessment, Health Care Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically. Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D003134 Commitment of Mentally Ill Legal process required for the institutionalization of a patient with severe mental problems. Outpatient Commitment,Commitment, Outpatient,Mentally Ill Commitments
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000437 Alcoholism A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. (Morse & Flavin for the Joint Commission of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism: in JAMA 1992;268:1012-4) Alcohol Abuse,Alcoholic Intoxication, Chronic,Ethanol Abuse,Alcohol Addiction,Alcohol Dependence,Alcohol Use Disorder,Abuse, Alcohol,Abuse, Ethanol,Addiction, Alcohol,Alcohol Use Disorders,Chronic Alcoholic Intoxication,Dependence, Alcohol,Intoxication, Chronic Alcoholic,Use Disorders, Alcohol

Related Publications

D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
October 2013, The virtual mentor : VM,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
June 2018, Rhode Island medical journal (2013),
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
January 1997, Psychiatric services (Washington, D.C.),
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
March 1996, Politics and the life sciences : the journal of the Association for Politics and the Life Sciences,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
September 2015, The journal of the American Academy of Psychiatry and the Law,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
August 1981, The American journal of psychiatry,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
January 1975, Louisiana law review,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
January 1988, NIDA research monograph,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
October 1993, The American journal of psychiatry,
D H Olson, and M M Mylan, and L A Fletcher, and S M Nugent, and J W Lynch, and M L Willenbring
January 1991, The Bulletin of the American Academy of Psychiatry and the Law,
Copied contents to your clipboard!