Teen Native American Girls Are More Likely to Finish Dependency Treatment

SEATTLE – Female Native American adolescents undergoing mandated chemical dependency treatment were significantly more likely than their male counterparts to complete such programs, a retrospective study found.

Results of the study were presented by Dr. Christopher M. Davidson and Dr. Michael C. Harlow, both forensic psychiatrists at the University of South Dakota, Sioux Falls, at the annual meeting of the American Academy of Psychiatry and the Law.

Dr. Davidson said treatment success rates tend to be low in addiction treatment, and information on minorities, particularly Native Americans, is sparse. They found that 74.5% of boys and 87.1% of girls completed treatment. Identifying factors associated with a reduced likelihood of treatment completion is an initial step toward improving this outcome, he noted.

The investigators reviewed the charts of 203 Native American adolescents who had undergone mandated treatment for chemical dependency at a South Dakota inpatient treatment center.

They determined each adolescent's criminal history, prior addiction treatment, mental health, and substance use, as assessed with the DSM-IV interview, the Million Adolescent Clinical Inventory (MACI), the Substance Abuse Subtle Screening Inventory (SASSI-A2), the Michigan Alcohol Screening Test (MAST), and the Drug Abuse Screening Test (DAST).

Study results indicated that the adolescents came from 13 states. Slightly more than half were male, and their mean age was 16 years. For 53% of the youth, treatment had been mandated by a court order; for the rest, it had been mandated by their tribal council or a precourt legal agreement. Half had been treated for addiction before. The mean age at first contact with the law was 11 years. Seventy percent had been previously arrested for drug-related offenses, and 35% had been arrested for violent crimes.

Fully 80% of the adolescents successfully completed the chemical dependency treatment program–a rate much higher than the national average. “This treatment facility has culturally specific programs for Native Americans, which we believe probably makes a difference,” Dr. Davidson said.

One of the findings proved surprising, said Dr. Harlow. “There was no correlation between having [court-ordered] treatment, having a previous treatment history, or having an arrest history, and their chances of successfully completing treatment,” he said.

Study results also showed high levels of comorbidities in the adolescents. For example, according to MACI scores, large proportions had Axis I findings, most commonly conduct disorder (49%), dysthymia (35%), disruptive behavior disorder (22%), parent-child relational problems (21%), and physical abuse (10%). In addition, the majority had Axis II features and traits, particularly an antisocial personality (60%), and a negativistic or passive-aggressive personality (51%).

“Once we figure out the issues that Native Americans face as far as succeeding in [mandated] treatment, we can hopefully tailor programming to optimize their chances of success,” Dr. Harlow said.

The investigators plan to compare the findings with those in a matched group of non-Native American adolescents and also study the same issues among Native American adults in chemical dependency treatment.

Dr. Davidson and Dr. Harlow reported that they had no conflicts of interest in association with the study.

SEATTLE – Female Native American adolescents undergoing mandated chemical dependency treatment were significantly more likely than their male counterparts to complete such programs, a retrospective study found.

Results of the study were presented by Dr. Christopher M. Davidson and Dr. Michael C. Harlow, both forensic psychiatrists at the University of South Dakota, Sioux Falls, at the annual meeting of the American Academy of Psychiatry and the Law.

Dr. Davidson said treatment success rates tend to be low in addiction treatment, and information on minorities, particularly Native Americans, is sparse. They found that 74.5% of boys and 87.1% of girls completed treatment. Identifying factors associated with a reduced likelihood of treatment completion is an initial step toward improving this outcome, he noted.

The investigators reviewed the charts of 203 Native American adolescents who had undergone mandated treatment for chemical dependency at a South Dakota inpatient treatment center.

They determined each adolescent's criminal history, prior addiction treatment, mental health, and substance use, as assessed with the DSM-IV interview, the Million Adolescent Clinical Inventory (MACI), the Substance Abuse Subtle Screening Inventory (SASSI-A2), the Michigan Alcohol Screening Test (MAST), and the Drug Abuse Screening Test (DAST).

Study results indicated that the adolescents came from 13 states. Slightly more than half were male, and their mean age was 16 years. For 53% of the youth, treatment had been mandated by a court order; for the rest, it had been mandated by their tribal council or a precourt legal agreement. Half had been treated for addiction before. The mean age at first contact with the law was 11 years. Seventy percent had been previously arrested for drug-related offenses, and 35% had been arrested for violent crimes.

Fully 80% of the adolescents successfully completed the chemical dependency treatment program–a rate much higher than the national average. “This treatment facility has culturally specific programs for Native Americans, which we believe probably makes a difference,” Dr. Davidson said.

One of the findings proved surprising, said Dr. Harlow. “There was no correlation between having [court-ordered] treatment, having a previous treatment history, or having an arrest history, and their chances of successfully completing treatment,” he said.

Study results also showed high levels of comorbidities in the adolescents. For example, according to MACI scores, large proportions had Axis I findings, most commonly conduct disorder (49%), dysthymia (35%), disruptive behavior disorder (22%), parent-child relational problems (21%), and physical abuse (10%). In addition, the majority had Axis II features and traits, particularly an antisocial personality (60%), and a negativistic or passive-aggressive personality (51%).

“Once we figure out the issues that Native Americans face as far as succeeding in [mandated] treatment, we can hopefully tailor programming to optimize their chances of success,” Dr. Harlow said.

The investigators plan to compare the findings with those in a matched group of non-Native American adolescents and also study the same issues among Native American adults in chemical dependency treatment.

Dr. Davidson and Dr. Harlow reported that they had no conflicts of interest in association with the study.

SEATTLE – Female Native American adolescents undergoing mandated chemical dependency treatment were significantly more likely than their male counterparts to complete such programs, a retrospective study found.

Results of the study were presented by Dr. Christopher M. Davidson and Dr. Michael C. Harlow, both forensic psychiatrists at the University of South Dakota, Sioux Falls, at the annual meeting of the American Academy of Psychiatry and the Law.

Dr. Davidson said treatment success rates tend to be low in addiction treatment, and information on minorities, particularly Native Americans, is sparse. They found that 74.5% of boys and 87.1% of girls completed treatment. Identifying factors associated with a reduced likelihood of treatment completion is an initial step toward improving this outcome, he noted.

The investigators reviewed the charts of 203 Native American adolescents who had undergone mandated treatment for chemical dependency at a South Dakota inpatient treatment center.

They determined each adolescent's criminal history, prior addiction treatment, mental health, and substance use, as assessed with the DSM-IV interview, the Million Adolescent Clinical Inventory (MACI), the Substance Abuse Subtle Screening Inventory (SASSI-A2), the Michigan Alcohol Screening Test (MAST), and the Drug Abuse Screening Test (DAST).

Study results indicated that the adolescents came from 13 states. Slightly more than half were male, and their mean age was 16 years. For 53% of the youth, treatment had been mandated by a court order; for the rest, it had been mandated by their tribal council or a precourt legal agreement. Half had been treated for addiction before. The mean age at first contact with the law was 11 years. Seventy percent had been previously arrested for drug-related offenses, and 35% had been arrested for violent crimes.

Fully 80% of the adolescents successfully completed the chemical dependency treatment program–a rate much higher than the national average. “This treatment facility has culturally specific programs for Native Americans, which we believe probably makes a difference,” Dr. Davidson said.

One of the findings proved surprising, said Dr. Harlow. “There was no correlation between having [court-ordered] treatment, having a previous treatment history, or having an arrest history, and their chances of successfully completing treatment,” he said.

Study results also showed high levels of comorbidities in the adolescents. For example, according to MACI scores, large proportions had Axis I findings, most commonly conduct disorder (49%), dysthymia (35%), disruptive behavior disorder (22%), parent-child relational problems (21%), and physical abuse (10%). In addition, the majority had Axis II features and traits, particularly an antisocial personality (60%), and a negativistic or passive-aggressive personality (51%).

“Once we figure out the issues that Native Americans face as far as succeeding in [mandated] treatment, we can hopefully tailor programming to optimize their chances of success,” Dr. Harlow said.

The investigators plan to compare the findings with those in a matched group of non-Native American adolescents and also study the same issues among Native American adults in chemical dependency treatment.

Dr. Davidson and Dr. Harlow reported that they had no conflicts of interest in association with the study.