Abstract

In order to better understand the needs of an increasing dually diagnosed population, this study compares the efficacy of integrated vs. nonintegrated treatment programs for a dually diagnosed population, residing at a Long Term Care facility in San Bernardino, California. Patients in this setting are diagnosed with chronic and acute mental illness and chemical dependency. This study tested the hypotheses that the nonintegrated treatment program would result in a higher frequency of assaults, PRNs, Q15s, and Code Reds; increase the duration of Q15s; and, increase the Addiction Severity Index’s (ASI) Family/Social and Psychiatric subscales’ scores, which would indicate lower levels of functioning. Archival secondary source data was used from 36 adult patients with a mean age of 39 years old. Fifty-five percent were female. The ethnic composition was: 63% Caucasian, 18% Hispanic, 16% African- American, and 3% Asian or other minority group. The breakdowns of the DSM-IV-TR diagnoses were: Schizoaffective Disorder 55%; Schizophrenia, Paranoid 22%; Schizophrenia, Undifferentiated 11%; Bipolar Disorder 6%; Major Depression 3%; and Psychotic Disorder 3%. Sixty-eight percent of the residents had secondary psychiatric diagnoses involving chemical dependency and/or histories of substance abuse. This was a quasi-experimental study with one independent variable: treatment method. Analyses were performed with three groups: integrated, nonintegrated, and crossover. Three analyses were used to test the hypotheses that the integrated treatment program would produce better outcomes than the nonintegrated. The tests used to analyze the data were one-way ANOVA, paired sample t-test, and repeated measures ANOVA. Six dependent variables (assaults-frequency, PRNs-frequency, Q15s-frequency, Q15s-duration, and ASI Family/Social scores) were found significant, and in support of the hypotheses. For assaults and PRNs, Bonferroni post hoc tests showed significant differences of PRNs among all three groups. However, although assaults in the nonintegrated group were statistically larger than those in the crossover and the integrated treatment groups, no significant differences were found in the frequency of assaults between the integrated and crossover groups. ASI Psychiatric scores were not significantly different among the three groups since there were similar increases in scores upon discharge. The results indicate that an integrated treatment approach produces better outcomes for dually diagnosed patients.

LLU Discipline

Psychology

Department

Psychology

School

Graduate Studies

First Advisor

Louis Jenkins

Second Advisor

Nick Andonov

Third Advisor

Matt Riggs

Degree Name

Master of Arts (MA)

Degree Level

M.A.

Year Degree Awarded

2006

Date (Title Page)

6-2006

Language

English

Library of Congress/MESH Subject Headings

Substance-Related Disorders -- prevention and control; Mental Health Services -- methods; Community Mental Health Centers; Mental Disorders; Psychotic Disorders; Psychoses, Substance-Induced

Type

Thesis

Page Count

xi; 76

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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