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| ID | Type | Description | Link |
|---|---|---|---|
| K23DA027720 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute on Drug Abuse (NIDA) | NIH |
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Substance use among criminal offenders constitutes a major public health problem and is tied to negative consequences for offenders, their families, and their communities. One of the direst of these consequences is repeated incarceration; thus, interventions that reduce criminal recidivism are needed. Forensic populations are often viewed with considerable therapeutic pessimism. However, offenders exhibit heterogeneity in personality traits, and the assessment of individual differences among offenders may provide valuable information that guides the use of psychotherapeutic interventions. Among offenders, psychopathy has emerged as an important personality construct for the understanding of violence and criminal recidivism. Moreover, core traits of psychopathy such as lack of empathy, deceitfulness, and lack of remorse may have negative implications for the efficacy of psychosocial interventions. A foundational premise of the present work is that understanding the moderating role of psychopathic traits on substance use treatment outcomes among offenders is essential to determining what works, and for whom. The current proposal is a Phase II randomized clinical trial that aims to examine the impact of psychopathic traits on the efficacy of a brief substance use intervention for offenders in a jail diversion program. Hypotheses that will be examined include: 1) that a Motivational Interviewing (MI) - based treatment will reduce substance use and related consequences relative to a Standard Care only condition, 2) that the reduction in substance use in the intervention group will mediate a reduction in later criminal recidivism relative to the Standard Care condition, and 3) that core psychopathic traits will moderate the efficacy of the intervention such that individuals with lower levels of these traits will derive greater benefits with regard to decreased substance use, decreased drug use consequences, and decreased criminal recidivism at a one-year follow-up.
Substance use among criminal offenders constitutes a major public health problem and is tied to negative consequences for offenders, their families, and their communities. One of the direst of these consequences is repeated incarceration; thus, interventions that reduce criminal recidivism are needed. Forensic populations are often viewed with considerable therapeutic pessimism. However, offenders exhibit heterogeneity in personality traits, and the assessment of individual differences among offenders may provide valuable information that guides the use of psychotherapeutic interventions. Among offenders, psychopathy has emerged as an important personality construct for the understanding of violence and criminal recidivism. Moreover, core traits of psychopathy such as lack of empathy, deceitfulness, and lack of remorse may have negative implications for the efficacy of psychosocial interventions. A foundational premise of the present work is that understanding the moderating role of psychopathic traits on substance use treatment outcomes among offenders is essential to determining what works, and for whom. The current proposal is a Phase II randomized clinical trial that aims to examine the impact of psychopathic traits on the efficacy of a brief substance use intervention for offenders in a jail diversion program. Hypotheses that will be examined include: 1) that a Motivational Interviewing (MI) - based treatment will reduce substance use and related consequences relative to a Standard Care only condition, 2) that the reduction in substance use in the intervention group will mediate a reduction in later criminal recidivism relative to the Standard Care condition, and 3) that core psychopathic traits will moderate the efficacy of the intervention such that individuals with lower levels of these traits will derive greater benefits with regard to decreased substance use, decreased drug use consequences, and decreased criminal recidivism at a one-year follow-up. This work has the potential to provide important data regarding which individuals can benefit from a brief intervention for substance use. Such data will inform the effective and efficient allocation of treatment resources for substance using offenders.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| brief therapy | Experimental | motivational enhancement therapy for substance use |
|
| Standard Care | Placebo Comparator | standard care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| motivational enhancement therapy | Behavioral | Four 45-minute MET sessions |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percent Days Abstinent Per Month From Drug Use | Using timeline followback data, frequency of substance use was assessed for months three through six and presented as average percent days abstinent per month. | three to six months post baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Shortened Inventory of Problems With Alcohol and Drugs (SIP-AD) | A measure of consequences of drug and alcohol use across several domains (e.g., social, work, health), SIP-AD scores range from 0-45, with higher scores indicating higher levels of substance use consequences. | six months |
| New Criminal Charge |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marc T. Swogger, Ph.D. | University of Rochester | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pretrial Services, Inc. | Rochester | New York | 14642 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26727409 | Result | Swogger MT, Conner KR, Caine ED, Trabold N, Parkhurst MN, Prothero LM, Maisto SA. A test of core psychopathic traits as a moderator of the efficacy of a brief motivational intervention for substance-using offenders. J Consult Clin Psychol. 2016 Mar;84(3):248-58. doi: 10.1037/ccp0000065. Epub 2016 Jan 4. |
| Label | URL |
|---|---|
| PI web page | View source |
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Inclusion criteria were harmful substance use in the past 6 months and enrollment in a jail diversion program subsequent to being charged with a crime.
Recruitment took place at a jail diversion program in Upstate NY between 2009 and 2014.
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| ID | Title | Description |
|---|---|---|
| FG000 | Brief Therapy | motivational enhancement therapy for substance use motivational enhancement therapy: Four 45-minute MET sessions |
| FG001 | Standard Care | standard care standard care: standard care |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Participants were adults in an urban pretrial jail diversion program in Upstate New York recruited between 2009 and 2014 subsequent to being charged with a crime.
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| ID | Title | Description |
|---|---|---|
| BG000 | Brief Motivational Intervention Plus Standard Care (BMI+SC) | Brief Motivational Intervention plus Standard Care; Individuals received up to 4 intervention sessions plus assessment and the usual range of services provided by Monroe County Pretrial |
| BG001 | Standard Care (SC) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent Days Abstinent Per Month From Drug Use | Using timeline followback data, frequency of substance use was assessed for months three through six and presented as average percent days abstinent per month. | 105 adults (68 men and 37 women) were recruited in an urban pretrial jail diversion program. 78 (74.3%) were retained through six months. Of these, 73 were out of controlled environments (e.g., jail, inpatient treatment) for long enough to have their substance use data analyzed. | Posted | Mean | Standard Deviation | percentage of days abstinent | three to six months post baseline |
|
Six months from baseline
Criminal recidivism is not considered an adverse event because it is one of the outcome variables. Participants were monitored for serious adverse events through six months of the study (i.e., the last study-related session). There were no adverse events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Brief Motivational Intervention Plus Standard Care | There were no adverse events for members of this group. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Marc T. Swogger, Ph.D. | University of Rochester | 585-275-7418 | marc_swogger@urmc.rochester.edu |
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| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| D000987 | Antisocial Personality Disorder |
| D000075665 | Recidivism |
| ID | Term |
|---|---|
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
| D010554 | Personality Disorders |
| D000066479 | Criminal Behavior |
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| ID | Term |
|---|---|
| D062405 | Motivational Interviewing |
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D037001 | Directive Counseling |
| D003376 | Counseling |
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
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| standard care | Other |
|
New criminal charge vs. no new criminal charge at follow-up as indicated by county database. |
| one year |
Standard Care: Individuals received assessment only, plus the usual range of services provided by Monroe County Pretrial |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Psychopathy Checklist-Revised - Factor One (F1) | The Psychopathy Checklist - Revised is a valid measure of psychopathy with scores ranging from 0-40 (higher indicating higher levels of psychopathy). Factor One of this scale measures interpersonal and affective psychopathic traits and ranges from 0-16. | Mean | Standard Deviation | units on a scale |
|
Assessment only plus the usual range of pretrial services
|
|
|
| Secondary | Shortened Inventory of Problems With Alcohol and Drugs (SIP-AD) | A measure of consequences of drug and alcohol use across several domains (e.g., social, work, health), SIP-AD scores range from 0-45, with higher scores indicating higher levels of substance use consequences. | Posted | Mean | Standard Deviation | units on a scale | six months |
|
|
|
|
| Secondary | New Criminal Charge | New criminal charge vs. no new criminal charge at follow-up as indicated by county database. | Posted | Number | participants | one year |
|
|
|
|
| 0 |
| 53 |
| 0 |
| 53 |
| EG001 | Standard Care | There were no adverse events for members of this group. | 0 | 52 | 0 | 52 |
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| D001519 | Behavior |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |