Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

The purpose of the current study was to classify adolescents receiving outpatient treatment for alcohol or other drug (AOD) problems via self-reports of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. American Psychiatric Association, 1994) psychiatric symptoms, and to identify group differences in measures of proximal risk factors for sexual risk behaviors (SRBs) and self-reported SRBs. Structured interviews were administered to 300 adolescent clients (202 males, 98 females; M = 16.22 years; SD = 1.13) receiving treatment services as part of a larger National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded randomized clinical trial. Ward's method cluster analysis (Ward, 1963) was used to classify adolescents into distinct groups based on psychiatric symptom profiles. A multivariate analysis of variance was used to identify significant between-cluster differences in self-reported SRBs and proximal risk factors for SRB. Substantial heterogeneity in patterns of psychiatric symptoms was documented in this treatment sample. Membership in certain psychiatric symptom clusters was associated with several self-reported SRBs and correlated proximal risk factors. Among youth receiving AOD treatment, interventions to promote HIV/STI risk reduction may need adaptation for those with differing psychiatric profiles.