Cohn Amy, Najavits Lisa M
Psychiatr Serv. 2014 Apr 1;65(4):504-10. doi: 10.1176/appi.ps.201300005.
Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders.
This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services.
Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility.
Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.
遭受家庭暴力和实施家庭暴力均与同时出现的精神障碍和物质使用障碍有关。
本研究使用了来自全国物质滥用治疗服务调查的数据,以考察13342家物质滥用治疗机构在是否提供家庭暴力服务方面,在组织因素、所提供的治疗方法以及客户层面因素上的差异。
只有36%的机构提供家庭暴力服务。提供此类服务的机构比未提供此类服务的机构更有可能治疗同时患有多种疾病的客户。主成分分析将八种治疗方法归纳为两个因素:心理社会服务和传统物质滥用服务。回归模型表明,提供心理社会服务的频率取决于该机构中正在接受治疗的同时患有多种疾病的客户的比例,以及该机构是否提供家庭暴力服务。具体而言,与提供家庭暴力服务的机构相比,不提供家庭暴力服务且同时患有多种疾病的客户比例较高的机构更有可能提供心理社会服务。与不提供家庭暴力服务的机构相比,提供家庭暴力服务的机构中有更大比例提供传统物质滥用治疗服务,但这种关系并不取决于每个机构中同时患有多种疾病的客户的比例。
应做出更大努力,调整治疗方法以适应家庭暴力、精神障碍和物质滥用之间的联系。