Browsing by Author "Rattermann, Mary Jo"

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    Individual factors predict substance use treatment course patterns among patients in community-based substance use disorder treatment
    (Public Library of Science, 2023-01-12) Argyriou, Evangelia; Bakoyannis, Giorgos; Wu, Wei; Rattermann, Mary Jo; Cyders, Melissa A.; Psychology, School of Science
    Background and objectives: Substance use disorders (SUDs) usually involve a complex natural trajectory of recovery alternating with symptom reoccurrence. This study examined treatment course patterns over time in a community SUD clinic. We examined depressive symptoms level, primary SUD assigned at each admission, and lifetime misuse of multiple substances as potential risk factors for premature treatment termination and subsequent treatment readmission. Methods: De-identified longitudinal data were extracted from charts of 542 patients from an SUD treatment center. Survival analysis methods were applied to predict two time-to-event outcomes: premature treatment termination and treatment readmission. Results: Primary opioid (vs alcohol) use disorder diagnosis at admission was associated with higher hazard of premature termination (HR = 1.91, p<0.001). The interaction between depressive symptoms level and substance use status (multiple vs single use) on treatment readmission was significant (p = 0.024), such that higher depressive symptoms level was predictive of readmission only among those with a history of single substance use (marginally significant effect). Lifetime use of multiple (vs single) substances (HR = 1.55, p = 0.002) and age (HR = 1.01, p = 0.019) predicted increased hazard of readmission. Conclusions: Findings did not support a universal role for depressive symptoms level in treatment course patterns. Primary SUD diagnosis, age, and history of substance misuse can be easily assessed and incorporated into treatment planning to support SUD patients and families. This study is the first to our knowledge that afforded a stringent test of these relationships and their interactions in a time-dependent, recurrent event, competing risks survival analysis examining both termination and readmission patterns utilizing a real-world clinic-based sample.
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    Mapping recovery: A qualitative node map approach to understanding factors proximal to relapse among adolescents in a recovery high school
    (Elsevier, 2022-07) Whitt, Zachary T.; Sturgeon, Taylor; Rattermann, Mary Jo; Salyers, Michelle; Zapolski, Tamika; Cyders, Melissa A.; Psychology, School of Science
    Introduction Despite data suggesting that recovery high schools are largely effective in reducing substance use, relapse in these settings is common. The goal of the current study was to characterize factors proximal to relapse among adolescents in a local recovery high school. Method Data for this study were 200 de-identified node maps (i.e., graphical break downs of a relapse event; randomly chosen from 600 available node maps) from the charts of students at a local recovery high school in a large Midwest city (Mean Age = 16.8 ± 1.9 years, 64.1% male, 89.1% White). A four-phase process of qualitative data sorting examined features most frequently described in relapse episodes. Results The most common elements reported were using with others ( n = 153, 76.5%), away from home ( n = 156, 78.0%), and in response to negative affect ( n = 93, 48.4%). Six relapse pathways emerged: coping ( n = 30), acting out (n = 15), unexpected temptation (n = 30), planned lapse ( n = 19), resistant to recovery ( n = 27), and passive agency (n = 30). The pathways identified represent three critical failures in the recovery system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these system failures can contribute to increased rapport and engagement, as well as planning for detailed and specific factors proximal for relapse for any given individual, both on the individual and system levels. Conclusion The use of node maps aligned with previous work, showed good face and content validity, can be used to reduce blame and increase engagement in substance use treatment among adolescents, and produced novel micro-frames with new vocabulary to accurately understand common factors associated with relapse among adolescents.
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    Mixed methods prospective findings of the initial effects of the U.S. COVID-19 pandemic on individuals in recovery from substance use disorder
    (Public Library of Science, 2022-07-01) Shircliff, Katherine; Liu, Melissa; Prestigiacomo, Christiana; Fry, Melissa; Ladd, Kevin; Kannapel Gilbert, Misty; Rattermann, Mary Jo; Cyders, Melissa A.; Psychology, School of Science
    The beginning of the U.S. COVID-19 pandemic interrupted integral services and supports for those in recovery from substance use disorders. The current study used qualitative and quantitative data to identify 1) pandemic-related barriers/stressors, 2) coping strategies employed, and 3) how the stressors and strategies predicted subsequent substance use frequency. Participants were 48 adults (40.5% female; 90.2% White) between 26 and 60 years old (M = 42.66, SD = 8.44) who were part of a larger, multi-year longitudinal study of individuals in recovery from substance use disorders. Individuals completed two interviews, one during the six weeks of initial stay-at-home orders in the state in which data were collected and the second within six to twelve months of their initial interview. Common barriers to recovery included cancelled support meetings, changes in job format (i.e., being fired or furloughed), and lack of social support. Common coping strategies included self-care, leisure activities/hobbies, taking caution against exposure, and strengthening personal relationships. The relationship between cravings at baseline and substance use at follow up was stronger for those who experienced worsening of their mental health (B = 21.80, p < .01) than for those who did not (B = 5.45, p = 0.09), and for those who were taking caution against exposure (B = 24.57, p < .01) than for those who were not (B = 1.87, p = 0.53). Those who engaged in self-care (B = 0.00, p>.99) had lower rates of substance use at follow-up than those who did not employ self-care as a coping mechanism (B = 16.10, p < .01). These findings inform research priorities regarding prospective effects of the pandemic on treatment endeavors, particularly emphasizing treating mental health and encouraging self-care strategies.
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    Young people in recovery from substance use disorders: an analysis of a recovery high school's impact on student academic performance & recovery success
    (2017-12-18) Knotts, Adam Christopher; Stone, Cynthia; Dixon, Brian; Harle, Chris; Pfeifle, Bill; Rattermann, Mary Jo
    The purpose of this dissertation was to produce knowledge on the academic performance and recovery success of students enrolled in a Recovery High School. The study site was Hope Academy, located in Indianapolis, IN, and at the time of this publication, one of just five schools in the U.S. accredited by the Association of Recovery Schools. Students enrolled between Fall 2010 and Spring 2017 were evaluated using academic test scores (NWEA-MAP), a measure of recovery success (GAIN-SS), as well as key informant interviews with 13 students and five staff members. It was concluded that recovery school students displayed similar levels of academic growth when compared to a nationallyrepresentative matched Virtual Comparison Group, t-stat = +0.849 (p=0.397). This finding provides evidence that even after experiencing a relapse, recovery school students were capable of achieving similar levels of academic growth as their peers not in recovery from substance use disorders. Interview participants provided more context to the quantitative findings with first-hand accounts of the impact the recovery school had on students.