Date of Degree

5-2015

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor(s)

Elizabeth L. Jeglic

Subject Categories

Clinical Psychology | Psychology

Keywords

addiction severity; insight; mental illness; substance abuse; treatment compliance

Abstract

Approximately 6% of the American population suffers from a severe mental illness such as Schizophrenia, Bipolar Disorder, Major Depressive Disorder, Post-Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. Treatment compliance in individuals with severe mental illness is imperative as without treatment these individuals may experience homelessness, unemployment, and a decreased life expectancy of up to 34 years. Consequently, researchers have increasingly examined factors that may affect overall compliance among these individuals, such as insight, social support, symptom severity, and substance abuse. However, many of these studies focus on compliance with prescribed medications and few examine compliance with recommended psychological treatment. The current study examined the effects of the aforementioned factors on treatment compliance among individuals with severe mental illness and substance use diagnoses. Defendants in an alternative-to-jail program were asked to complete a brief clinical interview and several self-report measures examining insight, perceived social support, psychiatric symptom severity, and substance use. Each individual's record was then examined at 3- and 6-month follow-up periods to determine the number of re-arrests, re-hospitalizations, and program removals they had experienced. Alcohol addiction severity and social support at intake were found to be significant predictors of treatment adherence at six-month follow-up. These findings will be discussed as they pertain to the implications for identifying and understanding the nature of the relationship between the client-centered factors that most directly impact treatment compliance among individuals with severe and persistent mental illness.

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