A Latent Class Analysis of Psychopathology Among Adults in Residential Substance Use Treatment: Associations With Craving and Treatment Dropout.

Abstract

Objective: Adults receiving residential treatment for substance use disorders (SUDs) who have comorbid psychopathology face unique challenges, including an increased risk of substance use craving and treatment dropout against medical advice (AMA). Prior studies have investigated associations between specific forms of psychopathology and these outcomes. However, psychological disorders often co-occur and may cluster together to amplify risk for craving and treatment dropout AMA.

Methods: This study used latent class analysis to identify patterns of psychopathology in 1046 adult patients receiving residential treatment for SUDs (73.7% men; M_age  = 42.31, SD = 12.13). We tested whether psychopathology classes differed in alcohol and drug cravings and treatment dropout AMA. We identified 4 latent classes: (1) high psychopathology, (2) moderate anxiety/depression, (3) illness anxiety/somatic problems, (4) low psychopathology.

Results: The high psychopathology class reported significantly more alcohol and drug cravings than all other classes. The moderate anxiety/depression class also reported more alcohol cravings than the low psychopathology class. Additionally, the high psychopathology, illness anxiety/somatic problems, and moderate anxiety/depression classes had higher proportions of patients who dropped out of treatment AMA compared to the low psychopathology class.

Conclusion: These findings suggest that comorbid psychopathology significantly impacts treatment outcomes in residential SUD treatment programs. Targeted interventions that address comorbid psychopathology may help reduce craving and improve treatment retention.