Dual diagnosis patients in substance abuse treatment: relationship of general coping and substance-specific coping to 1-year outcomes

Addiction. 1999 Dec;94(12):1805-16. doi: 10.1046/j.1360-0443.1999.941218056.x.


Aims: This study examined general and substance-specific coping skills and their relationship to treatment climate, continuing care and 1-year post-treatment functioning among dual diagnosis patients (i.e. co-occurrence of substance use and psychiatric disorders).

Design: In a prospective multi-site study, dual diagnosis patients participating in substance abuse treatment were assessed at intake, discharge and at a 1-year follow-up.

Setting: Patients were recruited from 15 substance abuse treatment programs, which were selected from a larger pool of 174 inpatient treatment programs in the Department of Veterans Affairs Health Care System.

Participants: A total of 981 male dual diagnosis patients participated in the study.

Measurements: Assessments included general and substance-specific coping skills, treatment climate, continuing outpatient care, abstinence and clinically significant psychiatric symptoms.

Findings: Dual diagnosis patients modestly improved on general and substance-specific coping skills over the 1-year follow-up period. Patients who were in programs with a 'dual diagnosis treatment climate' and who participated in more 12-Step self-help groups showed slightly more gains in adaptive coping. Both general and substance-specific coping were associated with abstinence, but only general coping was associated with freedom from significant psychiatric symptoms.

Conclusions: Enhancing general and substance-specific coping skills in substance abuse treatment may reduce dual diagnosis patients' post-treatment substance use and improve their psychological functioning.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Diagnosis, Dual (Psychiatry)
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / psychology*
  • Mental Disorders / therapy
  • Prospective Studies
  • Substance-Related Disorders / psychology*
  • Substance-Related Disorders / therapy
  • Surveys and Questionnaires