Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention

Abstract

Background: Our understanding of the conditions that influence substance abuse treatment retention in urban African American substance users is limited. This study examined the interacting effect of circumstances, motivation, and readiness (CMR) with distress tolerance to predict substance abuse treatment retention in a sample of urban African American treatment-seeking substance users.

Methods: Data were collected from 81 African American substance users entering residential substance abuse treatment facility in an urban setting. Participants completed self-reported measures on CMR and distress tolerance. In addition, participants were assessed on psychiatric comorbidities, substance use severity, number of previous treatments, and demographic characteristics. Data on substance abuse treatment retention were obtained using administrative records of the treatment center.

Results: Logistic regression analysis found that the interaction of CMR and distress tolerance was significant in predicting substance abuse treatment retention. Higher score on CMR was significantly associated with increased likelihood of treatment retention in substance users with higher distress tolerance, but not in substance users with lower distress tolerance.

Conclusions: Findings of the study indicate that at higher level of distress tolerance, favorable external circumstances, higher internal motivation, and greater readiness to treatment are important indicators of substance abuse treatment retention. The study highlights the need for assessing CMR and distress tolerance levels among substance users entering treatment, and providing targeted interventions to increase substance abuse treatment retention and subsequent recovery from substance abuse among urban African American substance users.

Keywords: Minority; Residential treatment dropout; Stages of change; Substance use disorders; Treatment completion.

Figure 1

The relation of circumstances, motivation and readiness (CMR) on substance abuse treatment retention as a function of distress tolerance. Note. DT = Distress Tolerance. All values are standardized. Low distress tolerance is 1 standard deviation below the mean. High distress tolerance is 1 standard deviation above the mean.