Senior Scientist Awards (K05)

Effective Ingredients of Behavioral Therapies for Drug Abuse

This project is the current stage of an ongoing program of research on testing psychosocial treatments for substance use disorders that goes back to 1976 when a research group at the University of Pennsylvania began to work together on this topic. The research group includes: A. Thomas McLellan, George Woody, Charles O'Brien and Lester Luborsky. This collaboration has resulted in nine contributions so far for substance abuse treatments that are related to this project.

Dr. Luborsky's major aim is to continue to work on completion of the NIDA Cocaine Collaborative Study. In study 1, data is being examined for predictive factors mainly by means of regression equations against outcome measures. In study 1 the randomization of subjects has been completed and the last patients entered into the study are being treated. The patients who are still in treatment are being followed with monthly assessments. Another aim is to continue involvement in the NIDA Collaborative Study which involves the development and testing of therapeutic alliance measures.

Another aim is to do a comparative psychotherapy trial examining Supportive-Expressive Psychotherapy (SE) and Individual Drug Counseling (IDC) treatments, plus adjunctive behavioral reinforcement for HIV positive, cocaine dependent women. This study has two primary aims: 1) to develop an effective treatment program for substance abusing women who are seropositive for the HIV virus and 2) to examine possible predictors of relapse within the content of the therapy sessions, first for SE therapy and then for CT and IDC sessions. The relationship of in-session predictors of relapse and therapeutic alliance will also be examined.

Diagnosis & Treatment of Substance Use Disorders

This Research Scientist Award will enable the candidate to pursue full-time research aimed at improving diagnostic and psychosocial treatment strategies for drug abusers. Dr. Rounsaville will conduct research projects of three types: a.) clinical trials to assess the efficacy of promising psychosocial interventions, b.) projects to improve methods of classifying substance abusers with the particular aim of defining clinically meaningful subgroups, and c.) family/genetic studies assessing rates and patterns of substance use disorders and psychopathology in the relatives of substance abusers. This project is aimed at a promising area in the diagnosis of drug abusers: psychiatric comorbidity, specifically DSM-III R/DSM-IV Axis II (Personality) disorders. This study will 1. Extend data analyses from the first study period, particularly in the areas of characterizing drug use severity and screening for drug abuse, 2. Give a comprehensive battery of assessments to determine rates of Personality Disorders and their clinical correlates in a.) a variety of clinical samples of substance abusers and b.) demographically matched community controls, 3. Assess several aspects of reliability and validity of differing systems and methods for diagnosing Personality Disorders/Dimensions in substance abusers, 4. Apply and evaluate methods to enhance the reliability and validity of existing instruments for diagnosing Personality Disorders/Dimensions in substance abusers, and 5. Evaluate the associations among different Personality Disorders in substance abusers and seek underlying dimensions of personality pathology in this special population.

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