Prosocial/other-oriented behavior - physical and psychological benefits: 1-13

Increased longevity14

Reduced psychological distress15

Reduced depression16,17

Higher self-esteem18

Fewer prosocial behaviors today than prior generations19,20

Fewer prosocial behaviors observed in substance dependent (SD) youth than normative youth21

Self-absorption theorized root cause of addiction22

Lack of empiricism supporting lower prosocial behaviors in adults with SD23-25

INTRODUCTION

Clinical Sample: Adults from IOP

43 adults (Age 20-82)

Inclusion Criteria: (1) at least 18 years; (2) stable address and telephone; (3) informed consent; (4) intensive outpatient status; (5) medically detoxed; (6) DSM-IV diagnostic criteria for at least one substance use disorder; (7) no major, chronic health problem other than AOD use; (8) not currently suicidal/ homicidal; and (9) English speaking

90-minute baseline interviews conducted within initial two weeks of treatment

Participants compensated $10

Approved by Case Medical Center University Hospitals Institutional Review Board

Data collected from January 2007- June 2008

Normative Sample: Adults from 2002 General Social Survey (GSS)

43 adults (Age 20-82)

Inclusion criteria: 1) resident of US household population; 2) aged 18 years and older; and 3) English or Spanish speaking

Participants not compensated

All research activities approved by NORC’s IRB

Data collected in 2002

SAMPLES AND PROCEDURES

First study providing empirical support for narcissism as root of illness 22

Study replicates prior work with SD youth21

Overall, SD adults engage in fewer prosocial behaviors than normative adults

Specifically, SD adults give less money to the homeless and charity

In contrast with SD youth, less volunteerism observed with SD adults

Differences observed beyond cohort or influence due to age and gender

Consideration of lower prosocial behaviors at intake and treatment planning important

CONCLUSIONS

FUTURE STUDIES

Replication with a larger, randomized controlled trial warranted

Explore consequences of link between low prosocial behaviors and poor treatment outcomes, also consequences of increased prosocial behavior and prognosis

LIMITATIONS

Cross-sectional comparison

Results may not generalize to less acute populations with addiction

STATISTICAL ANALYSIS

SAS version 9.2 (SAS Institute Inc., 2008)

Quasi-experimental design: Groups matched by age and gender

Kruskal-Wallis Chisq-Square Test for continuous variables

Two-side alpha p <.05

MEASURES

Demographic characteristics

Legal history: Treatment Services Review (TSR)26

Prosocial behaviors: General Social Survey (GSS)27

Substance Use Disorders: DSM-IV-TR (MINI-Plus)28, 29

Acknowledgements: This study was supported in part by a grant award (K01 AA015137) from the NationalInstitute on Alcohol Abuse and Alcoholism (NIAAA) and a grant award (#13591) from the John TempletonFoundation to Dr. Pagano. The authors thank Addiction Recovery Services, a treatment provider in the CaseMedical Center University Hospitals, for their assistance in the data collection. Analysis and poster preparationwere supported by the Department of Psychiatry, Division of Child Psychiatry at Case Western ReserveUniversity, Cleveland, OH. The authors and presenters report no other financial support or affiliations todisclose.

OBJECTIVE

To compare prosocial behaviors in adult subjects with and without addiction

COMPARISON OF PROSOCIAL BEHAVIORS AMONGST ADULTS WITH AND WITHOUT SUBSTANCE DEPENDENCY

Rebecca Carter, B.A., CCRP, Shannon Johnson, B.A., & Maria E. Pagano, Ph.DDepartment of Psychiatry, Case Western Reserve/Case Medical Center University Hospitals, Cleveland OH

TABLE 3: COMPARISON OF GSS ITEMS BETWEEN CLINICAL AND NORMATIVE SAMPLES

SD adults less giving:

1. Total Score (p <.01)

2. Money to charity (p <.001)

3. Food or money to the homeless (p <.0001)

4. Volunteer work (p <.001)

Notes:1. Altruism Module from the General Social Survey 20022. Substance Dependency Disorder3. Items range from 1 (once a week or more)

to 6 (never)4. Over past 12 months5. Household = plants/mail/pets6. P-Values:

* p< .05** p< .01*** p< .001**** p< .0001

Altruism1 Items3 Assessed 4 Total Adults (Normative) Adults with Substance Dependency2

N= 86 (100%) N=43 (50%) N=43 (50%)

Donate Blood (M, SD) 5.79 (.53) 5.77 (.53) 5.81 (.55)

Donate Money to Charity (M, SD) 3.97 (1.25) 3.53 (1.14) 4.40 (1.22)***

Donate Food/Money to Homeless (M, SD) 3.99 (1.5) 3.44 (1.20) 4.53 (1.50)****

Looked After Neighbor's Household5 (M, SD) 4.90 (1.30) 4.95 (1.02) 4.84 (1.54)

Community Service (M, SD) 4.69 (1.43) 4.16 (1.50) 5.21 (1.17)***

Carried Stranger's Belongings (M, SD) 4.41 (1.66) 4.44 (1.56) 4.37 (1.76)

Total Score (M, SD) 27.73 (4.61) 26.30 (3.58) 29.16 (5.09)**

RESULTS

70% current alcohol dependency, 67% current substance dependency, and 37% current narcotics dependency

60% smokers

Notes:1. Meeting DSM-IV diagnostic criteria as measured by

MINI-PLUS2. Defined as: Smoking at least 1 cigarette prior to IOP

Substance Dependency Disorder1

Type: Total (N, %)

AlcoholCurrent 30 (70%)Lifetime 31 (72%)

DrugCurrent 29 (67%)Lifetime 33 (77%)

Stimulant Dependency Current 2 (5%)Lifetime 9 (21%)

Cocaine DependencyCurrent 11 (26%)Lifetime 17 (40%)

Narcotics DependencyCurrent 16 (37%)Lifetime 19 (44%)

Hallucinogens DependencyCurrent 1 (2%)Lifetime 3 (7%)

Inhalants DependencyCurrent 0 (0%)Lifetime 1 (2%)

Marijuana DependencyCurrent 6 (14%)Lifetime 12 (28%)

Tranquilizers DependencyCurrent 6 (14%)Lifetime 8 (19%)

Misc. DependencyCurrent 0 (0%)Lifetime 1 (2%)

Nicotine Use2 Current 26 (60%)

Total number of SSD (M, SD) 2.49 (1.47)

TABLE 2: SUBSTANCE USE DEPENDENCY (SUD) STATUS OF CLINICAL SAMPLE

Average age: 42.8 years (SD = 14.6)

51% female, 58% single, 30% with college education

23% African-American

37% parole/probation history

35% physical abuse history, 33% sexual abuse history

Notes:1. Within the past 24 months2. Subjects completed a 5 day partial hospitalization

program, then were admitted into an intensive outpatient program lasting six weeks on average

3. Clinical Sample Size: N=43

Background Variable Categorical Level Total3 (N, %)Age at treatment M(SD) 42.8 (14.6)

Gender Female (%) 22 (51%)

Minority African American (%) 10 (23%)

Marital Status Single 25 (58%)

Non-Single 18 (42%)

Learning disability Yes (%) 3 (7%)

Years of Education 8th grade or less 1 (2%)

Partial high school 2 (5%)

HS diploma/GED 13 (30%)

Some college 14 (33%)

BA+ 6 (14%)

Graduate School 7 (16%)

History of Jail/Incarceration1 Yes (%) 14 (33%)

History of Parole/Probation1 Yes (%) 16 (37%)

Suicide History Yes (%) 4 (10%)

Sexual Abuse History Yes (%) 11 (28%)

Physical Abuse History Yes (%) 14 (35%)

TABLE 1: CLINICAL SAMPLE