The applicant will serve as principal investigator on three projects: a) Psychotherapy Disorders in Cocaine Abusers, b) Psychotherapy and Pharmacotherapy for Cocaine Abuse, and c) A Field Trial of DSM-III-R Substance Use Disorders. The first project is a survey of psychiatric diagnosis, addictive behaviors, family psychiatric history, and substance related disabilities in 450 cocaine abusers.
The aims of the study are to: a) assess the significance of assessment methods for use with cocaine abusers, and b) to assess clinical correlates of cocaine abuse. The second project is a randomized clinical trial of four treatments in 120 ambulatory cocaine abusers: a) Relapse Prevention, a cognitive-behavioral approach, b) Interpersonal Psychotherapy, a short-term psychodynamic approach, c) Desipramine plus Clinical Management, a pharmacological intervention, and d) Placebo plus Clinical Management. The third project includes 4 studies to assess reliability and validity of DSM-III-R substance use disorders. Study 1 is a survey and 1 year follow-up study of 6 clinical and non-clinical groups using questionnaires which are designed to obtain sufficient information on substance use to allow diagnoses to be made with a variety of systems (e.g., DSM-III-R, ICD-10). This study will provide data to assess the different systems' diagnostic concordance, reliability and several types of validity. Study 2 will compare diagnoses made from a single interview with those made by expert clinicians on the basis of longitudinal evaluations and of information received from multiple sources. Study 3 will assess concurrent validity of self-reported diagnostic criteria by comparing these ratings to data obtained from laboratory studies of human drug self-administration. Study 4 will consist of secondary analysis of data obtained from a field trial of the Structured Clinical Interview for DSM-III and from the NIDA- sponsored National Household Survey on Drug Abuse.
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