Impairments across domains

Impairments across domains

Impairments across domains

Discuss impairments across domains

Discussion: Identifying Addiction Issues

Discussion: Identifying Addiction Issues

As has been discussed previously, the DSM-5 saw substantial changes to the diagnoses associated with addiction. In fact, it could be argued that the new diagnostic structure in the substance-related and addiction section better serves the treatment process, as it focuses in functional impairments across domains, rather than specific quantities of use. As such, it also supports a more strength-based, wellness perspective, as the client’s overall health and individual experience are key aspects of diagnosis.

Such a focus is also the case with the commonly used screening and assessment tools. It is important for counselors to be well versed in the use of instruments, and to understand the strengths and limitations of each.

For this Discussion, after reviewing Chapter 7 of your text, you will select two assessment tools discussed on pages 300-302. Use the Walden Library to find at least one peer-reviewed article discussing the utilization and reliability for each instrument selected.

Post by Day 4 a brief description of the two assessment tools you selected and application. Then, describe one strength and one shortcoming of each, using specific examples to illustrate your points. Lastly, describe how the assessment tool might be used to support a provisional diagnosis of a substance-related or addictive disorder.

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Be sure to support your postings and responses with specific references to the Learning Resources.

Required Resources

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.
Chapter 7, “Screening and Assessment” (pp. 295-311)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
“Substance-Related and Addictive Disorders” (pp. 481–589)
One hundred thirteen patients (mean age 49 years; 68% women) were evaluated 3 months after SAH. Three simple tests of global mental status and neuropsychological tests to assess seven specific cognitive domains were administered. Four aspects of outcome (global handicap, disability, emotional status, and QOL) were compared between cognitively impaired and unimpaired patients with analysis-of-covariance models controlling for age, race/ethnicity, and education. Multiple linear regression was used to evaluate the relative contribution of global and domain-specific cognitive status for predicting concurrent modified Rankin Scale (mRS) and Sickness Impact Profile (SIP) scores.
RESULTS:
Impairment of global mental status on the Telephone Interview of Cognitive Status (TICS) was associated with poor performance in all seven cognitive domains (all p < 0.0005) and was the only cognitive measure associated with poor recovery in all four aspects of outcome (all p < or = 0.005). Cognitive impairment in four specific domains was also associated with functional disability or reduced QOL. After accounting for global cognitive impairment with the TICS, however, neuropsychological testing did not contribute additional predictive value for concurrent mRS or SIP total scores.