Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three-year follow-up data and predictive validity




Charlotte Alm, Åsa Eriksson, Natalie Durbeej, Tom Palmstiern, Anne H. Berman, Marianne Kristiansson & Clara Hellner Gumpert

Mental Health and Substance Use

27 Feb 2014



Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.