Denial and Diagnosis of Methamphetamine Dependence Severity

Myra Rice; Andy C Dean; Jaymee Suh; Edythe D London

doi:10.1177/11782218221135721

Denial and Diagnosis of Methamphetamine Dependence Severity

Subst Abuse. 2022 Nov 8:16:11782218221135721. doi: 10.1177/11782218221135721. eCollection 2022.

Authors

Myra Rice¹, Andy C Dean^{2

3}, Jaymee Suh², Edythe D London^{2

3

4}

Affiliations

¹ Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, CA, USA.
² Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
³ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Abstract

Introduction: Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence.

Methods: This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis.

Results: SCID summary scores were negatively correlated with URICA Precontemplation scores (P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems (t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01).

Conclusions: The findings highlight the importance of a patient's insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.

Keywords: Insight; Methamphetamine Dependence; Methamphetamine Use Disorder; URICA Scale; denial; diagnosis.

Abstract

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