A latent profile analysis of substance use and post-traumatic stress on substance use treatment outcomes among people involved with the justice system

Abstract

The present study used a person-centered analysis to classify legally-involved persons in substance use treatment into mutually exclusive groups based on their clinical presentation of substance use and post-traumatic stress. Predictors of group membership were tested, and group classification was evaluated as a predictor of progress in substance use treatment, defined using participants’ self-reported treatment engagement. Rearrest rates in the 4 years following treatment were evaluated as a function of group membership. The results showed that there was a signficant amount of variability in participants’ substance use and post-traumatic stress symptomology at the start of treatment. Psychological distress was the primary predictor of group classification and profile membership was differentially related to participants’ self- reported treatment engagement. Changes in treatment engagement did not mediate the relationship between profile membership and recidivism in the 4 years following treatment. These results can be used to inform screening tools, assessment protocols, and adaptive treatment models to better serve people involved with the legal system experiencing comorbid difficulties with substance use and post-traumatic stress.