The purpose of this dissertation is to examine the role internalized shame and Post Traumatic Stress Disorder (PTSD) play in the treatment outcomes of people in methadone programs. Clients at two methadone treatment sites were surveyed with Cook's Shame Scale and the MEMPI PK and PS sub-scales for PTSD. Over 63%—ten times that found in the general population and two and a half times the frequency found in other chemically dependent populations—tested for PTSD, which is often passed over as a generalized anxiety disorder. The study showed that the symptoms of PTSD, internalized shame and low self-esteem are highly intercorrelated in this population. The study also showed that there is a strong relationship between internalized shame and PTSD test scores, methadone dose levels, are predictors and the frequency of drug use, frequency which are treatment outcome variables. Secondary findings show that there is a correlation between sexual abuse, age of first drug use, shame and PTSD scores. Internalized shame, PTSD PS Scale scores and race also showed some trends. These findings, along with research on the biochemical effects of not only chemical dependency, but also of trauma and internalized shame support the understanding that PTSD and internalized shame do play a role in affecting treatment outcomes. Research in related fields describe biochemical feedback loops created by responses to trauma and the biochemistry of chemical dependency. These feedback loops are perpetuated and exacerbated by continued drug use and untreated trauma symptomology. The resultant biochemical deficiencies can be stabilized and replenished through time when direct interventions are made on the physical, behavioral and emotional levels of treatment. Methadone, while helping to decrease the use of heroin, may actually contribute to furthering the progression of chemical dependency and block treatment of PTSD by covering symptoms which when addressed could lessen or resolve and improve treatment outcomes. Further studies, which find ways to examine and measure these different aspects of trauma, internalized shame and PTSD need to be designed to understand more clearly how these conditions affect various outcome variables. A variety of therapeutic modalities which focus on overall wellness and recovery can be used and tested to design comprehensive treatment. Hopefully, this study will begin to build a bridge between conventional methadone treatment—which uses behavioral modification and drug replacement therapies—with the exciting new findings in neurobiochemistry.
| Identifer | oai:union.ndltd.org:UMASS/oai:scholarworks.umass.edu:dissertations-3232 |
| Date | 01 January 1999 |
| Creators | Paddy, Lizbeth L |
| Publisher | ScholarWorks@UMass Amherst |
| Source Sets | University of Massachusetts, Amherst |
| Language | English |
| Detected Language | English |
| Type | text |
| Source | Doctoral Dissertations Available from Proquest |
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