ELSEVIER Journal of Substance Abuse Treatment, Vol. 14, No. 4, pp. 351-358, 1997 Copyright © 1997 Elsevier Science Inc. Printed in the USA. All rights reserved 0740-5472/97 $17.00 + .00 PII S0740-5472(97)00005-6 ARTICLE Sexual and Physical Abuse: Do They Compromise Drug Treatment Outcomes? VIRGINIA GIL-RIVAS, MA, ROBERT FLORENTINE, PhD, M. DOUGLAS ANGLIN, PhD, AND ELLISE TAYLOR, BA UCLA Drug Abuse ResearchCenter, NeuropsychiatricInstitute,Universityof California--Los Angeles,Los Angeles, CA USA Abstract-Histories of sexual and physical abuse are frequently reported by individuals participating in substance abuse treatment, these experiences may be associated with psychopathology and poor drug treatment outcomes. This paper presents the findings from a longitudinal study of 330 subjects participat- ing in 26 outpatient treatment programs. Sexual abuse among women was associated with higher levels of depression, anxiety, suicidal ideation, suicide attempts, and PTSD, while physical abuse was associ- ated with fewer psychological disturbances. For men, sexual abuse was associated only with anxiety. Physical abuse was associated with depression, anxiety, suicidal ideation, and PTSD. However, no sig- nificant association was found between sexual and physical abuse, and lower levels of treatment partici- pation or drug use at follow-up. These findings indicate that there is a complex connection between abuse, psychopathology, treatment participation, and relapse. Clinical and research implications of these findings are discussed. © 1997 Elsevier Science Inc. Keywords-sexual and physical abuse; drug use; drug treatment outcomes. HISTORIES OF SEXUAL AND PHYSICAL abuse are fre- quently reported by individuals participating in sub- stance abuse treatment. Among women in drug treat- ment, alarmingly high rates of exposure to physical and sexual abuse are reported. Some studies demonstrate that up to half of them have experienced abuse at some time in their lives (Dunn, Ryan, & Dunn, 1994; Gil-Rivas, Fioren- fine, & Anglin, 1996; Paoene, Chavkin, Willets, Friedmann, & De Jarlais, 1992; Resnick, Kilpatrick, Dansky, Sanders, & Best, 1993; Teets, 1995; Windle, Windle, Scheidt, & Miller, 1995), compared to about one third of the women in This research was supportedby the Centerfor Substance Abuse Treat- ment (OT 90-01) and grants from the National Instituteof Drug Abuse (DA07699, DA00146). We thank Dayna Christou, Linda Katz, and Patti Sheafffor their assistancein conducting the research. Requests for reprints should be addressed to Virginia Gil-Rivas, UCLA NeuropsychiatricInstitute, Drug Abuse ResearchCenter, 1100 Glendon Avenue, Suite 763, Los Angeles, CA 90024. E-mail: vgil @ ucla.edu the general population (Finkelhor, Hotaling, Lewis, & Smith, 1990; Kilpatrick, Edmunds, & Seymour, 1992). For men, the prevalence of victimization is lower, yet signifi- cant, as 3% to 24% have experienced sexual or physical abuse (Blood & Cornwall, 19%; Gil-Rivas, Fiorentine, & Anglin, 1996; Rohsenow, Corbett, & Devine, 1988). Exposure to sexual and physical abuse often contrib- utes to the development of a variety of short- and long- term behavioral and psychological disturbances, such as depression, anxiety, anger, self-destructiveness, posttrau- matic stress disorder (PTSD), suicidal behavior, sub- stance abuse, revictimization, low self- esteem, and diffi- culties with interpersonal relationships, among others (Beitchman et al., 1992; Finkelhor, 1990; Ireland & Wi- dom, 1994; Lisak & Luster, 1994; Malinosky-Rummell & Hansen, 1993; Mullen, Martin, Anderson, Romans, & Herbison, 1993; Widom & Ames, 1994). Further, sexual and physical abuse have been found to both precede and contribute to substance abuse (Bennett & Kemper, 1994; Fox & Gilbert, 1994; Miller, Downs, & Testa 1995), and Received October25, 1996; AcceptedJanuary 17, 1997. 351