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Subthreshold depression impairs young people's quality of life and places them at greater risk of developing major depression. Cognitive behavioral therapy (CBT) is an evidence-based approach for addressing such depressive states. This study identified subtypes of university students with subthreshold depression and revealed discrete profiles of five CBT skills: self-monitoring, cognitive restructuring, behavioral activation, assertive communication, and problem solving. Using data from the Healthy Campus Trial (registration number: UMINCTR-000031307), a hierarchical clustering analysis categorized 1,080 students into three clusters: Reflective Low-skilled, Non-reflective High-skilled, and Non-reflective Low-skilled students. Non-reflective Low-skilled students were significantly more depressed than other students (p <.001). The severity of depression seemed to be related to the combination of self-monitoring skills and other CBT skills. Considering the high prevalence of poor self-monitoring skills in persons with autism, the most severe depression was observed in the significant association between Non-reflective Low-skilled students and autistic traits (p =.008). These findings suggest that subthreshold depression can be categorized into three subtypes based on CBT skill profiles. The assessment of autistic traits is also suggested when we provide CBT interventions for Non-reflective Low-skilled students. [ABSTRACT FROM AUTHOR]

Background and Objectives: Only 10% of Americans with substance use disorders (SUDs) receive treatment with insufficient treatment access and screening practices proposed and potential contributing factors. Methods: This retrospective cross‐sectional study used National Survey on Drug Use and Health (NSDUH) data to assess individuals with SUDs receiving treatment between 2016 and 2019 (survey n = 12,111; weighted n = 12,394,214). Demographic, access, and screening characteristics were investigated as predictors of treatment receipt using time‐series logistic regression analyses to test trends and assessed treatment receipt odds, controlling for demographic and treatment characteristics. Results: For those with past‐year SUDs, 13.0% reported receiving past‐year SUD treatment (survey n = 1605; weighted n = 1,612,154). The SUD treatment receipt rate remained statistically stable from 2016 to 2019, with a nonsignificant treatment receipt trend declining from 14% to 12%. Treatment changes were notable among Native Americans (+53.80%), Pacific Islanders (+94.10%), multiracial (−59.96%), ages 65+ (−70.18%), and ages 12−17 (−50.70%). In the regression model, race, sex, age, insurance status, and receiving mental health treatment were associated with SUD treatment receipt. Discussion and Conclusions: The treatment gap remains substantial and stable. Annually, about 87% of Americans with SUDs are not receiving the treatment they need. Asian Americans were less likely and those attending general mental health services were more likely to receive treatment. Scientific Significance: We present an updated SUD treatment gap evaluation, and identify access and screening characteristics associated with SUD treatment receipt. Policymakers, clinicians, and researchers must continue improving access and identification of those in need of care. [ABSTRACT FROM AUTHOR]

Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment settings (N = 467,233). Methods: Chi-square was used to analyze differences. Multivariate logistic regression including covariates and the student status predicted successful completion with risk differences (RD). Results: Students were more likely to successfully complete treatment than nonstudents (56.15% vs 41.96%; ?[superscript 2] = 1355.04, df = 1, p < 0.0001, RD = 14.19, 95% confidence interval [CI] [13.43, 14.95]), and students were 6.92 (95% CI [6.26, 7.58]) percentage points less likely than nonstudents to remain in treatment for longer than 4 months (?[superscript 2] = 367.24, df = 1, p < 0.0001). Conclusions: Treatment providers seem to have greater results retaining students in shorter periods. Suggestions for higher education treatment engagement are discussed.

Cultural capital is a known factor supporting success in substance use disorder (SUD) treatment. We investigated Asian American and Pacific Islander (AAPI) State population metrics in relation to SUD treatment completion for US clients from 2006–2017 (N = 5,404,374). Metrics that may signify greater available cultural capital were State AAPI Percentage, State AAPI Percent Change, and State AAPI Population. AAPI Percentage, AAPI Percent Change were positively associated, while AAPI Population was negatively associated with treatment completion (p < 0.001). Findings suggest treatment agencies in areas with low AAPI densities may improve outcomes by supporting AAPI community and cultural social networks. [ABSTRACT FROM AUTHOR]

Provider-evaluated substance use treatment completion and client-reported substance use improvement are standards in determining treatment success. The relationship between these two outcomes is anecdotally understood in practice. However, the relationship has not been empirically determined and factors related to provider/client conflicting assessments are unknown. This study investigates treatment success by investigating consensus and conflict between improvement and completion in a large national sample. The present study is a cross-sectional retrospective evaluation of US substance use treatment episodes from facilities receiving public funding from 2015 to 2019 (N = 5,047,714). Episodes were mostly male (64.5%), aged 25–34 (34.4%), and White (58.5%). Conflict, consensus, and client factors associated with conflicting outcome evaluations were compared with differences in proportions and their 95% confidence intervals. Logistic regression was used to predict completion from improvement, adjusting for covariates. For absolute percentages, clients and providers were in consensus in 48.3% of all episodes, 32.5% were in conflict, and 19.2% were missing. The adjusted analysis significantly predicted completion from improvement (aOR = 2.18, 95% CI = 2.17, 2.19). Importantly, outcome conflict demonstrated absolute meaningful associations with problem substance, referral source, employment status, service setting, and supplemental mutual-help group attendance. Completion and improvement are somewhat associated, but most likely represent separate factors of treatment success. Addressing factors associated with outcome conflict may improve client and provider consensus and increase successful recovery. Policies and programs can set standards aligned with a uniform definition of success accounting for use improvement. [ABSTRACT FROM AUTHOR]