ASSESSMENT OF SPECIAL POPULATIONS

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ASSESSMENT OF SPECIAL POPULATIONS
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YOUTH

• Assessment Considerations
• highest rates of substance abuse and highest
  rates of problem gambling
• Only minority will seek treatment themselves
• Need parental consent however, less likely to be
  honest with parents present
• Greater propensity for both exaggeration and
  minimization (more lying, less insight)
• Different psychometric screening instruments
• Given smaller body size and weaker tolerance,
  adolescents can experience dangerous effects at a
  lower level of consumption
• Tend to show fewer signs of dependence and fewer
  physical problems related to alcohol
• Treatment Considerations
• High rates of natural recovery
• Family involvement in treatment very important
  for success
• If motivation not there then need leverage

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Prevalence of heavy drug use as a function of age
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ELDERLY

• Assessment Considerations
• Diagnostic criteria based on adverse social
  consequences may not apply because elderly less
  likely to be employed, married, or involved in
  legal altercations
• Symptoms may be harder to recognize because
• Daily demands may be easier to achieve than if
  they were working or in a marital relationship
• Poor memory, accidental falls and lack of energy
  may be accepted as normal for elderly
• Self-report may be less valid
• Greater denial
• Poorer memory
• Quantity frequency needed to produce impairment
  is less
• Even when family members recognize a problem,
  they may deny its existence or inadvertently
  collude with the client out of their own feelings
  of shame
• High rates of rx substance abuse
• Substance abuse interferes with normal medication
  regime (either forget or drug interactions)
• Treatment Considerations
• Highest rates of suicide
• Individuals who have been abusing alcohol for
  extended period of time may become estranged from
  their families and distanced from potential
  assistance

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CROSS-CULTURAL ASSESSMENT

• need to appreciate cross-cultural differences in
  substance use
• Alcohol
• in many Muslim countries any alcohol drinking is
  regarded as culturally aberrant
• it is normal for children in many European
  countries to have alcohol with meals
• North Americans have a higher tolerance for
  drunken behaviour than most other places
• Opium
• opium a normal part of many middle eastern and
  Asian cultures
• In contrast, all non-rx use in western countries
  is illegal
• Cannabis
• More normative use in India and Jamaica compared
  to other countries
• Tobacco
• Religious significance in N.A. Aboriginal
  populations
• Peyote
• mescaline (peyote) a part of religious ceremonies
  of Native American Church of North America
• Others
• cocaine and Andean Indians
• kava kava and south pacific
• Gambling

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• Cross-cultural differences in what is considered
  pathological
• suicide in Japan and India (widows)
  hallucinations and witch doctors "wolf-boy of
  Thompson" pedophilia in South Pacific and New
  Guinea female assertiveness
• cross-cultural differences in manifestation of
  psychopathology
• psychosomatic problems more common forms of
  distress in some cultures
• In Aboriginals it is not uncommon for depression
  to take the form of a loss or disturbed sense of
  spirituality/connection with ancestors/connection
  with the creator.
• need to understand cross-cultural differences in
  how problems are communicated
• much more humiliating to admit a problem in Asian
  cultures
• admitting problems historically not encouraged in
  Aboriginal culture
• need to ensure culturally congruent interventions