Relevance of psychopathic traits to therapeutic processes and outcomes for veterans with substance use disorders.

Psychopathic traits have been routinely associated with poor treatment outcomes in correctional settings. Less is known about how psychopathic traits relate to treatment processes (e.g., perceptions of treatment; adjustment to treatment), particularly in nonforensic settings. The current study tested for relationships between psychopathic traits, as operationalized by the Triarchic Psychopathy Measure (TriPM) and treatment processes and outcomes in a sample of 200 U.S. military veterans enrolled in a residential substance use disorder treatment program at a Veteran's Affairs (VA) medical center. Participants were interviewed using several measurement instruments at 4 time points: treatment entry, 1 month into treatment, treatment discharge, and 12 months post discharge. The TriPM was administered at baseline, and measures of treatment processes/outcomes were measured during treatment and at postdischarge. The TriPM scales exhibited differential associations with treatment processes and outcomes in multivariate analyses. Specifically, higher Boldness was associated with fewer psychiatric symptoms at baseline, but more rule-breaking behaviors and more peer-reported conflicts with other residents in treatment; higher Meanness predicted more negative perceptions of the treatment milieu; and higher Disinhibition predicted poorer substance use outcomes posttreatment. Together, these findings demonstrate associations between psychopathy and therapy processes/outcomes and highlight the potentially unique contribution of psychopathic traits to substance use disorder treatment programming. (PsycInfo Database Record (c) 2021 APA, all rights reserved).