Interpersonal problems of cocaine dependent adults differ from those of a normative sample

Our research examined patterns of interpersonal problems in patients with a primary diagnosis of cocaine dependence (CD), comparing them with those in a normative sample. We hypothesized that the patterns of individuals with CD would reveal constellations of interpersonal problems distinct from those of the sample, not only at baseline, but also at termination of treatment. Analysis was conducted on 402 CD patients from the training and the main trial phases of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Responses to the Inventory for Interpersonal Problems were analyzed—from baseline, from month one, and at treatment termination—according to the Interpersonal Circumplex Model and were compared to the normative sample. The CD sample was described using four distinct subtypes, named according to their relative angular displacement at baseline and highest two subscale means: Cold and Socially Avoidant, Vindictive and Domineering, Overly Nurturant and Intrusive, Nonassertive and Exploitable. Each subtype remained distinct across treatment and consistently reported different types of interpersonal difficulties than the normative population at termination, consistent with the interpersonal pathoplasticity model. In all subtypes, overall interpersonal distress decreased over the course of treatment, to the extent that by treatment termination they were no more or less distressed than the normative sample. These findings have important clinical implications. The interpersonal challenges of patients struggling with addiction to cocaine warrant clinical attention, beyond mediating levels of distress.