Factors associated with victimization in dual diagnosis patients

Patients with a substance use disorder and co-occurring mental disorder are prone to victimization. There is a lack of research identifying variables related to violent and property victimization in this high risk group. The aim of this study was to identify factors associated with violent and property victimization in male and female dual diagnosis patients in order to identify targets for prevention.

In a cross-sectional study, victimization and demographic, clinical and psychological characteristics were assessed in 243 treatment-seeking patients with dual diagnosis. Patients were recruited in an addiction-psychiatry clinic and an allied outpatient care facility in Amsterdam, The Netherlands.

In a multiple logistic regression analysis, violent victimization was independently associated with younger age, female gender, violent offending and a self-sacrificing and overly accommodating interpersonal style (p<0.001; χ²=108.83, d.f.=8, R²=0.49) in dual diagnosis patients. In male patients, violent victimization was independently associated with younger age, violent offending and a self-sacrificing and overly accommodating interpersonal style (p<0.001; χ²=91.90, d.f.=7, R²=0.56). In female patients, violent victimization was independently positively associated with homelessness, violent offending, a domineering/controlling interpersonal style, and negatively associated with being socially inhibited and cold/distant (p<0.001; χ²=34.08, d.f.=4, R²=0.53). Property victimization was independently associated with theft offending (p<0.001, χ²=26.99, d.f.=5, R²=0.14).

Given the high prevalence of victimization in dual diagnosis patients and its related problems, preventive interventions should be developed. Interventions should target interpersonal skills to decrease vulnerability to victimization, address the overlap between victimization and offending and incorporate gender-specific elements.