COMPARISON OF THE FREQUENCY AND ENJOYABILITY OF PLEASANT EVENTS IN COCAINE ABUSERS VS. NON-ABUSERS USING A STANDARDIZED BEHAVIORAL INVENTORY

Aims. To examine whether cocaine abusers differ from non-abusers in th eir frequency and enjoyability of engaging in various ''pleasant event s': in order to approximate the density of positive reinforcement expe rienced in their natural environment. Design. Comparisons of cocaine a busers to normative data and matched controls. Setting. An outpatient substance abuse treatment center in Burlington, Vermont, USA. Particip ants. Subjects included 100 individuals enrolled in outpatient treatme nt for cocaine abuse or dependence and 50 community volunteers without histories of drug abuse or other major psychiatric illness and matche d to cocaine-dependent patients on age, sex and SES. Measurements. Dia gnostic assessments were based upon clinical interviews using the DSM- III-R checklist. The primary focus of this study was the Pleasant Even ts Schedule (PES), a self-rated behavioral inventory of the frequency and enjoyability of engaging in ''pleasant'' activities. Cocaine use h istory, treatment outcome and other relevant variables were also asses sed. Findings. Cocaine abusers reliably reported lower frequency of no n-social, introverted, passive outdoor and mood-related activities tha n controls. These differences remained after controlling for demograph ic and life-style differences between groups, with the exception of mo od-related activities. Perceived enjoyability of the activities did no t differ across groups. Intravenous cocaine use and prior treatment fo r cocaine abuse predicted particularly low frequency of pleasant activ ities. Greater frequency of non-social activities predicted better tre atment outcome. Conclusions. Drug abuse is associated with low density of certain types of non-drug reinforcement. Systematic increases in t hese activities may improve treatment outcome.