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Valued Living and Its Relationship to Medication Adherence in Patients with Bipolar and Comorbid Substance Use Disorders

Gaudiano, Brandon A. PhD; Wenze, Susan J. PhD; Weinstock, Lauren M. PhD; Tezanos, Katherine M. BA; Miller, Ivan W. PhD

The Journal of Nervous and Mental Disease: March 2017 - Volume 205 - Issue 3 - p 178–181
doi: 10.1097/NMD.0000000000000533
Brief Report

Bipolar disorder with comorbid substance abuse is associated with high rates of treatment nonadherence. Adherence interventions developed to date have had mixed effects in this population. Valued living (i.e., the consistency between a patient’s personal values and daily actions) represents a potentially useful treatment target that may improve adherence. We investigated the relationship between valued living, medication adherence, symptoms, and functioning in a sample of 39 patients diagnosed with bipolar disorder and a comorbid substance use disorder. Results showed that greater values-action consistency explained a unique amount of variance (R 2 change = 15.2%) in medication adherence even after controlling for symptom severity, functional impairment, and other reported reasons for nonadherence. Drug use and treatment beliefs also predicted nonadherence. Findings suggest that valued living should be investigated further as a potentially malleable treatment target in future adherence intervention research.

*Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; †Psychosocial Research, Butler Hospital, Providence, RI; and ‡Department of Psychology, Lafayette College, Easton, PA.

Send reprint requests to Brandon A. Gaudiano, PhD, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. E-mail:

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