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线索暴露反应性的性别差异及9个月的结果。

Gender differences in cue exposure reactivity and 9-month outcome.

作者信息

Sterling Robert C, Dean Jessica, Weinstein Stephen P, Murphy Jennifer, Gottheil Edward

机构信息

Department of Psychiatry and Human Behavior, Division of Substance Abuse Programs, Thomas Jefferson University, 1021 South 21st Street, Philadelphia, PA 19146, USA.

出版信息

J Subst Abuse Treat. 2004 Jul;27(1):39-44. doi: 10.1016/j.jsat.2004.03.008.

Abstract

Gender differences have been shown to be related to the course of cocaine dependence and treatment. While previous research has shown cue exposure procedures to be somewhat effective at reducing reactivity of substance dependent individuals to drug related stimuli, the few studies that have examined gender differences in craving and cue-reactivity have yielded equivocal results. We have recently demonstrated that an active cue-exposure procedure that featured cocaine-dependent individuals receiving immediate feedback about their level of physiological arousal following videotaped exposure to cocaine-related stimuli was capable of positively influencing in-treatment (helplessness, abstinence efficacy) as well as 9-month followup outcome (i.e., urinalysis) indices (Sterling, R., Gottheil, E., Murphy, J., & Weinstein, S. (2001). Cue exposure and abstinence efficacy. College on Problems of Drug Dependence, Phoenix, AZ, June 17, 2001). The purpose of the present study was to determine whether differential in-treatment or 9-month followup outcomes were obtained for male and female study participants. Subjects in this study were 81 individuals (47 male/34 female) who met DSM-IV criteria for cocaine dependence and who had consented to be randomly assigned to either the active cue-exposure or control conditions. Participants were compared along a myriad of pre-treatment, in-treatment, and 9-month followup measures. Other than males reporting more recent employment, there was no obvious systematic pattern of differences on pre-treatment indices. No gender differences in treatment retention were observed. With respect to 9-month followup, no gender differences on measures of addiction severity, psychological functioning, or urinalyses were noted. However males were more "cue-reactive" and more successful at establishing control over their reactivity to the cocaine stimuli. Additional research is needed to determine whether these differences in reactivity can be more clearly defined and utilized positively in a treatment setting.

摘要

性别差异已被证明与可卡因依赖的病程及治疗有关。虽然先前的研究表明,线索暴露程序在一定程度上能有效降低物质依赖个体对药物相关刺激的反应性,但少数研究性别在渴望和线索反应性方面差异的研究结果并不明确。我们最近证明,一种积极的线索暴露程序,即让可卡因依赖个体在观看与可卡因相关的刺激视频后,立即得到关于其生理唤醒水平的反馈,能够对治疗期间(无助感、戒断效能)以及9个月随访结果(即尿液分析)指标产生积极影响(斯特林,R.,戈特尔,E.,墨菲,J.,& 温斯坦,S.(2001年)。线索暴露与戒断效能。药物依赖问题学会,亚利桑那州凤凰城,2001年6月17日)。本研究的目的是确定男性和女性研究参与者在治疗期间或9个月随访结果上是否存在差异。本研究的受试者为81名符合DSM - IV可卡因依赖标准且同意被随机分配到积极线索暴露组或对照组的个体(47名男性/34名女性)。参与者在一系列治疗前、治疗期间和9个月随访指标上进行了比较。除了男性报告近期有工作外,治疗前指标上没有明显的系统差异模式。未观察到治疗保留率方面的性别差异。关于9个月随访,在成瘾严重程度、心理功能或尿液分析指标上未发现性别差异。然而,男性对可卡因刺激的反应更“敏感”,并且在控制对可卡因刺激的反应方面更成功。需要进一步的研究来确定这些反应性差异是否能在治疗环境中得到更明确的界定并被积极利用。

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