Moos Rudolf H
Center for Health Care Evaluation, Veterans Affairs Health Care System, 795 Willow Road (152-MPD), Menlo Park, California 94025, USA.
Clin Psychol Rev. 2007 Jun;27(5):537-51. doi: 10.1016/j.cpr.2006.12.006. Epub 2006 Dec 30.
Four related theories about the personal and social resources that shield individuals from developing substance use disorders and foster the process of remission from these disorders are described. These theories are social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. Next, the social processes specified by these theories are highlighted, including the provision of support, goal direction, and monitoring; engagement in rewarding activities other than substance use, exposure to abstinence-oriented norms and models, and attempts to build self-efficacy and coping skills. Then, a review of the literature considers evidence about the association between the personal and social resources specified by the four theories and remission from substance use disorders. The discussion highlights several issues that need to be addressed to enhance our understanding of the protective resources involved in stable remission, such as how to develop integrated measures of the key resources and specify their associations with substance use outcomes, the extent to which the resources amplify or compensate for the influence of treatment, and how treatment and continuing care can be tailored to strengthen the protective resources that promote remission.
本文描述了四种相关理论,这些理论涉及保护个体不发展为物质使用障碍并促进从这些障碍中康复的个人和社会资源。这些理论分别是社会控制理论、行为经济学和行为选择理论、社会学习理论以及压力与应对理论。接下来,重点介绍了这些理论所规定的社会过程,包括提供支持、目标导向和监督;参与除物质使用之外的有益活动、接触以节制为导向的规范和榜样,以及尝试建立自我效能感和应对技能。然后,对文献的回顾考察了关于这四种理论所规定的个人和社会资源与物质使用障碍康复之间关联的证据。讨论突出了几个需要解决的问题,以增进我们对稳定康复中所涉及的保护资源的理解,例如如何制定关键资源的综合测量方法并明确它们与物质使用结果的关联、这些资源在多大程度上放大或补偿治疗的影响,以及如何调整治疗和持续护理以加强促进康复的保护资源。