Warren Jazmin I, Stein Judith A, Grella Christine E
Department of Psychology, University of California-Los Angeles, Los Angeles, CA 90095, USA.
Drug Alcohol Depend. 2007 Jul 10;89(2-3):267-74. doi: 10.1016/j.drugalcdep.2007.01.009. Epub 2007 Feb 27.
Individuals with co-occurring substance use and psychiatric disorders have a more severe clinical course and poorer outcomes than do individuals with one disorder. In an attempt to find intervening variables that may contribute to improvement in treatment outcomes among individuals with co-occurring disorders, we investigated the roles of social support and self-efficacy in a sample of 351 clients with co-occurring disorders in residential drug abuse treatment programs (53% male; 35% African American, 13% Hispanic). Given their demographic variability, we also explored how ethnicity and age influence self-efficacy and access to social support, as well as their relationships to the outcomes. Structural equation modeling was used to examine the impact of the demographics and baseline psychological status, substance use, social support, and self-efficacy on mental health and substance use outcomes 6 months after treatment entry. Time in treatment was included as a control. Greater social support at baseline predicted better mental health status and less heroin and cocaine use; greater self-efficacy predicted less alcohol and cocaine use. Older clients reported less social support. African-American ethnicity was associated with more cocaine use at baseline and follow-up; however, African Americans reported more self-efficacy, which moderated their cocaine use. The current study highlights the potential therapeutic importance of clients' personal resources, even among a sample of severely impaired individuals.
同时患有物质使用障碍和精神疾病的个体，相较于仅患有一种疾病的个体，有着更严重的临床病程和更差的治疗结果。为了找到可能有助于改善同时患有这两种疾病的个体治疗效果的干预变量，我们在一个有351名同时患有这两种疾病的住院药物滥用治疗项目的样本中，研究了社会支持和自我效能感的作用（53%为男性；35%为非裔美国人，13%为西班牙裔）。鉴于他们在人口统计学上的变异性，我们还探讨了种族和年龄如何影响自我效能感和获得社会支持的机会，以及它们与治疗结果的关系。采用结构方程模型来检验人口统计学、基线心理状态、物质使用情况、社会支持和自我效能感对治疗开始6个月后的心理健康和物质使用结果的影响。将治疗时间作为一个控制变量纳入分析。基线时更大的社会支持预示着更好的心理健康状态以及更少的海洛因和可卡因使用；更强的自我效能感预示着更少的酒精和可卡因使用。年龄较大的患者报告的社会支持较少。非裔美国人的种族与基线和随访时更多的可卡因使用有关；然而，非裔美国人报告有更强的自我效能感，这缓和了他们的可卡因使用情况。当前的研究突出了患者个人资源潜在的治疗重要性，即使是在一个严重受损个体的样本中。
