Conner Bradley T, Longshore Douglas, Anglin M Douglas
Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 1640 South Sepulveda Boulevard, Suite 200, Los Angeles, CA 90025-7535, USA.
J Behav Health Serv Res. 2009 Apr;36(2):150-8. doi: 10.1007/s11414-008-9119-1. Epub 2008 Jun 6.
Motivation for change has historically been viewed as the crucial element affecting responsiveness to drug treatment. Various external pressures, such as legal coercion, may engender motivation in an individual previously resistant to change. Dramatic relief may be the change process that is most salient as individuals internalize such external pressures. Results of structural equation modeling on data from 465 drug users (58.9% male; 21.3% Black, 34.2% Hispanic/Latino, and 35.1% White) entering drug treatment indicated that internal motivation and external pressure significantly and positively predicted dramatic relief and that dramatic relief significantly predicted attitudes towards drug treatment: chi (2) = 142.20, df = 100, p < 0.01; Robust Comparative Fit Index = 0.97, Root Mean Squared Error of Approximation = 0.03. These results indicate that when external pressure and internal motivation are high, dramatic relief is also likely to be high. When dramatic relief is high, attitudes towards drug treatment are likely to be positive. The findings indicate that interventions to get individuals into drug treatment should include processes that promote Dramatic Relief. Implications for addictions health services are discussed.
从历史上看，改变的动机一直被视为影响药物治疗反应性的关键因素。各种外部压力，如法律强制，可能会激发一个先前抗拒改变的人的动机。当个体将这种外部压力内化时，戏剧性缓解可能是最显著的改变过程。对465名进入药物治疗的吸毒者（58.9%为男性；21.3%为黑人，34.2%为西班牙裔/拉丁裔，35.1%为白人）的数据进行结构方程建模的结果表明，内部动机和外部压力显著且正向地预测了戏剧性缓解，并且戏剧性缓解显著预测了对药物治疗的态度：卡方（2）= 142.20，自由度 = 100，p < 0.01；稳健比较拟合指数 = 0.97，近似均方根误差 = 0.03。这些结果表明，当外部压力和内部动机较高时，戏剧性缓解也可能较高。当戏剧性缓解较高时，对药物治疗的态度可能是积极的。研究结果表明，促使个体接受药物治疗的干预措施应包括促进戏剧性缓解的过程。文中讨论了对成瘾健康服务的影响。
