Aharonovich Efrat, Amrhein Paul C, Bisaga Adam, Nunes Edward V, Hasin Deborah S
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Psychol Addict Behav. 2008 Dec;22(4):557-62. doi: 10.1037/a0012971.
Patients' cognitive abilities and verbal expressions of commitment to behavioral change predict different aspects of substance abuse treatment outcome, but these 2 traits have never been examined conjointly. The authors therefore investigated patients' cognitive abilities and verbal expressions of commitment to behavioral change as predictors of retention and drug use outcomes in an outpatient cognitive behavioral treatment (CBT) of adult cocaine-dependent patients. A neuropsychological battery was administered at baseline. Two independent raters used recordings of CBT sessions to code commitment language strength across the temporal segments (e.g., beginning, middle, and end) of 1 session per patient. Better cognitive abilities predicted treatment retention (p < .01) but not drug use, whereas mean commitment strength across the session segments predicted reduced drug use (p = .01). Results indicate that although commitment to behavioral changes such as abstinence may occur independently of patients' cognitive abilities, engagement in the behavioral intervention process appears to depend on cognitive abilities. Future clinical studies should further investigate the relations between cognition and commitment to change and their differential contributions to treatment processes and outcome.
患者的认知能力以及对行为改变的言语承诺预示着药物滥用治疗结果的不同方面，但这两个特征从未被联合考察过。因此，作者在一项针对成年可卡因依赖患者的门诊认知行为治疗（CBT）中，研究了患者的认知能力以及对行为改变的言语承诺，将其作为治疗保留率和药物使用结果的预测指标。在基线时进行了一组神经心理学测试。两名独立评估者使用CBT疗程的录音，对每位患者每个疗程的不同时间段（如开始、中间和结束）的承诺语言强度进行编码。较好的认知能力预示着治疗保留率（p < .01），但与药物使用情况无关，而整个疗程各时间段的平均承诺强度预示着药物使用量减少（p = .01）。结果表明，尽管对诸如戒除等行为改变的承诺可能独立于患者的认知能力而出现，但参与行为干预过程似乎取决于认知能力。未来的临床研究应进一步调查认知与改变承诺之间的关系，以及它们对治疗过程和结果的不同贡献。
