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阿片类药物依赖者进入纳曲酮治疗的应对压力特征:与健康对照组的比较。

A stress-coping profile of opioid dependent individuals entering naltrexone treatment: a comparison with healthy controls.

机构信息

Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT 06519, USA.

出版信息

Psychol Addict Behav. 2009 Dec;23(4):613-9. doi: 10.1037/a0017324.

Abstract

BACKGROUND

Stress is known to increase addiction vulnerability and risk of relapse to substance use. PURPOSE & METHOD: We compared opioid dependent individuals entering naltrexone treatment (n = 57) with healthy controls (n = 75) on measures of stress, coping, and social support and examined the relative contribution of group membership, coping, and social support to stress within the sample. Analyses of variance (ANOVA) and covariance (ANCOVA), and stepwise multiple regression were conducted.

RESULTS

Compared with controls, opioid dependent subjects reported greater stress, less use of adaptive coping, but comparable use of maladaptive/avoidant coping. No group differences were found with respect to social support. Perceived stress was predicted by group membership, low social support, and greater use of maladaptive/avoidant coping, and the prediction by social support and maladaptive/avoidant coping did not differ by group.

CONCLUSION

Opioid dependent individuals entering naltrexone treatment experience higher levels of stress and report less use of adaptive coping strategies when compared with controls. Group membership, maladaptive/avoidant coping, and social support independently contribute to perceived stress. Findings suggest that novel treatment approaches that decrease maladaptive/avoidant coping and improve social support are important aspects of decreasing stress during early recovery from opioid addiction.

摘要

背景

压力会增加成瘾易感性和物质使用复发的风险。

目的和方法

我们比较了进入纳曲酮治疗的阿片类药物依赖者(n = 57)与健康对照组(n = 75)的压力、应对和社会支持措施,并考察了在样本中群体归属、应对和社会支持对压力的相对贡献。进行了方差分析(ANOVA)和协方差分析(ANCOVA)以及逐步多元回归分析。

结果

与对照组相比,阿片类药物依赖者报告的压力更大,适应性应对方式的使用较少,但非适应性/回避性应对方式的使用相当。在社会支持方面,两组之间没有差异。感知压力由群体归属、低社会支持和更多使用非适应性/回避性应对方式预测,而社会支持和非适应性/回避性应对方式的预测在两组之间没有差异。

结论

与对照组相比,进入纳曲酮治疗的阿片类药物依赖者经历更高水平的压力,并且报告较少使用适应性应对策略。群体归属、非适应性/回避性应对和社会支持独立地对感知压力做出贡献。研究结果表明,减少非适应性/回避性应对和改善社会支持的新治疗方法是减少阿片类药物成瘾早期康复期间压力的重要方面。

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