Center for the Study of Addictions and Recovery at the National Development and Research Institutes, Inc., (NDRI), NYC, NY 10010, USA.
J Subst Abuse Treat. 2010 Jun;38(4):317-27. doi: 10.1016/j.jsat.2010.01.007. Epub 2010 Feb 25.
Commitment to abstinence, a motivational construct, is a strong predictor of reductions in drug and alcohol use. Level of commitment to abstinence at treatment end predicts sustained abstinence, a requirement for recovery. This study sought to identify predictors of commitment to abstinence at treatment end to guide clinical practice and to inform the conceptualization of motivational constructs. Polysubstance users (N = 250) recruited at the start of outpatient treatment were reinterviewed at the end of services. Based on the extant literature, potential predictors were during treatment measures of substance use and related cognitions, psychological functioning, recovery supports, stress, quality of life satisfaction, and treatment experiences. In multivariate analyses, perceived harm of future drug use, abstinence self-efficacy, quality of life satisfaction, and number of network members in 12-step recovery contributed 26.6% of the variance explained in the dependent variable, a total of 49.6% when combined with the control variables (demographics and baseline level of the outcome). Gender subgroup analyses yielded largely similar results. Clinical implications of findings for maximizing commitment to abstinence when clients leave treatment are discussed as are future research directions.
承诺戒除,一种动机结构,是减少药物和酒精使用的强有力预测因素。治疗结束时对戒除的承诺程度预测着持续的戒除,这是恢复的要求。本研究旨在确定治疗结束时戒除承诺的预测因素,以指导临床实践,并为动机结构的概念化提供信息。在门诊治疗开始时招募的多药物使用者(N=250)在服务结束时接受了重新访谈。基于现有文献,潜在的预测因素是治疗期间的物质使用和相关认知、心理功能、康复支持、压力、生活质量满意度以及治疗经验的测量。在多变量分析中,未来药物使用的感知危害、戒除自我效能、生活质量满意度和 12 步康复网络成员数量解释了因变量的 26.6%的差异,当与控制变量(人口统计学和基线结果水平)结合时,共解释了 49.6%的差异。性别亚组分析产生了大致相似的结果。讨论了在客户离开治疗时最大限度地提高戒除承诺的发现的临床意义,以及未来的研究方向。