Department of Psychiatry, Menninger Clinic Baylor College of Medicine, Houston, Texas 77035, USA.
Am J Addict. 2013 Jan;22(1):14-7. doi: 10.1111/j.1521-0391.2013.00318.x.
A strong dose-response relationship exists for psychosocial treatments for co-morbid substance abuse disorders; yet rates of attrition are exceedingly high for those seeking treatment in residential and hospital settings. This study examined patient characteristics, including attachment style as predictors of completing 42 contiguous days of inpatient dual-diagnosis treatment among patients with substance use disorders.
Baseline characteristics were assessed in 187 consecutively admitted patients with research diagnosis of substance use disorders. Hierarchical logistic regression analysis was used to examine predictors of treatment retention.
Results indicated a two-variable model consisting of total number of co-occurring Axis I and II disorders, and pre-occupied attachment style, accounting for 17% of the variance. Attachment status predicted retention above and beyond psychiatric co-morbid disorders, demonstrating incremental predictive validity. Moderator analyses failed to detect an interaction.
Among inpatients with substance abuse disorders, anxious-preoccupied attachment style predicted treatment retention, reflecting the importance of interpersonal components of treatment relationships in completing treatment. This study adds to a growing body of evidence linking attachment style with treatment adherence. Further research is needed to examine possible mechanisms associated with this relationship.
心理社会治疗对共病物质滥用障碍具有很强的剂量反应关系；然而，在住院和医院环境中寻求治疗的患者，其退出率极高。本研究考察了患者特征，包括依恋模式，作为预测物质使用障碍患者完成 42 天连续住院双诊断治疗的指标。
对 187 名连续入院的物质使用障碍患者进行了基线特征评估。采用层次逻辑回归分析考察了治疗保留的预测因素。
结果表明，有两个变量的模型，包括共患的轴 I 和轴 II 障碍的总数和专注的依恋模式，占 17%的方差。依恋状态预测了保留率，超过了精神共病障碍，显示出增量预测的有效性。调节分析未能检测到相互作用。
在物质滥用障碍的住院患者中，焦虑型专注的依恋模式预测了治疗保留，反映了治疗关系中人际成分在完成治疗中的重要性。本研究增加了越来越多的证据，将依恋模式与治疗依从性联系起来。需要进一步研究，以检查与这种关系相关的可能机制。
