Dias Nadeeka R, Lane Scott D, Rathnayaka Nuvan, Schmitz Joy M, Green Charles E
The University of Texas Health Science Center at Houston.
Addict Disord Their Treat. 2015 Jun;14(2):70-77. doi: 10.1097/adt.0000000000000046.
Underlying heterogeneity among individuals with cocaine dependence is widely postulated in the literature, however, identification of a group of factors that explain risk of cocaine use severity has yet to be confirmed.
Latent mixture modeling evaluated 338 cocaine-dependent individuals recruited from the community to assess the evidence for the presence of distinct subgroups. Variables included 5 baseline questionnaires measuring cognitive function (Shipley), impulsivity (BIS), mood (BDI), affective lability (ALS), and addiction severity (ASI). Results failed to suggest multiple subgroups. Given a lack of evidence for discrete latent classes, an exploratory factor analysis (EFA) followed by exploratory structural equation modeling (ESEM) was implemented to identify functional dimensions to enhance interpretation of these variables.
Findings from the EFA indicated a 3-factor model as the best fit, and the subsequent ESEM solution resulted in associations with lifetime cocaine use. Factor 1, best characterized by demographic factors (gender, age), is associated with less lifetime cocaine use. Psychological problems best characterize factor 2, which is associated with higher lifetime cocaine use. Finally, factor 3 is characterized by other substance use (alcohol and marijuana). Although this factor did not demonstrate a statistically reliable relation with self-reported, lifetime cocaine use, it did indicate a potentially meaningful positive association.
These 3 factors delineate dimensions of functioning that likewise help characterize the variability found in previously established associations with self-reported cocaine use.
文献中广泛假定可卡因依赖个体存在潜在异质性,然而,一组能解释可卡因使用严重程度风险的因素尚未得到证实。
潜在混合模型对从社区招募的338名可卡因依赖个体进行评估,以评估是否存在不同亚组的证据。变量包括5份基线问卷,用于测量认知功能(希普利)、冲动性(BIS)、情绪(BDI)、情感不稳定性(ALS)和成瘾严重程度(ASI)。结果未显示存在多个亚组。鉴于缺乏离散潜在类别证据,实施探索性因素分析(EFA),随后进行探索性结构方程建模(ESEM),以确定功能维度,增强对这些变量的解释。
EFA结果表明三因素模型拟合最佳,随后的ESEM解决方案得出与终生可卡因使用的关联。因素1最能由人口统计学因素(性别、年龄)表征,与终生较少的可卡因使用相关。因素2最能由心理问题表征,与较高的终生可卡因使用相关。最后,因素3由其他物质使用(酒精和大麻)表征。虽然该因素与自我报告的终生可卡因使用未显示出统计学上可靠的关系,但确实表明存在潜在有意义的正相关。
这三个因素描绘了功能维度,同样有助于刻画先前已确立的与自我报告的可卡因使用相关的变异性。