Chung Tammy, Maisto Stephen A
University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA 15213, United States.
Syracuse University, Department of Psychology, Syracuse, NY 13244, United States.
Addict Behav. 2016 Jun;57:62-8. doi: 10.1016/j.addbeh.2016.02.015. Epub 2016 Feb 10.
An important goal of addictions treatment is to develop a positive association between high levels of confidence and motivation to abstain from substance use. This study modeled the time-varying association between confidence and motivation to abstain from marijuana use among youth in treatment, and the time-varying effect of pre-treatment covariates (marijuana abstinence goal and perceived peer marijuana use) on motivation to abstain.
150 adolescents (75% male, 83% White) in community-based intensive outpatient treatment in Pennsylvania completed a pre-treatment assessment of abstinence goal, perceived peer marijuana use, and motivation and confidence to abstain from marijuana. Ratings of motivation and confidence to abstain also were collected after each session. A time-varying effect model (TVEM) was used to characterize changes in the association between confidence and motivation to abstain (lagged), and included covariates representing pre-treatment abstinence goal and perceived peer marijuana use.
Confidence and motivation to abstain from marijuana generally increased during treatment. The association between confidence and motivation strengthened across sessions 1-4, and was maintained through later sessions. Pre-treatment abstinence goal had an early time-limited effect (through session 6) on motivation to abstain. Pre-treatment perception of peer marijuana use had a significant effect on motivation to abstain only at session 2.
Early treatment sessions represent a critical period during which the association between confidence and motivation to abstain generally increased. The time-limited effects of pre-treatment characteristics suggest the importance of early sessions in addressing abstinence goal and peer substance use that may impact motivation to abstain from marijuana.
成瘾治疗的一个重要目标是在高水平的信心与戒除物质使用的动机之间建立积极的关联。本研究对接受治疗的青少年中信心与戒除大麻使用动机之间随时间变化的关联，以及治疗前协变量（大麻戒除目标和感知到的同伴大麻使用情况）对戒除动机的随时间变化的影响进行了建模。
宾夕法尼亚州社区强化门诊治疗中的150名青少年（75%为男性，83%为白人）完成了对戒除目标、感知到的同伴大麻使用情况以及戒除大麻的动机和信心的治疗前评估。每次治疗后还收集了戒除动机和信心的评分。使用随时间变化的效应模型（TVEM）来描述信心与戒除动机之间关联的变化（滞后），并纳入了代表治疗前戒除目标和感知到的同伴大麻使用情况的协变量。
在治疗期间，戒除大麻的信心和动机总体上有所增加。信心与动机之间的关联在第1至4次治疗期间增强，并在后续治疗中保持。治疗前的戒除目标对戒除动机有早期的限时效应（直至第6次治疗）。治疗前对同伴大麻使用的感知仅在第2次治疗时对戒除动机有显著影响。
早期治疗阶段是一个关键时期，在此期间，信心与戒除动机之间的关联通常会增强。治疗前特征的限时效应表明早期治疗阶段在解决可能影响戒除大麻动机的戒除目标和同伴物质使用方面的重要性。
