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青少年的工作记忆容量与成瘾治疗结果

Working memory capacity and addiction treatment outcomes in adolescents.

作者信息

Houck Jon M, Feldstein Ewing Sarah W

机构信息

a Center on Alcoholism, Substance Abuse, and Addictions , University of New Mexico , Albuquerque , NM , USA.

b Department of Child & Adolescent Psychiatry , Oregon Health & Science University , Portland , OR , USA.

出版信息

Am J Drug Alcohol Abuse. 2018;44(2):185-192. doi: 10.1080/00952990.2017.1344680. Epub 2017 Jul 20.

Abstract

BACKGROUND

Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Working memory depends upon brain structures and functions that change markedly during neurodevelopment and that can be negatively impacted by substance use.

OBJECTIVES

In a secondary analysis of data from a clinical trial for adolescent substance use comparing alcohol/marijuana education and MI, we evaluated the relationship between working memory and three-month treatment-outcomes with the hypothesis that the relationship between intervention conditions and outcome would be moderated by working memory.

METHODS

With a diverse sample of adolescents currently using alcohol and/or marijuana (N = 153, 64.7% male, 70.6% Hispanic), we examined the relationship between baseline measures of working memory and alcohol and cannabis-related problem scores measured at the three-month follow-up.

RESULTS

The results showed that lower working memory scores were associated with poorer treatment response only for alcohol use, and only within the education group. No relationship was found between working memory and treatment outcomes in the MI group.

CONCLUSION

The results suggest that issues with working memory capacity may interfere with adolescents' ability to process and implement didactic alcohol and marijuana content in standard education interventions. These results also suggest that MI can be implemented equally effectively across the range of working memory functioning in youth.

摘要

背景

包括动机性访谈(MI)在内的简短成瘾治疗已显示出对青少年有效的前景,但影响该人群治疗效果的因素仍不清楚。其中一个可能的因素是工作记忆,即把事实或想法记在脑海中的能力。这一点很重要,因为在治疗中,客户在与临床医生合作时必须保持并处理各种想法。工作记忆依赖于在神经发育过程中会发生显著变化且会受到物质使用负面影响的脑结构和功能。

目的

在一项针对青少年物质使用的临床试验数据的二次分析中,该试验比较了酒精/大麻教育和动机性访谈,我们评估了工作记忆与三个月治疗结果之间的关系,假设干预条件与结果之间的关系会受到工作记忆的调节。

方法

以目前正在使用酒精和/或大麻的青少年为多样本(N = 153,64.7%为男性,70.6%为西班牙裔),我们研究了工作记忆的基线测量值与在三个月随访时测量的与酒精和大麻相关的问题得分之间的关系。

结果

结果表明,仅在教育组中,较低的工作记忆分数仅与酒精使用方面较差的治疗反应相关。在动机性访谈组中,未发现工作记忆与治疗结果之间存在关联。

结论

结果表明,工作记忆容量问题可能会干扰青少年在标准教育干预中处理和实施关于酒精和大麻的教学内容的能力。这些结果还表明,动机性访谈在青少年不同工作记忆功能水平上都能同样有效地实施。

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