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女性康复中的分分秒秒:一项随机对照试验方案,旨在测试基于正念的干预措施对物质使用障碍住院治疗女性的治疗维持率和预防复发的疗效。

Moment-by-Moment in Women's Recovery: Randomized controlled trial protocol to test the efficacy of a mindfulness-based intervention on treatment retention and relapse prevention among women in residential treatment for substance use disorder.

作者信息

Amaro Hortensia, Black David S

机构信息

Suzanne Dworak-Peck School of Social Work, University of Southern California, United States; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, United States.

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, United States; Norris Comprehensive Cancer Center, University of Southern California, United States.

出版信息

Contemp Clin Trials. 2017 Nov;62:146-152. doi: 10.1016/j.cct.2017.09.004. Epub 2017 Sep 14.

Abstract

Although therapeutic treatments exist for substance use disorder (SUD), about half of individuals who enter treatment leave early and relapse to substance use. Early dropout from residential treatment places individuals at risk of relapse, and women in SUD residential treatment represent a vulnerable population. Evidence gaps persist for the use of mindfulness-based interventions (MBIs) among racially and ethnically diverse women with SUDs, especially regarding the efficacy of MBIs adapted to prevent residential dropout and relapse. We previously developed and pilot tested an MBI, Moment-by-Moment in Women's Recovery (MMWR), adapted to support women with SUD during residential treatment. The 12-session MMWR program tested in the present study integrates relapse prevention, addresses literacy level and trauma experiences and mental health problems, and is relevant to issues surrounding treatment- and relapse-related stressors among women. The primary objective of the current Phase II randomized controlled trial is to adequately test the efficacy of MMWR on residential treatment retention and substance use relapse and determine psychosocial and neural mechanisms of action underlying MMWR. Participants are women in residential SUD treatment from a community-based residential site that serves mainly women who are low-income and racially and ethnically diverse. A subgroup of participants from each treatment group also completes functional and structural neuroimaging assessments before and after the intervention to explore possible structural and functional brain correlates of change associated with participation in the MMWR program. Findings are expected to inform the utility of adapting MBIs to improve treatment success among vulnerable women in SUD residential treatment.

摘要

虽然存在针对物质使用障碍(SUD)的治疗方法,但约一半接受治疗的人会提前离开并重新使用成瘾物质。住院治疗中的早期退出会使个体面临复发风险,而接受SUD住院治疗的女性是弱势群体。对于在种族和民族多样化的患有SUD的女性中使用基于正念的干预措施(MBI),证据空白依然存在,尤其是关于为预防住院治疗退出和复发而调整的MBI的疗效。我们之前开发并进行了一项MBI试点测试,即女性康复中的时刻关注(MMWR),旨在在住院治疗期间为患有SUD的女性提供支持。本研究中测试的12节MMWR课程整合了预防复发,解决了识字水平、创伤经历和心理健康问题,并且与女性治疗及复发相关应激源周围的问题相关。当前II期随机对照试验的主要目标是充分测试MMWR对住院治疗保留率和物质使用复发的疗效,并确定MMWR潜在的心理社会和神经作用机制。参与者是来自一个社区住院场所接受SUD住院治疗的女性,该场所主要服务低收入且种族和民族多样化的女性。每个治疗组的一个亚组参与者还在干预前后完成功能和结构神经影像学评估,以探索与参与MMWR项目相关的大脑结构和功能变化的可能关联。研究结果有望为调整MBI以提高SUD住院治疗中弱势女性的治疗成功率提供参考。

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