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大麻使用过程中的瞬间因素可预测年轻人试图戒除期间的复吸。

Momentary factors during marijuana use as predictors of lapse during attempted abstinence in young adults.

机构信息

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.

出版信息

Addict Behav. 2018 Aug;83:167-174. doi: 10.1016/j.addbeh.2017.12.032. Epub 2017 Dec 29.

Abstract

INTRODUCTION

Young adults using marijuana heavily often try multiple times to quit on their own. We sought to identify momentary experiences during marijuana use that could aid in predicting lapse when young adults subsequently attempt abstinence.

METHODS

Young adults (N=34) age 18-25 using marijuana ≥5days/week and planning to quit completed a survey of sociodemographic characteristics, substance use, marijuana expectancies, use motives, perceived social support, and confidence to abstain. They completed ecological momentary assessment (EMA) smartphone reports several times/day for two weeks prior to, then during two weeks of attempted abstinence. Use period EMA reports assessed affect, craving, accessibility, situational permissibility, use, and motivation to abstain. Baseline survey and EMA data were examined in relation to subsequent lapse during attempted abstinence.

RESULTS

Nearly 3 in 4 participants (73.5%) reported lapsing during attempted abstinence from marijuana. On bivariate analyses, lower baseline dependence severity score, negative effect expectancies, perceived family support, and confidence to abstain were each associated with lapse. Of the use period EMA variables, greater percent of days with marijuana use, reports of easy accessibility, and reports of situational permissibility were each associated with lapse. Modeled together, negative effect expectancies, perceived family support, confidence to abstain, and situational permissibility during use were highly accurate in predicting lapse during attempted abstinence.

CONCLUSIONS

Momentary factors may add to conventionally-surveyed characteristics to enhance prediction of lapse during attempted abstinence among young adults with heavy marijuana use. Momentary assessment prior to a quit attempt may thus enable more effective personalized approaches to preventing lapse.

摘要

简介

经常大量使用大麻的年轻人常常会多次尝试自行戒烟。我们试图确定年轻人在试图戒烟时,在使用大麻期间的瞬间体验,这些体验可能有助于预测他们的复吸。

方法

年龄在 18-25 岁之间、每周至少使用大麻 5 天且计划戒烟的年轻人完成了一项关于社会人口特征、物质使用、大麻预期、使用动机、感知社会支持和戒烟信心的调查。他们在试图戒烟前两周和戒烟期间的两周内,每天多次使用智能手机完成多次即时评估(EMA)报告。使用期 EMA 报告评估了情绪、渴望、可及性、情境许可、使用和戒烟动机。根据基线调查和 EMA 数据,研究了与随后试图戒烟期间的复吸有关的问题。

结果

近四分之三(73.5%)的参与者在试图戒烟期间报告复吸。在单变量分析中,较低的基线依赖严重程度评分、负面效应预期、感知家庭支持和戒烟信心与复吸有关。在使用期 EMA 变量中,每天使用大麻的天数比例较高、易获取报告和情境许可报告与复吸有关。综合来看,使用期间的负面效应预期、感知家庭支持、戒烟信心和情境许可对预测试图戒烟期间的复吸具有很高的准确性。

结论

瞬间因素可能会增加常规调查特征,从而提高对有大量大麻使用的年轻人试图戒烟期间复吸的预测能力。因此,在戒烟尝试之前进行即时评估可能会使更有效的个性化方法预防复吸。

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