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多地点概念验证研究:计算机化趋近回避训练在青少年大麻使用者中的应用。

A multi-site proof-of-concept investigation of computerized approach-avoidance training in adolescent cannabis users.

机构信息

University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.

University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.

出版信息

Drug Alcohol Depend. 2018 Jun 1;187:195-204. doi: 10.1016/j.drugalcdep.2018.03.007. Epub 2018 Apr 11.

Abstract

BACKGROUND

Few effective treatment options exist for cannabis-using youth. This pilot study aimed to test Approach-Avoidance Training to reduce cannabis use with non-treatment-seeking adolescents.

METHODS

Eighty cannabis-using non-treatment-seeking adolescents (average age 19) were recruited from San Diego, California and Charleston, South Carolina, and randomized to complete either six sessions of Cannabis Approach-Avoidance Task Training (CAAT-training) designed to reduce automatic approach biases for cannabis cues or CAAT-sham training. Change in two primary outcome variables was examined: 1) cannabis approach bias and 2) percent cannabis use days over study enrollment. Change in percent alcohol use days over study enrollment was explored as a secondary outcome.

RESULTS

A mixed models repeated measures analysis confirmed the group by time interaction effect for approach bias failed to reach statistical significance (p = .06). Significant group by time interaction effects (ps < 0.05) predicted percent days of cannabis and alcohol use over study enrollment. Participants randomized to the avoid cannabis condition (CAAT-training) reported 7% fewer days of cannabis use compared to 0% change for sham; unexpectedly, those in the avoid cannabis condition reported 10% percent more alcohol use days compared to 3% more for sham.

CONCLUSIONS

Computerized cognitive bias modification paradigms may have utility in reducing adolescent cannabis use. Future work should consider developing a paradigm that addresses both cannabis and alcohol, as well as alternative computerized approaches for coping with addictive behavior in conjunction with bias modification.

摘要

背景

目前针对大麻吸食青少年的有效治疗方案寥寥无几。本研究旨在通过接近回避训练(Approach-Avoidance Training),探索一种减少非治疗寻求青少年大麻使用的方法。

方法

研究招募了来自加利福尼亚州圣地亚哥和南卡罗来纳州查尔斯顿的 80 名非治疗寻求的大麻使用者青少年(平均年龄 19 岁),并随机分为两组,分别完成六次大麻接近回避任务训练(Cannabis Approach-Avoidance Task Training,CAAT-training)或 CAAT 假训练,旨在减少大麻线索的自动接近偏见。主要结果变量 1:大麻接近偏见;2:研究期间大麻使用天数的百分比,变化情况。次要结果变量为研究期间的酒精使用天数百分比变化情况。

结果

混合模型重复测量分析证实,接近偏见的组间时间交互作用未达到统计学意义(p = .06)。显著的组间时间交互作用(p<0.05)预测了研究期间大麻和酒精使用的天数百分比。与假训练相比,被随机分配到避免大麻条件(CAAT 训练)的参与者报告的大麻使用天数减少了 7%,而假训练组的大麻使用天数增加了 0%;出乎意料的是,避免大麻条件组的参与者报告的酒精使用天数增加了 10%,而假训练组增加了 3%。

结论

计算机化认知偏见修正范式可能有助于减少青少年的大麻使用。未来的工作应考虑开发一种既针对大麻又针对酒精的范式,以及与偏见修正相结合的应对成瘾行为的替代计算机化方法。

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