寻求药物滥用治疗的退伍军人的药物使用后果、心理健康问题和改变的准备情况。
Substance use consequences, mental health problems, and readiness to change among Veterans seeking substance use treatment.
机构信息
Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
Department of Psychiatry, University of Michigan Addiction Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
出版信息
J Subst Abuse Treat. 2018 Nov;94:113-121. doi: 10.1016/j.jsat.2018.08.005. Epub 2018 Aug 19.
Individuals seeking substance use treatment who have one or more co-occurring mental health problems tend to have lower treatment engagement, higher rates of attrition, and poorer treatment outcomes. Readiness to change (RTC) is an integral construct in the recovery process, with higher RTC associated with improved treatment outcomes. However, the impact of psychiatric symptoms on RTC is not fully understood, especially among specialty subpopulations, such as military Veterans. Therefore, the aim of the present study was to examine the associations of mental health problems with RTC in a sample of Veterans initiating outpatient substance use treatment. The present sample was comprised of 278 Veterans (12% women, M = 48.22, SD = 14.06) who completed self-report intake measures assessing past month substance use frequency, substance-related consequences, symptoms of insomnia, depression, and anxiety, and importance and confidence to change one's substance use. Four separate canonical correlation analyses focusing on RTC alcohol, opioid, cannabis, and nicotine use were conducted. Veterans' inclusion in each analysis was not mutually exclusive. Results indicated that greater depression, anxiety, consequences, and frequency of alcohol use corresponded with greater importance to change alcohol use. Likewise, greater depression, anxiety, and insomnia symptoms along with frequency of use and consequences related to greater importance and confidence to change one's opioid use. In contrast, greater anxiety, depression, insomnia, and frequency of use were associated with less confidence in one's ability to change cannabis use. None of these variables were related to one's RTC nicotine use. Findings highlight the importance of assessing mental health problems at outset of substance use treatment, as they may be an indication of RTC and could be used as a catalyst to advance Veterans forward in the process of behavior change.
寻求物质使用治疗的个体如果存在一种或多种共病性心理健康问题，往往会降低治疗参与度、更高的流失率和更差的治疗结果。改变准备度（RTC）是康复过程中的一个重要结构，更高的 RTC 与改善治疗结果相关。然而，精神症状对 RTC 的影响尚不完全清楚，特别是在特种亚人群中，如退伍军人。因此，本研究的目的是在开始门诊物质使用治疗的退伍军人样本中检查心理健康问题与 RTC 的关联。本样本包括 278 名退伍军人（12%为女性，M=48.22，SD=14.06），他们完成了自我报告的摄入措施，评估过去一个月物质使用频率、与物质相关的后果、失眠、抑郁和焦虑症状，以及改变物质使用的重要性和信心。进行了四项独立的典型相关分析，重点关注 RTC 酒精、阿片类药物、大麻和尼古丁使用。退伍军人在每项分析中的参与并非相互排斥。结果表明，抑郁、焦虑、后果和酒精使用频率的增加与改变酒精使用的重要性成正比。同样，抑郁、焦虑和失眠症状的增加以及使用频率和后果的增加与改变阿片类药物使用的重要性和信心成正比。相比之下，焦虑、抑郁、失眠和使用频率的增加与对自己改变大麻使用能力的信心降低有关。这些变量都与改变尼古丁使用的信心无关。研究结果强调了在物质使用治疗开始时评估心理健康问题的重要性，因为它们可能是 RTC 的一个指标，并可作为推动退伍军人在行为改变过程中前进的催化剂。
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