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自我药疗假说和家庭社会化理论:检验导致狂饮的独立和共同机制。

Self-medication Hypothesis and Family Socialization Theory: Examining Independent and Common Mechanisms Responsible for Binge Drinking.

机构信息

Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX.

出版信息

Fam Process. 2020 Mar;59(1):288-305. doi: 10.1111/famp.12403. Epub 2018 Oct 25.

Abstract

For many, binge drinking behaviors start early and become a persistent pattern of use throughout the lifespan. In an effort to strengthen understanding of etiology, this study considered the mechanisms from the self-medication hypothesis and family socialization theory. The goal was to identify whether emotional distress is a potential shared mechanism that accounts for the development of binge drinking in different developmental periods. This study used the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset to examine binge drinking across time for n = 9,421 participants ranging in age from 11 to 18 (M = 15.39, SD = 1.62) at Wave I and ranging from 24 to 32 (M = 28.09, SD = 1.61) at Wave IV of the study. Using an autoregressive cross-lagged model, I examined how parent-child closeness, depressive symptoms, and binge drinking were related over three developmental periods. In examining cross-sectional and longitudinal relations, depressive symptoms were significantly related to binge drinking more often than parent-child closeness; however, results indicated the self-medication model may primarily account for concurrent drinking behaviors rather than long-term. The family socialization theory was indicated to account for some variability above and beyond the self-medication hypothesis. No indirect association between binge drinking and the parent-child relationship was detected through depressive symptoms, failing to support a shared mechanism between the two theories. The results provide support for a multifaceted assessment process for substance using clients, and support the use of Multisystemic Family Therapy, Multidimensional Family Therapy, and perhaps Attachment-Based Family Therapy.

摘要

对于许多人来说,狂饮行为始于早期,并在整个生命周期中成为持续的使用模式。为了加强对病因学的理解,本研究考虑了自我药物治疗假说和家庭社会化理论的机制。目的是确定情绪困扰是否是一个潜在的共同机制,可以解释不同发展时期的狂饮行为的发展。本研究使用全国青少年到成人健康纵向研究(Add Health)数据集,在时间上考察了 n = 9421 名参与者的狂饮行为,他们的年龄从第 I 波的 11 岁到 18 岁(M = 15.39,SD = 1.62),到第 IV 波的 24 岁到 32 岁(M = 28.09,SD = 1.61)。通过自回归交叉滞后模型,我考察了在三个发展时期内,亲子亲密程度、抑郁症状和狂饮行为是如何相互关联的。在考察横断面和纵向关系时,抑郁症状与狂饮行为的关系比亲子亲密程度更为显著;然而,结果表明,自我药物治疗模型可能主要解释了当前的饮酒行为,而不是长期的。家庭社会化理论表明,它可以在自我药物治疗假说之外解释一些可变性。在抑郁症状中没有检测到狂饮行为和亲子关系之间的间接关联,这也未能支持这两种理论之间的共同机制。研究结果为物质使用客户的多方面评估过程提供了支持,并支持使用多系统家庭治疗、多维家庭治疗,也许还有依恋为基础的家庭治疗。

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