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一项随机对照试验,比较了基于条件强化的戒烟方案与基于条件强化的戒烟塑造方案:一年的结果。

A randomized controlled trial of contingency management for smoking abstinence versus contingency management for shaping cessation: One-year outcome.

机构信息

Department of Psychology.

出版信息

Exp Clin Psychopharmacol. 2019 Dec;27(6):561-568. doi: 10.1037/pha0000269. Epub 2019 Mar 14.

DOI:10.1037/pha0000269
PMID:30869980
Abstract

This study analyzed whether a contingency management (CM) for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. A total of 110 patients were randomly assigned to 1 of 2 treatment conditions: CMA ( = 55) or CMS ( = 55). All participants received cognitive-behavioral treatment (CBT) implemented in 6 group-based sessions. CMA participants earned voucher-based incentives contingent on providing biochemical evidence of smoking abstinence. CMS reinforced closer approximations to smoking abstinence. At posttreatment, patients assigned to the CMA group achieved the same rates of smoking abstinence (point-prevalence) as those in the CMS group (94.5%; > .05). At the 6-month follow-up, 43.6% of the patients who received CMA maintained smoking abstinence in comparison to 32.7% in the CMS group ( > .05). At the 12-month follow-up, 40% of the participants assigned to the CMA group were abstinent, in comparison to 29.1% who received CMS (p > .05). There were no statistically significant differences in continuous smoking abstinence between the treatment conditions in any of the follow-ups (p > .05). These results offer a novel contribution by suggesting that CM was associated with enduring effects up to 12 months after the end of treatment and that CM for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

这项研究分析了在单纯禁欲期(CMS)之前实施的应急管理(CM)是否会改善寻求治疗的患者在社区环境中的治疗效果,这种 CM 可以塑造戒烟期,而不是仅强化固定的禁欲标准(CMA)。共有 110 名患者被随机分配到 2 种治疗条件之一:CMA(n = 55)或 CMS(n = 55)。所有参与者都接受了 6 次基于小组的认知行为治疗(CBT)。CMA 参与者通过提供吸烟禁欲的生物化学证据来赚取基于凭证的奖励。CMS 则强化了更接近戒烟的目标。在治疗后,被分配到 CMA 组的患者与 CMS 组的患者达到相同的吸烟禁欲率(点患病率)(94.5%;>.05)。在 6 个月的随访中,接受 CMA 的患者中有 43.6%保持吸烟禁欲,而 CMS 组为 32.7%(>.05)。在 12 个月的随访中,被分配到 CMA 组的 40%的参与者保持吸烟禁欲,而接受 CMS 的参与者为 29.1%(p>.05)。在任何随访中,治疗条件之间的连续吸烟禁欲率都没有统计学上的显著差异(p>.05)。这些结果提供了一个新的贡献,表明 CM 与治疗结束后长达 12 个月的持久效果相关,并且在社区环境中,在单纯禁欲期之前实施的 CM 可以改善寻求治疗的患者的治疗效果,而不是仅强化固定的禁欲标准(CMA)。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。

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