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辩证行为疗法技能训练对酒精使用障碍个体成瘾行为的治疗:情绪调节和经验性回避的作用

Dialectical behaviour therapy skills training for the treatment of addictive behaviours among individuals with alcohol use disorder: the effect of emotion regulation and experiential avoidance.

作者信息

Cavicchioli Marco, Ramella Pietro, Vassena Giulia, Simone Giulia, Prudenziati Francesca, Sirtori Federica, Movalli Mariagrazia, Maffei Cesare

机构信息

Department of Psychology, University "Vita-Salute San Raffaele" , Milan, Italy.

Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan, Italy.

出版信息

Am J Drug Alcohol Abuse. 2020 May 3;46(3):368-384. doi: 10.1080/00952990.2020.1712411. Epub 2020 Jan 28.

Abstract

BACKGROUNDS

Dialectical behavior therapy skills training (DBT-ST) is an effective treatment for alcohol use disorder (AUD). AUD frequently co-occurs with other addictive behaviors.

OBJECTIVE

s: These secondary analyses of prior studies on the effectiveness of a 3-month DBT-ST program for AUD investigated pre- post-treatment changes in the severity of concurrent addictive behaviors. The study hypothesized that emotion regulation and experiential avoidance should be the key therapeutic mechanisms involved in the treatment of addictive behaviors.

METHODS

The research included 186 individuals (110 males; 76 females) with a primary diagnosis of AUD. Mediational models were performed considering shorter PROMIS questionnaire subscales (i.e., gambling, sex, shopping, food binging, and starvation) as dependent variables. The difficulties in emotion regulation scale and acceptance and action questionnaire-II total scores were independent and mediator variables, respectively.

RESULTS

Clinical variables significantly improved during the treatment, independent of baseline levels. Changes in emotion regulation showed significant total effects on improvements in addictive behaviors. Significant indirect effects of changes in experiential avoidance were detected considering compulsive buying and dysfunctional eating behaviors.

CONCLUSION

The DBT-ST was a feasible treatment for several addictive behaviors frequently reported by individuals with AUD. The improvements in emotion regulation and experiential avoidance were relevant therapeutic mechanisms involved in the treatment of these conditions. Future controlled trials and follow-up studies are recommended to support the efficacy of DBT-ST as a stand-alone intervention for the treatment of different classes of addictive behaviors.

摘要

背景

辩证行为疗法技能训练(DBT-ST)是治疗酒精使用障碍(AUD)的一种有效方法。AUD常与其他成瘾行为同时出现。

目的

这些对先前关于为期3个月的DBT-ST项目治疗AUD有效性研究的二次分析,调查了治疗前后并发成瘾行为严重程度的变化。该研究假设情绪调节和经验性回避应是治疗成瘾行为的关键治疗机制。

方法

该研究纳入了186名初步诊断为AUD的个体(110名男性;76名女性)。以较短的患者报告结果测量信息系统问卷子量表(即赌博、性、购物、暴饮暴食和节食)作为因变量进行中介模型分析。情绪调节困难量表得分和接纳与行动问卷-II总分分别作为自变量和中介变量。

结果

治疗期间临床变量显著改善,与基线水平无关。情绪调节的变化对成瘾行为的改善显示出显著的总体效应。考虑强迫性购买和功能失调性饮食行为时,经验性回避的变化存在显著的间接效应。

结论

DBT-ST是治疗AUD患者经常报告的几种成瘾行为的一种可行疗法。情绪调节和经验性回避的改善是治疗这些疾病的相关治疗机制。建议未来进行对照试验和随访研究,以支持DBT-ST作为治疗不同类型成瘾行为的独立干预措施的疗效。

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