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支持成瘾的心理社会、疾病和脑部疾病模型:对澳大利亚、英国和美国治疗提供者态度的调查

Support for the psychosocial, disease and brain disease models of addiction: A survey of treatment providers' attitudes in Australia, the UK, and U.S.

机构信息

Turning Point, Eastern Health, Melbourne, Australia; School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.

School of Social Sciences, Faculty of Arts, Monash University, Melbourne, Australia.

出版信息

J Subst Abuse Treat. 2020 Aug;115:108033. doi: 10.1016/j.jsat.2020.108033. Epub 2020 May 12.

Abstract

BACKGROUND

How addiction treatment providers view different models of addiction has implications for workforce development and addiction treatment, however research exploring their views is limited. This study examined Australian, UK and US treatment providers': (1) levels of support for the psychosocial, disease model of addiction (DMA) and brain disease model of addiction (BDMA); and, (2) individual demographic characteristics that were associated with support for these models.

METHODS

A total of 1438 treatment providers in Australia (n = 337), the UK (n = 165) and US (n = 936) completed an online survey. Support for the psychosocial and DMA were measured using the Short Understanding of Substance Abuse Scale (SUSS) (Humphreys et al., 1996) and BDMA support using a measure created by the authors. Hierarchical multiple linear regression analyses were used to analyze associations between treatment providers' demographic characteristics (i.e., previous addiction status, attended 12-step programmes, age, gender, education level) and level of support for each model.

RESULTS

There were no significant differences in treatment providers' support for the psychosocial model between the three country groups. US participants had significantly higher levels of support for the DMA than the UK group, and the UK group was higher than the Australian group. US participants had significantly higher levels of support for the BDMA than Australian and UK participants. Regression analyses found that being younger in all three country groups and a higher level of education in the UK group was associated with greater psychosocial model support. A personal experience of addiction and 12-step programmes was associated with stronger support for the DMA, as was older age in the Australian and US treatment provider groups. In the US group, a personal experience of addiction and 12-step programmes was associated with support for the BDMA.

CONCLUSION

Treatment providers from different backgrounds and in different countries vary in how they view the etiology of addiction. How differences in views about addiction impact service delivery and clients' experience of care remains an important topic for future research. Furthermore, policy makers should consider treatment providers' heterogenous views about addiction and the implications for service delivery and workforce policy development.

摘要

背景

成瘾治疗提供者对不同成瘾模式的看法会影响劳动力发展和成瘾治疗,但目前探索这些看法的研究有限。本研究考察了澳大利亚、英国和美国的治疗提供者:(1)对心理社会、疾病模型成瘾(DMA)和大脑疾病模型成瘾(BDMA)的支持程度;以及(2)与支持这些模型相关的个体人口统计学特征。

方法

澳大利亚(n=337)、英国(n=165)和美国(n=936)共有 1438 名治疗提供者完成了在线调查。使用短期理解物质滥用量表(SUSS)(Humphreys 等人,1996)测量对心理社会和 DMA 的支持,BDMA 支持使用作者创建的度量标准。使用分层多元线性回归分析来分析治疗提供者的人口统计学特征(即以前的成瘾状态、参加 12 步程序、年龄、性别、教育水平)与对每种模型的支持程度之间的关联。

结果

三组国家的治疗提供者对心理社会模式的支持没有显著差异。美国参与者对 DMA 的支持水平明显高于英国组,而英国组则高于澳大利亚组。美国参与者对 BDMA 的支持水平明显高于澳大利亚和英国参与者。回归分析发现,在所有三个国家组中,年龄越小和英国组的教育水平越高,对心理社会模式的支持越大。在澳大利亚和美国的治疗提供者群体中,个人成瘾经历和 12 步程序与对 DMA 的更强支持相关。在美国组中,个人成瘾经历和 12 步程序与对 BDMA 的支持相关。

结论

来自不同背景和不同国家的治疗提供者在如何看待成瘾的病因学方面存在差异。对成瘾的看法差异如何影响服务提供和客户的护理体验仍然是一个重要的研究课题。此外,政策制定者应考虑治疗提供者对成瘾的异质观点及其对服务提供和劳动力政策制定的影响。

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