Division of Alcohol and Drug Abuse, McLean Hospital.
Psychiatric Biostatistics Laboratory, McLean Hospital.
Health Psychol. 2020 Sep;39(9):806-814. doi: 10.1037/hea0000862.
More than 2 million people in the United States had an opioid use disorder in 2017. Treatment for opioid use disorder-particularly medication combined with psychosocial support-is effective for reducing opioid use and decreasing overdose risk. However, approximately 50% of people who receive treatment will relapse or drop out. Stress reactivity, defined as the subjective and physiological response to stress, is heightened in people with opioid use disorder and higher stress reactivity is associated with poorer outcomes. Preliminary studies suggest that stress reactivity may be a key mechanistic target for improving outcomes. This article describes the design of an ongoing study examining behavioral strategies for reducing stress reactivity in adults with opioid use disorder. Our objective is to test the efficacy of two behavioral strategies for reducing stress reactivity and enhancing behavioral persistence in the context of stress (distress tolerance).
We will recruit 120 adults with opioid use disorder and randomly assign them to brief training in (a) cognitive reappraisal, (b) affect labeling, or (c) a psychoeducational control. Participants will receive the training intervention followed by a laboratory stressor during which they will be instructed to apply the trained skill.
Subjective and physiological responses to stress will be measured as indices of stress reactivity and the stressor task will include a behavioral persistence component as a measure of distress tolerance.
The ultimate goal of this study is to inform the development of behavioral interventions that can be used as an adjunct to medication-based treatment for opioid use disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
2017 年，美国有超过 200 万人患有阿片类药物使用障碍。阿片类药物使用障碍的治疗方法——特别是药物联合心理社会支持——对于减少阿片类药物的使用和降低过量风险是有效的。然而，大约 50%接受治疗的人会复发或退出。应激反应性是指对压力的主观和生理反应，在患有阿片类药物使用障碍的人中更为强烈，较高的应激反应性与较差的治疗结果相关。初步研究表明，应激反应性可能是改善治疗结果的一个关键机制靶点。本文介绍了一项正在进行的研究的设计，该研究旨在探讨减少阿片类药物使用障碍成人应激反应性的行为策略。我们的目的是测试两种行为策略在应激（耐痛苦）环境下降低应激反应性和增强行为坚持性的疗效。
我们将招募 120 名患有阿片类药物使用障碍的成年人，并将他们随机分配到简短的认知重评（a）、情感标签（b）或心理教育对照（c）训练中。参与者将接受培训干预，然后在实验室应激源下进行，他们将被指示应用训练过的技能。
应激的主观和生理反应将作为应激反应性的指标进行测量，应激源任务将包括行为坚持性作为耐痛苦的测量指标。
本研究的最终目标是为开发行为干预措施提供信息，这些干预措施可以作为阿片类药物使用障碍药物治疗的辅助手段。（PsycInfo 数据库记录（c）2020 APA，保留所有权利）。
