Macatee Richard J, Albanese Brian J, Okey Sarah A, Afshar Kaveh, Carr Meghan, Rosenthal M Zachary, Schmidt Norman B, Cougle Jesse R
Department of Psychology, Auburn University, Auburn, AL, USA.
Department of Psychology, Auburn University, Auburn, AL, USA.
J Subst Abuse Treat. 2021 Feb;121:108194. doi: 10.1016/j.jsat.2020.108194. Epub 2020 Nov 5.
Prevalence of regular cannabis use and cannabis use disorder (CUD) have increased in the past two decades, but treatment-seeking is low and extant brief interventions do not target causal risk factors implicated in etiological models of addiction. Elevated distress intolerance (DI) is one risk factor that has been empirically linked with greater CUD severity and maintenance in regular users, but, to our knowledge, research has never targeted it in a brief intervention among cannabis users with CUD or at high risk. The current RCT evaluated the impact of a DI intervention (i.e., Distress Tolerance Intervention [DTI]) compared to a healthy habits control intervention (i.e., Healthy Video Control [HVC]) on DI and cannabis use outcomes.
We randomized cannabis users with high DI (N = 60) to the DTI or HVC condition and they received two computerized intervention sessions. We assessed relief cannabis craving at pre- and post-treatment; and we assessed DI, cannabis use coping motives, use-related problems, and use frequency at pre- and post-treatment as well as one- and four-month follow-ups. We assessed CUD symptoms via interviews at pre-treatment and four-month follow-up.
Significant, durable reductions in DI and all cannabis use outcomes occurred in both conditions. Compared to the HVC condition, the DTI led to greater reductions in use frequency during the treatment period. Reductions in self-reported DI were correlated with reductions in coping motives and CUD symptoms.
The DTI's impact on all outcomes was largely comparable to the control condition, though it may have utility as an adjunctive intervention.
在过去二十年中,经常使用大麻及大麻使用障碍(CUD)的患病率有所上升,但寻求治疗的比例较低,且现有的简短干预措施并未针对成瘾病因模型中涉及的因果风险因素。痛苦不耐受性(DI)升高是一个风险因素,经实证研究发现其与经常使用者中更严重的CUD及维持使用大麻有关,但据我们所知,在针对患有CUD或处于高风险的大麻使用者的简短干预中,从未将其作为目标。当前的随机对照试验评估了一种DI干预措施(即痛苦耐受干预[DTI])与一种健康习惯对照干预措施(即健康视频对照[HVC])对DI及大麻使用结果的影响。
我们将高DI的大麻使用者(N = 60)随机分为DTI组或HVC组,他们接受了两次计算机化干预课程。我们在治疗前和治疗后评估缓解大麻渴望的情况;并在治疗前和治疗后以及1个月和4个月随访时评估DI、大麻使用应对动机、与使用相关的问题以及使用频率。我们在治疗前和4个月随访时通过访谈评估CUD症状。
在两种情况下,DI及所有大麻使用结果均出现了显著且持久的降低。与HVC组相比,DTI组在治疗期间使用频率的降低幅度更大。自我报告的DI降低与应对动机及CUD症状的降低相关。
DTI对所有结果的影响在很大程度上与对照条件相当,不过它可能作为一种辅助干预措施具有一定作用。