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渴望管理:探索影响年轻人中与大麻使用相关的瞬间渴望风险的因素。

Craving management: Exploring factors that influence momentary craving-related risk of cannabis use among young adults.

作者信息

Enkema Matthew C, Hallgren Kevin A, Bowen Sarah, Lee Christine M, Larimer Mary E

机构信息

Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 354944, 1100 NE 45(th) St, Suite 300, Seattle, WA 98105, United States; Veterans Affairs, Puget Sound Health Care System, Seattle Division, 1660 S Columbian Way SE, 98108, United States.

Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, Seattle, WA 98195, United States.

出版信息

Addict Behav. 2021 Apr;115:106750. doi: 10.1016/j.addbeh.2020.106750. Epub 2020 Dec 3.

Abstract

Young adult frequent cannabis use has increased in prevalence and some frequent users have problems reducing their use. A strong link between momentary craving and subsequent use behaviors among individuals with problematic cannabis use has been reported in the literature, including young adults. In treatment contexts, interventions based on associative learning and reinforcement aim to reduce the prevalence of problematic substance use by altering the association between craving and use by increasing craving management skills such as mindfulness and reducing unhelpful responding such as avoidance or suppression. However, this model has not been tested among young adult cannabis users. The current study examined the influence of trait and state craving management strategies (mindfulness, coping style, experiential avoidance, and craving beliefs) on the link between momentary craving and use, using ecological momentary assessment in a sample of young adults with problematic use interested in reducing their use. Results demonstrated that two craving management constructs were associated with use: non-reactivity (p = 0.02) and non-judgment (p < 0.01). Interactions with momentary craving were observed for two constructs: non-judgmentalness (p = 0.02) and craving beliefs (p < 0.01). Findings suggest that treatments that increase non-reactivity and non-judgmentalness may reduce the occurrence of cannabis use for young adults contemplating reduction during an important period of biopsychosocial development by mitigating the impact of craving or directly reducing use. Additionally, negative beliefs about craving may serve a protective function during acute periods of elevation in momentary craving, an unexpected finding deserving further investigation.

摘要

年轻成年人频繁使用大麻的情况在患病率上有所增加,一些频繁使用者在减少使用量方面存在问题。文献报道,包括年轻成年人在内,有问题的大麻使用者中,瞬间渴望与随后的使用行为之间存在紧密联系。在治疗环境中,基于联想学习和强化的干预措施旨在通过改变渴望与使用之间的关联来降低有问题物质使用的患病率,具体方式包括提高如正念等渴望管理技能,以及减少如回避或抑制等无益反应。然而,该模型尚未在年轻成年大麻使用者中进行测试。本研究使用生态瞬时评估法,对有减少使用意愿的有问题使用的年轻成年人样本进行研究,考察特质和状态渴望管理策略(正念、应对方式、经验回避和渴望信念)对瞬间渴望与使用之间联系的影响。结果表明,两种渴望管理结构与使用相关:无反应性(p = 0.02)和无评判性(p < 0.01)。观察到两种结构与瞬间渴望存在交互作用:非评判性(p = 0.02)和渴望信念(p < 0.01)。研究结果表明,通过减轻渴望的影响或直接减少使用,增加无反应性和无评判性的治疗方法可能会减少处于生物心理社会发展重要阶段且考虑减少大麻使用的年轻成年人的大麻使用发生率。此外,对渴望的负面信念可能在瞬间渴望升高的急性期起到保护作用,这一意外发现值得进一步研究。

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