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慢性阿片类药物使用障碍患者的日常意义感:考察住院治疗期间的社会体验及其与治疗后复发的关联。

Daily meaningfulness among patients with opioid use disorder: Examining the role of social experiences during residential treatment and links with post-treatment relapse.

机构信息

Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.

Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States; Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, United States.

出版信息

Addict Behav. 2021 Aug;119:106914. doi: 10.1016/j.addbeh.2021.106914. Epub 2021 Mar 16.

Abstract

BACKGROUND

A sense of meaningfulness is an important initial indicator of the successful treatment of addiction, and supports the larger recovery process. Most studies address meaningfulness as a static trait, and do not assess the extent to which meaningfulness might vary within an individual, or how it may vary in response to daily life events such as social experiences.

METHODS

Ecological momentary assessment (EMA) was used to: 1) examine the amount of within-person variability in meaningfulness among patients in residential treatment for prescription opioid use disorder; 2) determine whether that variability was related to positive or negative social experiences on a daily basis; and 3) assess whether those day-to-day relationships were related to relapse at four months post-treatment. Participants (N = 73, 77% male, M = 30.10, Range = 19-61) completed smartphone-based assessments four times per day for 12 days. Associations among social experiences, meaningfulness, and relapse were examined using multilevel modeling.

RESULTS

Between-person variability accounted for 52% (95% CI = 0.35, 0.67) of variance in end-of-day meaningfulness. End-of-day meaningfulness was higher on days when participants reported more positive social experiences (β = 1.17, SE = 0.33, p < .05, ΔR = 0.041). On average, participants who relapsed within four months post-residential treatment exhibited greater within-day reactivity to negative social experiences (β = -1.89, SE = 0.88, p < .05, ΔR = 0.024) during treatment than participants who remained abstinent.

CONCLUSION

Individual differences in maintaining meaningfulness day by day when faced with negative social experiences may contribute to the risk of relapse in the early months following residential treatment.

摘要

背景

意义感是成瘾治疗成功的一个重要初始指标,它支持着更大的康复过程。大多数研究将意义感视为一种静态特征,并未评估其在个体内部的变化程度,或者它如何因日常生活事件(如社交经历)而变化。

方法

使用生态瞬时评估(EMA):1)检查参加住宅治疗的处方类阿片类药物使用障碍患者的意义感在个体内的变化程度;2)确定这种变化程度是否与每天的积极或消极社交经历有关;3)评估这些日常关系是否与治疗后四个月的复发有关。参与者(N=73,77%为男性,M=30.10,范围为 19-61)在 12 天内每天完成 4 次基于智能手机的评估。使用多层建模来检验社交经历、意义感和复发之间的关系。

结果

个体间的变异性解释了结束时意义感的 52%(95%CI=0.35, 0.67)的方差。当参与者报告更多积极的社交经历时,结束时的意义感更高(β=1.17,SE=0.33,p<0.05,ΔR=0.041)。平均而言,在住宅治疗后四个月内复发的参与者在治疗期间对消极社交经历的日内反应性大于未复发的参与者(β=-1.89,SE=0.88,p<0.05,ΔR=0.024)。

结论

在面对消极社交经历时,每天保持意义感的个体差异可能会增加住宅治疗后早期复发的风险。

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