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大麻使用障碍的精准心理健康护理:一种生物社会认知理论对治疗的指导作用

Precision Mental Health Care for Cannabis Use Disorder: Utility of a bioSocial Cognitive Theory to Inform Treatment.

作者信息

Gullo Matthew J, Papinczak Zoë E, Feeney Gerald F X, Young Ross McD, Connor Jason P

机构信息

National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia.

Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia.

出版信息

Front Psychiatry. 2021 Jun 28;12:643107. doi: 10.3389/fpsyt.2021.643107. eCollection 2021.

Abstract

Globally, cannabis is the most frequently used controlled substance after alcohol and tobacco. Rates of cannabis use are steadily increasing in many countries and there is emerging evidence that there is likely to be greater risk due to increased concentrations of delta-9-tetrahydrocannabinol (THC). Cannabis use and Cannabis Use Disorder (CUD) has been linked to a wide range of adverse health outcomes. Several biological, psychological, and social risk factors are potential targets for effective evidence-based treatments for CUD. There are no effective medications for CUD and psychological interventions are the main form of treatment. Psychological treatments based on Social Cognitive Theory (SCT) emphasize the importance of targeting 2 keys psychological mechanisms: drug outcome expectancies and low drug refusal self-efficacy. This mini-review summarizes the evidence on the role of these mechanisms in the initiation, maintenance, and cessation of cannabis use. It also reviews recent evidence showing how these psychological mechanisms are affected by social and biologically-based risk factors. A new is outlined that integrates these findings and implications for psychological cannabis interventions are discussed. Preliminary evidence supports the application of bSCT to improve intervention outcomes through better targeted treatment.

摘要

在全球范围内,大麻是仅次于酒精和烟草的最常使用的管制物质。许多国家的大麻使用率正在稳步上升,并且有新出现的证据表明,由于δ-9-四氢大麻酚(THC)浓度增加,可能存在更大风险。大麻使用和大麻使用障碍(CUD)与广泛的不良健康后果有关。几种生物学、心理学和社会风险因素是CUD有效循证治疗的潜在目标。目前尚无治疗CUD的有效药物,心理干预是主要治疗形式。基于社会认知理论(SCT)的心理治疗强调针对两个关键心理机制的重要性:药物结果预期和低药物拒绝自我效能感。本综述总结了这些机制在大麻使用的起始、维持和戒断中的作用的证据。它还回顾了最近的证据,表明这些心理机制是如何受到社会和基于生物学的风险因素影响的。概述了一个新的框架,并讨论了这些发现对心理大麻干预的影响。初步证据支持应用行为社会认知理论(bSCT)通过更有针对性的治疗来改善干预效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c60f/8273258/cd1e36130e0f/fpsyt-12-643107-g0001.jpg

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