Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Roanoke, VA, United States.
Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States; Department of Statistics, Virginia Tech, Blacksburg, VA, United States.
J Subst Abuse Treat. 2022 May;136:108665. doi: 10.1016/j.jsat.2021.108665. Epub 2021 Nov 15.
Substance use disorders (SUDs) remain challenging maladies to treat in the United States and impose significant societal costs. Despite these challenges, a significant number of individuals endorse being in recovery from SUD. The scientific understanding of SUD recovery has evolved to include not only improvements in substance use but also improvements in personal wellness and psychosocial functioning. The devaluation of future rewards (delay discounting; DD) is broadly associated with SUD inception and outcomes. We sought to investigate the relationship between DD, time in recovery, and recovery progress.
We conducted an online assessment of 127 individuals in recovery from SUD who the study recruited via the International Quit and Recovery Registry (IQRR). The research team obtained measures of recovery progress via the Addiction Recovery Questionnaire (ARQ) and the Treatment Effectiveness Assessment (TEA). Additionally, the study collected measures of DD, time in recovery, and endorsement of abstinence in recovery (i.e., requiring abstinence vs. not). We utilized linear regression to test for associations among these variables and performed a mediation analysis to test the role of DD in mediating the relationship between time in recovery and measures of recovery progress.
Time in recovery was positively associated with the ARQ (p < .001) and TEA (p < .001). Furthermore, an individual's delay discounting rate mediated the relationship between time in recovery and ARQ/TEA. Of the participants, 66% endorsed recovery requiring total abstinence from alcohol and drugs. Last, through an exhaustive model selection, the study did not find an individual's endorsement of abstinence in recovery to be a primary predictor of recovery progress.
This study presents evidence that, for individuals in recovery, the temporal view (i.e., focus on immediate vs. future rewards) is a significant influence on recovery progress. Additionally, an individual's endorsement of abstinence in recovery was not significantly associated with recovery progress, suggesting the importance of a holistic view of SUD recovery. These findings contribute to the understanding of recovery as a multidimensional process and provide further support for DD as a behavioral marker of addiction.
物质使用障碍（SUD）在美国仍然是难以治疗的疾病，给社会带来了巨大的成本。尽管面临这些挑战，但仍有相当数量的人表示自己已从 SUD 中康复。对 SUD 康复的科学理解已经发展到不仅包括物质使用的改善，还包括个人健康和心理社会功能的改善。未来奖励的贬值（延迟折扣；DD）与 SUD 的发生和结果广泛相关。我们试图研究 DD、康复时间和康复进展之间的关系。
我们对通过国际戒烟与康复登记处（IQRR）招募的 127 名 SUD 康复者进行了在线评估。研究团队通过成瘾康复问卷（ARQ）和治疗效果评估（TEA）获得了康复进展的测量。此外，研究还收集了 DD、康复时间和康复中是否戒酒（即需要戒酒与不需要戒酒）的测量。我们利用线性回归检验这些变量之间的关联，并进行中介分析检验 DD 在中介康复时间与康复进展测量之间的关系。
康复时间与 ARQ（p<0.001）和 TEA（p<0.001）呈正相关。此外，个体的延迟折扣率中介了康复时间与 ARQ/TEA 的关系。在参与者中，66%的人表示需要完全戒酒和戒毒才能康复。最后，通过彻底的模型选择，研究没有发现个体在康复中是否戒酒是康复进展的主要预测因素。
本研究表明，对于康复中的个体，时间视角（即关注即时与未来奖励）对康复进展有重要影响。此外，个体在康复中是否戒酒与康复进展没有显著关联，这表明 SUD 康复的整体视角很重要。这些发现有助于理解康复是一个多维的过程，并进一步支持 DD 作为成瘾的行为标志物。
