Department of Behavioral Science, University of Kentucky College of Medicine.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine.
J Exp Anal Behav. 2022 Jul;118(1):83-95. doi: 10.1002/jeab.770. Epub 2022 May 10.
Contingency management (CM) interventions are the most effective psychosocial interventions for substance use disorders. However, further investigation is needed to create the most robust intervention possible. This study investigated the effects of 1) reinforcer magnitude; and 2) fixed and escalating and resetting incentives on cocaine abstinence in an outpatient trial. In this analysis, 34 treatment-seeking individuals with Cocaine Use Disorder received either high or low value incentives for providing a benzoylecgonine-negative urine sample or were in a control condition and received incentives for providing a urine sample regardless of the results. Participants received either escalating and resetting incentives, wherein the value of each incentive increased with consecutive negative samples and reset to the initial level upon a positive sample (Experiment 1), or fixed incentives, wherein they received the same value incentive for each negative urine sample they provided (Experiment 2). Large incentives produced more abstinence, although escalating and resetting reinforcer values did not have a differential effect. Large, fixed incentives promoted abstinence faster than other reinforcers, whereas smaller incentives resulted in poor abstinence and took many visits to achieve initial abstinence. Future research comparing different schedules on cocaine abstinence in a randomized control trial with a larger sample size is required.
contingency management (CM) 干预措施是治疗物质使用障碍最有效的心理社会干预措施。然而,需要进一步的研究来创建最强大的干预措施。本研究在一项门诊试验中调查了 1)强化物大小;以及 2)固定和递增及重置激励对可卡因戒除的影响。在这项分析中,34 名寻求治疗的可卡因使用障碍患者要么提供苯甲酰基古柯碱阴性尿液样本,要么接受高或低价值的奖励,要么处于控制条件下,无论结果如何,只要提供尿液样本,就会得到奖励。参与者接受递增和重置激励,其中每个激励的价值随着连续的阴性样本而增加,并在阳性样本时重置为初始水平(实验 1),或者接受固定激励,即他们为提供的每个阴性尿液样本提供相同价值的激励(实验 2)。大的激励产生更多的戒除,尽管递增和重置强化值没有产生差异。大的、固定的激励可以更快地促进戒除,而较小的激励则导致戒除不良,并且需要多次访问才能实现最初的戒除。需要在一项更大样本量的随机对照试验中比较不同方案对可卡因戒除的影响。