Department of Family and Community Medicine.
Department of Statistics.
Exp Clin Psychopharmacol. 2023 Feb;31(1):127-139. doi: 10.1037/pha0000580. Epub 2022 Jun 16.
Contingency management (CM), in which financial incentives are provided upon verification of abstinence from alcohol, cigarettes, and/or illicit substances, is one of the most highly effective and empirically supported treatments for substance use disorders. However, the financial cost of implementation has been identified as a major barrier to implementation of this treatment. The purpose of this study was to develop behavioral economic purchase tasks to assess interest in CM as a function of treatment cost and perceived effectiveness of CM as a function of abstinence incentive size in alcohol drinkers. Alcohol drinkers recruited from Amazon Mechanical Turk (MTurk) completed behavioral economic purchase tasks measuring demand for CM based on targeted abstinence intervals and treatment effectiveness and alcohol use disorder severity assessments. Nonlinear mixed-effects modeling was used to fit demand curves and assess the relationship between individual characteristics and demand metrics for CM. Results reveal that participants reported higher probability of remaining abstinent from drinking when offered larger incentives and required larger incentives when duration of abstinence required to earn the incentive was increased. Additionally, willingness to pay for treatment increased as effectiveness of treatment increased. Abstinence interval and treatment effectiveness are important features to consider when developing effective CM for widespread use, as these variables affected participants' likelihood of being abstinent and their interest in treatment. Future work will validate these assessments with actual treatment outcomes and determine predictors of CM treatment effectiveness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
contingency management (CM)，即通过验证是否戒除酒精、香烟和/或非法物质来提供经济奖励，是治疗物质使用障碍最有效和最有经验支持的方法之一。然而，实施的经济成本已被确定为实施这种治疗的主要障碍。本研究的目的是开发行为经济学购买任务，以评估对 CM 的兴趣，其取决于治疗成本，以及对 CM 的有效性的看法，取决于戒断奖励的大小，这些都与酒精饮酒者有关。从亚马逊 Mechanical Turk (MTurk)招募的酒精饮酒者完成了行为经济学购买任务，根据目标戒断间隔和治疗效果以及酒精使用障碍严重程度评估，衡量了对 CM 的需求。使用非线性混合效应模型拟合需求曲线，并评估 CM 的需求指标与个体特征之间的关系。结果表明，当提供更大的奖励时，参与者报告说他们更有可能保持饮酒戒断，而当获得奖励所需的戒断持续时间增加时，他们需要更大的奖励。此外，随着治疗效果的提高，支付治疗费用的意愿也会增加。在开发广泛使用的有效 CM 时，戒断间隔和治疗效果是需要考虑的重要特征，因为这些变量会影响参与者保持戒断的可能性和他们对治疗的兴趣。未来的工作将通过实际的治疗结果来验证这些评估，并确定 CM 治疗效果的预测因素。
