Rice Myra, Dean Andy C, Suh Jaymee, London Edythe D
Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, CA, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
Subst Abuse. 2022 Nov 8;16:11782218221135721. doi: 10.1177/11782218221135721. eCollection 2022.
Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence.
This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc -tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis.
SCID summary scores were negatively correlated with URICA Precontemplation scores ( = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems ( = 3.066, = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, = .26; = .01).
The findings highlight the importance of a patient's insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
否认，即对与药物滥用相关问题缺乏认识，是药物使用障碍的一个常见特征，可能会影响治疗参与度和康复情况。本研究测试了否认与甲基苯丙胺依赖诊断中使用的症状严重程度之间的关联。
这项二次分析使用了69名参与者（52.2%为男性）的数据，这些参与者在《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈（SCID）中符合甲基苯丙胺依赖的诊断标准。通过SCID总结分数（8项）确定的诊断严重程度与通过（URICA）未考虑阶段分数测量的否认之间的关联，采用Pearson相关性检验。在事后检验中，对在个别SCID项目上存在差异的参与者的未考虑阶段分数进行了比较。还对额外的URICA子量表（考虑阶段、维持阶段、行动阶段）进行了二次测试。
SCID总结分数与URICA未考虑阶段分数呈负相关（r = -0.342，p = 0.003）。事后检验显示，尽管存在持续或反复出现的问题但仍否认继续使用甲基苯丙胺的参与者（SCID项目6）的未考虑阶段分数显著高于承认这些问题的参与者（t = 3.066，p = 0.003）。相比之下，在URICA上，诊断严重程度与更大的改变开放性/意愿之间存在正相关（例如，维持阶段，r = 0.26，p = 0.01）。
研究结果突出了患者对自身成瘾问题的洞察力在临床诊断中的重要性。由于尽量减少甲基苯丙胺使用的影响可能会妨碍或延迟治疗，建议补充自我报告以提高诊断准确性。
