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使用康复资本模型探索物质使用障碍、精神疾病合并症和轻度至边缘性智力障碍个体康复的障碍与促进因素:病例系列

Using the Recovery Capital Model to Explore Barriers to and Facilitators of Recovery in Individuals with Substance Use Disorder, Psychiatric Comorbidity and Mild-to-Borderline Intellectual Disability: A Case Series.

作者信息

Pars Esther, VanDerNagel Joanne E L, Dijkstra Boukje A G, Schellekens Arnt F A

机构信息

Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Centre for Neuroscience, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.

Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands.

出版信息

J Clin Med. 2023 Sep 12;12(18):5914. doi: 10.3390/jcm12185914.

Abstract

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce. This study offers an initial exploration of the viability of (N)RC in three individuals with SUD, psychiatric comorbidities, and an intellectual disability (a triple diagnosis) in inpatient addiction treatment. We collected case file data, ranked recovery goals, and conducted follow-up interviews. The data were subjected to template analysis, using (N)RC domains as codes. All domains were prevalent and relevant, showing dynamic and reciprocal effects, influenced by critical life events acting as catalysts. Notably, during treatment, patients prioritized individual skill development despite challenges in other domains. RC emerges as a valuable concept for mapping recovery barriers and facilitators in individuals with a triple diagnosis, serving as an alternative to the medical model and complementing the biopsychosocial model. It provides a systematic framework to assess critical factors for recovery in complex cases and accordingly align interventions. Future studies should explore the intersections of NRC domains and the dynamic nature of (N)RC to enhance the understanding of the challenges faced by individuals with a triple diagnosis.

摘要

康复资本(RC)涵盖了个人可用于从物质使用障碍(SUD)中康复的广泛资源。它由五个子领域组成:人力、社会、文化、财务和社区康复资本。负面康复资本(NRC)代表康复的障碍。对复杂多重疾病人群中(N)RC的研究很少。本研究初步探讨了(N)RC在三名患有物质使用障碍、精神疾病合并症和智力残疾(三重诊断)的住院成瘾治疗患者中的可行性。我们收集了病例档案数据,对康复目标进行了排序,并进行了随访访谈。使用(N)RC领域作为编码对数据进行模板分析。所有领域都很普遍且相关,显示出动态和相互的影响,受到作为催化剂的关键生活事件的影响。值得注意的是,在治疗期间,尽管在其他领域存在挑战,但患者仍将个人技能发展列为优先事项。康复资本作为一种有价值的概念,可用于描绘三重诊断患者的康复障碍和促进因素,是医学模式的一种替代方案,并补充生物心理社会模式。它提供了一个系统框架,用于评估复杂病例中康复的关键因素,并据此调整干预措施。未来的研究应探索负面康复资本领域的交叉点以及(N)RC的动态性质,以增进对三重诊断患者所面临挑战的理解。

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本文引用的文献

1
Substance Use in Pregnancy: Identifying Stigma and Improving Care.孕期物质使用:识别污名并改善护理。
Subst Abuse Rehabil. 2021 Nov 23;12:105-121. doi: 10.2147/SAR.S319180. eCollection 2021.
2
The science of recovery capital: where do we go from here?恢复资本科学:我们的下一步在哪里?
Addiction. 2022 Apr;117(4):1139-1145. doi: 10.1111/add.15732. Epub 2021 Dec 1.
6
Substance use disorders in people with intellectual disability.智力残疾者的物质使用障碍。
Curr Opin Psychiatry. 2020 Mar;33(2):124-129. doi: 10.1097/YCO.0000000000000569.
8
Mapping and conceptualizing recovery capital of recovered gamblers.绘制和概念化康复赌徒的恢复资本。
Am J Orthopsychiatry. 2020;90(1):22-36. doi: 10.1037/ort0000382. Epub 2018 Dec 27.

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