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迈向青少年物质使用障碍表现、预防和治疗的新动态交互模型:一项叙述性综述

Towards a New Dynamic Interaction Model of Adolescent CUD Manifestation, Prevention, and Treatment: A Narrative Review.

作者信息

Oosten Wesley, Vos Elena, Los Leontien, Nelwan Michel, Pieters Toine

机构信息

Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands.

Trimbos Institute, P.O. Box 80 125, 3500 AS Utrecht, The Netherlands.

出版信息

Psychoactives. 2023 Oct 17;2(4):294-316. doi: 10.3390/psychoactives2040019.

Abstract

BACKGROUND

Cannabis is one of the most popular drugs of the 21st century, especially among adolescents and young adults. Evidence of a variety of lasting neuropsychological deficits as a result of chronic cannabis use has increased. Furthermore, regular cannabis use is found to be a predictor of mental health problems, less motivation in school, and school dropout.

AIM

Our goal is to propose a theoretical model of adolescent cannabis use disorder (CUD) based on Zinberg's drug, set, and setting model and explicated by a review of the literature on adolescent cannabis use to improve the prevention and treatment of CUD for adolescents.

METHODS

PubMed and Web of Science were searched for relevant publications as part of a hypothesis-based and model-generating review.

RESULTS

Individual (set) and environmental (setting) risk factors play important roles in the development of CUD in adolescents. School performance, motivation, and attendance can be negatively influenced by persistent cannabis use patterns and adolescent brain development can consequently be impaired. Thus, cannabis use can be understood as both being the cause of poor school performance but also the consequence of poor school performance. To prevent and reduce adolescent CUD the drug, set, and setting must all be considered. It is important to notice that the multiple feedback loops (indicated in our dynamic interaction model) are not mutually exclusive, but offer important intervention focus points for social workers, addiction professionals, parents, and other care takers.

CONCLUSION

We argue that the three dimensions of drug, set, and setting contribute significantly to the eventual manifestation of CUD. Based on our dynamic interaction model, recommendations are made for possible preventive and therapeutic interventions for the treatment of adolescents and young adults with CUD.

摘要

背景

大麻是21世纪最流行的毒品之一,尤其在青少年和年轻人中。长期使用大麻导致各种持久性神经心理缺陷的证据有所增加。此外,经常使用大麻被发现是心理健康问题、在校缺乏动力和辍学的一个预测因素。

目的

我们的目标是基于津伯格的药物、个体因素和环境因素模型,提出一个青少年大麻使用障碍(CUD)的理论模型,并通过对青少年大麻使用文献的综述进行阐释,以改善青少年CUD的预防和治疗。

方法

作为基于假设和生成模型的综述的一部分,在PubMed和科学网中搜索相关出版物。

结果

个体(个体因素)和环境(环境因素)风险因素在青少年CUD的发展中起重要作用。持续的大麻使用模式会对学业成绩、动力和出勤率产生负面影响,进而可能损害青少年大脑发育。因此,大麻使用既可以被理解为学业成绩差的原因,也可以被理解为学业成绩差的结果。为了预防和减少青少年CUD,必须综合考虑药物、个体因素和环境因素。需要注意的是,多个反馈回路(在我们的动态交互模型中显示)并非相互排斥,而是为社会工作者、成瘾专业人员、家长和其他照顾者提供了重要的干预重点。

结论

我们认为,药物、个体因素和环境因素这三个维度对CUD的最终表现有显著影响。基于我们的动态交互模型,针对患有CUD的青少年和年轻人的治疗,提出了可能的预防和治疗干预建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f9e/7616443/954768c3f36d/EMS198172-f001.jpg

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