Kane Louisa, Reese Elizabeth D, Paquette Catherine, Paladino Michael, Linares Abrego Paulina, Daughters Stacey B
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill.
Department of Population Health Sciences, Duke University.
Psychol Addict Behav. 2025 May;39(3):238-253. doi: 10.1037/adb0001051. Epub 2025 Jan 9.
Although research supports an association between increased alternative reinforcement and decreased substance use, the impact of substance use on changes in reinforcement during posttreatment recovery remains untested. This study tested the effect of abstinence duration and substance use frequency on the trajectories of four reinforcement mechanisms, behavioral activation, reward probability, reward barriers, and valued living, from pre- to 12-month posttreatment.
Adults in intensive outpatient substance use disorder treatment ( = 206) completed self-report measures of the four reinforcement constructs and substance use over six timepoints from pre- to 12-month posttreatment. Latent curve models were used to test the association between reinforcement trajectories and abstinence duration and substance use frequency, respectively.
Lower substance use frequency was associated with significantly improved behavioral activation, reward probability, and reward barriers across the posttreatment period (s < .05). Higher substance use frequency was associated with significantly lower valued living at each timepoint (s < .05). Longer abstinence duration was significantly associated with higher behavioral activation and valued living, and lower reward barriers at 12-months (s < .05).
Substance-free reinforcement improves during treatment and is negatively impacted by substance use frequency during posttreatment. Abstinence duration is positively associated with substance-free reinforcement at 12-month posttreatment. These findings support the conceptualization of reinforcement as a malleable treatment target that is negatively impacted by substance use. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
尽管研究支持增加替代强化与减少物质使用之间存在关联，但物质使用对治疗后康复期间强化变化的影响仍未得到检验。本研究测试了禁欲时长和物质使用频率对从治疗前到治疗后12个月的四种强化机制（行为激活、奖励概率、奖励障碍和有价值的生活）轨迹的影响。
接受强化门诊物质使用障碍治疗的成年人（=206）在从治疗前到治疗后12个月的六个时间点完成了四种强化结构和物质使用的自我报告测量。使用潜在曲线模型分别测试强化轨迹与禁欲时长和物质使用频率之间的关联。
较低的物质使用频率与治疗后期间行为激活、奖励概率和奖励障碍的显著改善相关（p <.05）。较高的物质使用频率与每个时间点有价值的生活显著降低相关（p <.05）。较长的禁欲时长与12个月时较高的行为激活和有价值的生活以及较低的奖励障碍显著相关（p <.05）。
无物质强化在治疗期间有所改善，且在治疗后受到物质使用频率的负面影响。禁欲时长与治疗后12个月时的无物质强化呈正相关。这些发现支持将强化概念化为一个可塑的治疗目标，它会受到物质使用的负面影响。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
