Sirvent-Ruiz Carlos Miguel, Miranda María, Moral-Jiménez María de la Villa
Research and Teaching Department, Fundación Instituto Spiral, Madrid, Spain.
Department of Psychology, University of Oviedo, Oviedo, Spain.
PLoS One. 2025 Jun 27;20(6):e0326853. doi: 10.1371/journal.pone.0326853. eCollection 2025.
Withdrawal from addiction treatment is a frequent but difficult-to-predict contingency. We clarify and contextualize the concept of dropouts in addiction treatment, as well as the external and internal elements that most frequently lead to such dropouts. The main instruments used to measure dropout are summarized, after which a new tool, Predictors of Dropout from Addiction Treatment (PDAT) scale, is presented. The PDAT consists of four factors: 1) Motivation: desire to recover and to actively engage in current treatment; 2) Craving: longing for the use of substances and/or the substance addiction environment; 3) Problem awareness: level of insight, or degree of knowledge, and ability to objectify the problem and the disease, with the renunciations and limitations that this entails; and 4) Dysphoria: dyade inner restlessness - moodiness, i.e., emotional disturbance and depressive anticipation that precedes treatment withdrawal.
The sample consisted of 243 addicted subjects in residential treatment, ranging in age from 18 to 63 years (average = 38.43, standard deviation = 10.95), who completed an initial 26-item PDAT questionnaire. The factor structure of the PDAT was determined by factor analysis. Mixed effects logistic regressions and receiver operating characteristics curve (ROC) analyses were applied to assess the predictive validity of the PDAT. Results: The 13-item PDAT showed adequate reliability and convergent and discriminant validity, with both the general scale and each of its factors having predictive validity 7 and 15 days after administration.
The scale is a useful instrument with proven clinical efficacy and brevity of application. In addition, its four factors are useful for targeting interventions based on the unbalanced factors.
从成瘾治疗中退出是一种常见但难以预测的情况。我们阐明并将成瘾治疗中退出的概念置于具体情境中，以及最常导致此类退出的外部和内部因素。总结了用于衡量退出的主要工具，之后介绍了一种新工具——成瘾治疗退出预测因子（PDAT）量表。PDAT由四个因素组成：1）动机：康复的愿望以及积极参与当前治疗的意愿；2）渴望：对使用物质和/或物质成瘾环境的渴望；3）问题意识：洞察力水平、知识程度以及将问题和疾病客观化的能力，以及随之而来的放弃和限制；4）烦躁不安：内心不安与喜怒无常的二元组合，即治疗退出前的情绪困扰和抑郁预期。
样本包括243名接受住院治疗的成瘾者，年龄在18至63岁之间（平均 = 38.43，标准差 = 10.95），他们完成了一份初始的26项PDAT问卷。通过因子分析确定PDAT的因子结构。应用混合效应逻辑回归和受试者工作特征曲线（ROC）分析来评估PDAT的预测效度。结果：13项PDAT显示出足够的信度、收敛效度和区分效度，量表及其各个因子在施测后7天和15天均具有预测效度。
该量表是一种有用的工具，具有已证实的临床疗效和应用简便性。此外，其四个因素有助于基于不平衡因素进行有针对性的干预。
