Psychology of Addictive Behaviors最新文献

Objective: 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.

Method: Adults in intensive outpatient substance use disorder treatment (N = 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.

Results: Lower substance use frequency was associated with significantly improved behavioral activation, reward probability, and reward barriers across the posttreatment period (ps < .05). Higher substance use frequency was associated with significantly lower valued living at each timepoint (ps < .05). Longer abstinence duration was significantly associated with higher behavioral activation and valued living, and lower reward barriers at 12-months (ps < .05).

Conclusions: 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).

Objective: Although Black/African American (hereinafter Black) adults who smoke are a tobacco disparities population in the United States, little systematic research has sought to explicate how differences in the distinct experience of race-related threat are associated with established and clinically important smoking processes in one overarching model. The present investigation sought to bridge this gap and test perceived racial/ethnic discrimination and racial trauma in the context of one another regarding an array of processes involved in the maintenance and relapse of smoking behavior.

Method: Participants included 517 Black individuals who smoked cigarettes daily (≥ 5; M_age = 45.07, SD = 14.72, 51.5% identified as female).

Results: Results indicated that in adjusted models, perceived racial/ethnic discrimination and racial trauma were each associated with an increased risk of more severe problems when quitting smoking as well as somatic symptoms and harmful consequences in smoking abstinence expectancies. For perceived barriers to quitting and negative mood abstinence expectancies, only racial trauma exerted a statistically significant main effect. In contrast, there was a statistically significant main effect only for perceived racial/ethnic discrimination for positive smoking abstinence expectancies, such that greater perceived racial/ethnic discrimination was associated with less positive beliefs about the consequences of abstinence (e.g., positive affect).

Conclusion: Overall, the present investigation indicated that both perceived racial/ethnic discrimination and racial trauma were relatively consistent and impactful explanatory variables for several clinically significant smoking processes, even in the context of one another, among Black adults who smoke in the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Simultaneous use of alcohol and cannabis is prevalent among young adults and associated with heightened risk for harms. Individuals who engage in simultaneous use report a variety of types of use occasions and risk factors driving use occasions are unique and dynamic in nature. Intervention content may thus need to adapt to address differences across occasions. As a first step toward developing momentary interventions, it is critical to identify whether and when psychosocial factors are associated with simultaneous use. The present study aimed to identify the most critical morning and afternoon risk factors for later-day simultaneous use.

Method: Participants were 119 young adult college students (63% female; 73% non-Hispanic/Latinx White) who reported weekly simultaneous use at baseline. Participants completed an online baseline survey and an ecological momentary assessment protocol (eight prompts/day) across four consecutive weekends.

Results: Multilevel models revealed that morning willingness to engage in simultaneous use and social motives were associated with higher odds of later-day simultaneous use. Afternoon willingness and cross-fading motives were significantly associated with higher odds of later-day use. Morning and afternoon conformity motives were associated with lower odds of use.

Conclusions: Early-day willingness to use, morning social motives, and afternoon cross-fading motives were the most salient predictors of later-day simultaneous use and may serve as viable tailoring variables to incorporate in momentary interventions. As simultaneous use episodes commonly start after 9 p.m., there is a large time window in between early-day predictors and use behavior during which timely intervention content could be delivered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Most individuals attending detoxification clinics do not pursue subsequent treatment. Earlier research has suggested that emerging technologies like mHealth interventions could address the postdetoxification treatment gap, yet it remains unclear whether patients themselves endorse such approaches. Our study aimed to qualitatively explore perceived treatment barriers and assessed potential of mHealth among individuals who have undergone alcohol detoxification.

Method: We conducted a single-interview-per-participant qualitative study, sampling participants (n = 23) that had visited the Stockholm substance use disorder emergency department for alcohol-related reasons, of whom n = 8 were purposively included due to having missed their scheduled follow-up outpatient appointment. Semistructured telephone interviews were conducted (2021-2022) and then systematically analyzed using reflexive thematic analysis.

Results: Across both areas of analysis, we identified six themes in total. We clustered barriers to postdetoxification treatment into three themes (10 subthemes) that may offer a nuancing perspective on previous research: "Misalignment between the treatment system and the individual," "Practical hurdles" and "Between reaching out and retreating." We identified three themes in participants' perspectives on mHealth as aftercare support, revealing expectations that such an approach may promote "self-awareness on own terms," assist in "navigating from solitary substance use struggles to supportive connections," and "offer a lifeline when needed most," thereby potentially resolving several barriers to treatment.

Conclusions: This first qualitative study on barriers to alcohol treatment and mHealth potential postdetoxification offered various insights that may be translated into effective, real-world solutions to bridge the postdetoxification treatment gap. A natural next step for future research is to evaluate the impact of mHealth postdetoxification. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The current qualitative study examines the perspectives of women with opioid use disorder (OUD) and professionals that serve them on barriers to engaging in overdose prevention and harm reduction practices and recommendations for improving engagement.

Method: Semistructured interviews (N = 42) were conducted with women with a history of OUD (n = 20), substance use disorder treatment professionals (n = 12), and criminal legal professionals (n = 10). The interviews were inductively coded to identify themes and subthemes regarding experiences with overdose and harm reduction practices.

Results: Themes included heightened vulnerability to overdose, harm reduction challenges faced by women with OUD, and recommendations for overdose prevention and harm reduction practices. Heightened vulnerability to overdose included concerns about toxic supply and concerns about women's drug use behaviors. Challenges to women's harm reduction engagement included lack of knowledge and education about harm reduction tools and strategies and continued stigma toward harm reduction practices. Finally, recommendations for improving harm reduction engagement included increasing accessibility of harm reduction tools, expanding harm reduction education, and shifting away from "abstinence-only" paradigms.

Conclusions: Finding ways to teach women with OUD about harm reduction, more effectively distribute harm reduction tools to them, and reduce stigma among providers and professionals is essential to reduce overdose risk for women with OUD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Understanding the causal mechanisms through which telephone and mobile health continuing care approaches reduce alcohol use can help develop more efficient interventions that effectively target these mechanisms. Self-efficacy for successfully coping with high-risk alcohol relapse situations is a theoretically and empirically supported mediator of alcohol treatment. This secondary analysis aims to examine self-efficacy as a mechanism through which remote-delivered continuing care interventions reduce alcohol use.

Method: The study included 262 adults (M_age = 46.9, SD = 7.4) who had completed 3 weeks of an intensive outpatient alcohol treatment program. The sample was predominantly male (71%), African American (82%), and completed a high school education (71%). The four-arm randomized clinical trial compared three active continuing care interventions (telephone monitoring and counseling [TMC], addiction comprehensive health enhancement support system [ACHESS], and combined delivery of TMC and ACHESS) to usual care and assessed longitudinal measures of alcohol use and self-efficacy. Analyses employed the potential outcomes framework and sensitivity analyses to address threats to causal inference resulting from an observed mediator variable.

Results: Relative to usual care, the two intervention conditions that included TMC reduced alcohol use through improvements to self-efficacy. There was no evidence that self-efficacy mediated the effect of ACHESS on alcohol use.

Conclusions: Based on our findings, self-efficacy is an important mechanism through which telephone continuing care interventions affect alcohol use. Future research to identify which components of TMC influence self-efficacy and factors that mediate ACHESS effects could enhance the effectiveness of remote delivery of continuing care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: While social networks influence individuals with substance use disorders (SUDs), the mechanisms for such influence are under-explored among women who use drugs. This study triangulates the perspectives of criminal justice professionals, SUD treatment professionals, and women with past and current experiences with substance use to explore these dynamics.

Method: We conducted semistructured interviews (N = 42) in 2022 with women with current or past opioid use disorder (n = 20), SUD treatment professionals (n = 12), and criminal justice professionals (n = 10) who work with women with opioid use disorder. Interviews centered around participants' backgrounds, perceived barriers and facilitators to medications for opioid use disorder (MOUD) treatment, and gender-specific issues in MOUD treatment. All interviews were audio-recorded, transcribed, and deidentified. We used a four-step qualitative data analysis process to code transcripts.

Results: Across these participants' accounts, we identified mechanisms by which women's social networks influenced their opioid use trajectories: intergenerational substance use, family support and strain, intimate partner influence, and peer support and pressure. Overall, the emergent themes in the present study reflect the embedded nature of support within social systems. Women who had access to and engaged with various forms of social support tended to be those who use/used MOUD and self-identified as in recovery.

Conclusions: Combining MOUD treatment with psychosocial interventions allows women to heal from trauma, learn effective coping skills, and receive valuable resources to support recovery. Interventions focusing on family resilience and peer recovery support can disrupt the cycle of addiction and promote MOUD treatment success. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Theory and evidence indicate that affirming the value of the self before exposure to a threatening message fosters more open-minded appraisal of message content. We predicted that college students mandated to a computer-delivered personalized feedback intervention (PFI) and who engaged in a self-affirmation (SA) exercise would demonstrate reduce drinking and consequences relative to those who received an attention control.

Method: Participants were 484 undergraduates (age 18-24, 56% male, 78% White) mandated to participate in an alcohol intervention following a first-time alcohol policy violation. After a baseline assessment, each was randomized to SA (n = 256) or attention control (n = 227) prior to a computer-delivered PFI intervention. Posttest measures included an affirmation manipulation check; primary outcomes (past month weekly quantity, peak drinks, binge frequency, consequences) were assessed at 1-, 3-, 6-, 9-, and 12-month follow-ups. We used latent growth curve modeling to test study hypotheses.

Results: The SA exercise increased positive self-evaluation at posttest (p < .001). Overall reductions in drinking and consequences were observed at early follow-up (all p < .05), but the SA manipulation was not associated with intercept or slope factor differences in the models. Engaging in assessments during COVID restrictions was generally associated with reduced drinking and consequences.

Conclusions: The SA exercise did not differentially affect trajectories of alcohol use and consequences, despite evidence that the exercise had the predicted effect on participant's self-evaluations. The lack of SA effects could be attributed to a nonthreatening PFI intervention that is generally accepted among mandated students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: How people define recovery may affect their recovery goals, service use, and ultimately their outcomes. We examined recovery definitions among adults in recovery from an alcohol use disorder (AUD) who had different service use histories.

Method: We analyzed online survey data from 1,492 adults with resolved lifetime AUD in "treated recovery" (any use of specialty services, such as inpatient or outpatient rehabilitation; n = 375), "assisted recovery" (any use of lay services, such as mutual-help groups, and no use of specialty services; n = 174), or "independent recovery" (no use of specialty or lay services; n = 943). Surveys assessed recovery definitions using the 39-item What Is Recovery? (WIR) scale. We compared endorsement of WIR domains and individual recovery elements across groups using survey-weighted chi-square tests and logistic regression.

Results: Endorsement of WIR scale domains was significantly lower among the independent than treated and assisted groups, but few differences emerged between the treated and assisted groups. Two recovery elements were endorsed by approximately equivalent majorities of all groups: "being honest with myself" (92.7%-94.8%) and "taking care of my physical health" (87.4%-90.9%). Five additional elements were similarly endorsed by large majorities (≥ 85%) in each group, albeit at lower levels in the independent group.

Conclusions: People who have experienced AUD and have not obtained alcohol services may have a narrower definition of recovery compared to those accessing treatment or attending mutual-help groups. This suggests a need to broaden alcohol services to better match varied recovery definitions; however, some highly endorsed elements suggest commonalities across recovery pathways. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Recovery capital (RC) is a framework for conceptualizing the resources individuals use to support alcohol and other drug recovery across social, physical, human, and cultural domains. The goal of this study was to identify subgroups of individuals in recovery with distinct combinations of RC across domains and characteristics of individuals with unique RC patterns.

Method: Latent profile analyses investigated patterns in both within-domain amount and variability of RC across each of the four domains using the Multidimensional Inventory of Recovery Capital, a theoretically and psychometrically sound RC measure. The sample included U.S. participants closely reflecting 2020 Census demographics (n = 482, 49% female, 38% racial/ethnic minority, M_age = 42.57) identifying as having resolved a prior problem with alcohol (alone or with other drugs).

Results: Latent profile analyses distinguished four RC profiles: Low/Inconsistent (23%), Moderate/Consistent (43%), Moderate/Inconsistent (12%), and High/Consistent (22%). Females and individuals who were unemployed, nonabstinent, and had greater alcohol problem severity were more likely to belong to the Low/Inconsistent profile. Individuals in unassisted recovery were more likely to belong to the Moderate/Inconsistent profile. Older age and more time in recovery were associated with High/Consistent profile membership. Race/ethnicity was not associated with profile membership.

Conclusions: These person-oriented analyses elucidate complex patterns of resources that individuals utilize during recovery and individual characteristics underpinning differences across RC patterns. The empirically derived subgroups in this heterogeneous sample highlight multiple combinations of resources that individuals leverage to achieve recovery and indicate characteristics of individuals who may need greater amounts and/or consistency of RC to continue sustaining recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).