Advances in Dual Diagnosis最新文献_第4页

Neurocognitive and substance use disorders in older adults: challenges and evidence 老年人神经认知和物质使用障碍:挑战和证据

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2022-03-29 DOI: 10.1108/add-01-2022-0004

Aditi Agrawal, Rayah Touma Sawaya, M. Ojeahere, Vanessa Padilla, S. El Hayek

PurposeThis study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.Design/methodology/approachElectronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.FindingsResearch about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.Originality/valueThis review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

目的本研究旨在回顾老年人物质使用障碍的表现，成瘾如何与神经认知障碍交织以及如何接近这一弱势群体。设计/方法/方法使用关键词“神经认知”、“痴呆”、“物质使用”、“成瘾”、“老年人”和“老年人”对PubMed、Medline和Cochrane图书馆(2000-2021年)进行电子数据搜索。作者一致选择了关键研究，并对研究结果进行了叙述综合。研究结果关于老年人物质使用障碍的研究是有限的，特别是在那些有叠加神经认知障碍的老年人中。双重诊断会使任何一种疾病的识别和治疗变得具有挑战性。管理应采用包括医疗专业人员和护理人员在内的综合多学科方法。原创性/价值本综述强调了老年人物质使用障碍和神经认知障碍之间的一些相互交织的方面。它提供了对这一人群治疗的现有证据的全面总结。

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引用次数: 0

Social recovery and economy: a thematic analysis of staffs’ experiences with promoting social community participation for residents with co-occurring problems 社会恢复与经济:工作人员为有共同问题的居民促进社会社区参与的经验专题分析

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2022-03-04 DOI: 10.1108/add-11-2021-0014

E. Ogundipe, Knut Tore Sælør, S. Biong

PurposeThis study aims to explore and describe staff working in a Norwegian supportive housing site’s experiences with promoting social community participation for residents with co-occurring problems. The research question addressed was: how does residential support staff experience promoting social community participation for residents with co-occurring problems?Design/methodology/approachNine residential support staff participated in qualitative interviews. All interviews were recorded and transcribed verbatim. The transcripts were analysed using Braun and Clarke's approach to thematic analysis.FindingsThe analysis process resulted in two themes: “It is all about economics” and “Who will pay for it?”Practical implicationsRegarding the Nordic welfare system, the need for a redistribution of financial resources in health services is discussed. The authors recommend that further studies explore people outside the regular health-care system perspectives on how they can contribute to making community inclusion a reality for persons experiencing co-occurring problems.OriginalityThis study provides a nuanced understanding of how financial resources can impede or support efforts and opportunities to promote community inclusion for residents experiencing co-occurring problems.

目的本研究旨在探讨和描述在挪威一个支持性住房站点工作的工作人员在促进有共同问题的居民参与社会社区方面的经验。研究的问题是:住宿支援人员如何促进有共同问题的居民的社会社区参与?设计/方法/方法9名住宿支持人员参加了定性访谈。所有的采访都被逐字记录下来。使用Braun和Clarke的主题分析方法对文本进行分析。分析过程产生了两个主题:“这一切都是关于经济的”和“谁将为此买单?”关于北欧福利制度的实际意义，讨论了在卫生服务中重新分配财政资源的必要性。这组作者建议，进一步的研究应该探索常规卫生保健系统之外的人，看看他们如何能够为经历共同出现的问题的人实现社区包容做出贡献。本研究提供了一个细致入微的理解，财政资源如何阻碍或支持努力和机会，以促进社区包容的居民经历共同发生的问题。

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引用次数: 0

Acceptability and preliminary effectiveness of a text messaging intervention to reduce high-risk alcohol use among adults 50 and older: an exploratory study 一项探索性研究:短信干预在50岁及以上成年人中减少高风险酒精使用的可接受性和初步有效性

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2022-02-17 DOI: 10.1108/add-11-2021-0012

A. Kuerbis, S. Behrendt, V. Arora, Frederick J Muench

PurposePrevalence rates of older adults (OA, 50+) with high-risk alcohol use are rapidly growing. Barriers to intervention persist for OA. Mobile interventions, specifically short message service (SMS, also known as text messaging), provide an opportunity to overcome such barriers. The purpose of this paper is to explore the acceptability and preliminary effectiveness of four SMS intervention conditions compared to mobile assessment only among OA (50–65 years old, n = 49) who drink at high-risk levels compared to younger adults (YA, 21–49 years old, n = 102).Design/methodology/approachWithin and between age group differences at baseline and end-of-treatment (12 weeks) were explored. Generalized linear modeling was used to test age by receipt of any SMS intervention (compared to assessment only) effects across health outcomes. Effect sizes and visual analyses were generated to assess for age by type of SMS interactions.FindingsBoth age groups reported intervention satisfaction. Two-thirds elected to continue receiving SMSs after treatment concluded. Descriptively, SMS groups demonstrated reduced drinking across age groups at end-of-treatment compared to mobile assessment only, though slightly larger effects were found for YA than for OA. Age significantly moderated the receipt of any SMS intervention only for depression (i.e., older age weakened the therapeutic effect). Of all the SMS types, tailored messages outperformed the other conditions on drinking outcomes for both age groups. Depression, craving and alcohol problems responded to gain-framed messages among OA and loss-framed messages among YA.Research limitations/implicationsThe findings of this paper suggest that SMS is acceptable and potentially effective across age groups. Further adaptation of SMS across age groups could enhance its effectiveness.Originality/valueThis is the first paper to explore the impact of older age on the efficacy of text messaging as an intervention for hazardous alcohol use.

目的:老年人(OA, 50岁以上)高危饮酒的患病率正在迅速上升。OA的干预障碍依然存在。移动干预措施，特别是短消息服务(SMS，也称为文本信息)，为克服这些障碍提供了机会。本文的目的是探讨与仅移动评估相比，饮酒处于高危水平的OA(50-65岁，n = 49)与年轻人(YA, 21-49岁，n = 102)相比，四种SMS干预条件的可接受性和初步有效性。设计/方法学/方法:探讨各组内和组间基线和治疗结束时(12周)的差异。使用广义线性模型通过接受任何SMS干预(与仅评估相比)来测试年龄对健康结果的影响。产生效应量和可视化分析，以评估按SMS交互类型的年龄。两个年龄组都报告了干预的满意度。三分之二的人选择在治疗结束后继续接受短信。描述性地说，与移动评估相比，短信组在治疗结束时显示出跨年龄组饮酒减少，尽管YA的效果略大于OA。年龄显著减缓了任何SMS干预的接受，仅针对抑郁症(即，年龄较大削弱了治疗效果)。在所有短信类型中，定制短信对两个年龄组的饮酒结果都优于其他条件。抑郁、渴望和酒精问题与OA中的增益框架信息和YA中的损失框架信息有关。研究局限/启示本论文的研究结果表明，短信是可以接受的，并且在各个年龄段都可能有效。短信在不同年龄组之间的进一步适应可以提高其有效性。原创性/价值这是第一篇探讨年龄对短信作为危险饮酒干预效果影响的论文。

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引用次数: 0

Participatory practice guideline development at the intersections of domestic and family violence, mental distress and/or parental substance use 在家庭和家庭暴力、精神痛苦和/或父母药物使用的交叉点制定参与式实践指南

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2022-02-16 DOI: 10.1108/add-12-2021-0017

Susan Heward‐Belle, Margaret Kertesz, C. Humphreys, Menka Tsantefski, Jasmin Isobe

PurposeIt is well established that the service system has a poor history of responding holistically to address the needs of children and families living with co-occurring complexities such as domestic violence, parental mental health and/or substance use. The purpose of this conceptual paper is to primarily describe the developmental process used to create guidelines to inform practice at the intersections of domestic violence, mental health and alcohol and other drug services, ensuring that the tactics of coercive control are visible in contexts of complexity.Design/methodology/approachThe guidelines were developed through undertaking a literature review, followed by a practice-led research approach with practitioners from 33 organisations across three Australian states, Safe & Together consultants and researchers. Communities of practice composed of practitioners providing interventions to children and families were central to the approach. Data that informed the development of the guidelines included a literature review, ethnographic notes, qualitative interviews, quantitative surveys and reflections.FindingsPractice-led research engaged practitioners in the development of guidelines to promote an integrated response to working with families experiencing domestic violence, substance use and mental health issues. The integrated approach drew from the Safe & Together model, emphasising partnering with women survivors, pivoting to the perpetrator, focusing on children’s safety and well-being, promoting worker safety, collaborating across agencies and influencing organisational change. The process demonstrated the usefulness of this integrated approach, using practitioner-based examples.Originality/valueSuccessful iterative processes to develop the guidelines were undertaken to support cultural change towards holistic and collaborative work across multiple sectors and organisations.

目的:众所周知，服务系统在整体应对生活在家庭暴力、父母心理健康和/或药物使用等共同发生的复杂情况下的儿童和家庭的需求方面的历史很差。本概念性文件的目的主要是描述用于制定指导方针的发展过程，以便在家庭暴力、心理健康、酒精和其他药物服务的交叉点为实践提供信息，确保在复杂情况下可以看到强制控制的策略。设计/方法/方法该指南是通过文献综述制定的，随后是由来自澳大利亚三个州的33个组织的从业人员、Safe & Together顾问和研究人员采用以实践为主导的研究方法。由向儿童和家庭提供干预措施的从业人员组成的实践社区是该方法的核心。为制定准则提供信息的数据包括文献审查、民族志说明、定性访谈、定量调查和反思。以实践为主导的研究使从业人员参与制定准则，以促进对遭受家庭暴力、药物使用和精神健康问题的家庭采取综合对策。综合办法借鉴了“安全与团结”模式，强调与妇女幸存者合作，以肇事者为中心，关注儿童安全和福祉，促进工人安全，跨机构合作，并影响组织变革。该过程使用基于从业者的示例演示了这种综合方法的有效性。创意/价值采用成功的迭代过程来制定指导方针，以支持跨多个部门和组织的整体和协作工作的文化变革。

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引用次数: 1

Addiction recovery stories: Neil Curran in conversation with Lisa Ogilvie 成瘾康复故事:Neil Curran与Lisa Ogilvie的对话

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2022-01-24 DOI: 10.1108/add-12-2021-0016

Neil Curran, L. Ogilvie

PurposeThis paper aims to explore the transition from addiction to recovery. It is the second in a series of recovery stories that examine candid accounts of addiction and recovery. Shared components of recovery are considered, along with the change and growth needed to support the transition.Design/methodology/approachThe CHIME framework comprises five elements important to recovery (Connectedness, Hope, Identity, Meaning and Empowerment). It provides a standard to qualitatively study mental health recovery, having also been applied to addiction recovery. In this paper, an element for Growth is included in the model (G-CHIME), to consider both recovery, and sustained recovery. A first-hand account of addiction recovery is presented, followed by a semi-structured e-interview with the author of the account. This is structured on the G-CHIME model.FindingsThis paper shows that addiction recovery is a remarkable process that can be effectually explained using the G-CHIME model. The significance of each element in the model is apparent from the biography and e-interview presented.Originality/valueEach account of recovery in this series is unique, and as yet, untold.

目的探讨成瘾到康复的过渡过程。这是一系列关于戒毒和康复的故事中的第二篇。复苏的共同组成部分，以及支持转型所需的变革和增长，都被考虑在内。设计/方法/方法CHIME框架包括五个对恢复很重要的元素(连通性、希望、身份、意义和赋权)。它为定性研究心理健康康复提供了一个标准，也已应用于成瘾康复。在本文中，在模型(G-CHIME)中加入了增长因素，以考虑复苏和持续复苏。介绍了成瘾恢复的第一手资料，随后对该帐户的作者进行了半结构化的电子采访。这是基于G-CHIME模型构建的。研究结果表明，成瘾恢复是一个显著的过程，可以用G-CHIME模型有效地解释。模型中每个元素的重要性从所呈现的传记和电子访谈中显而易见。原创性/价值在这个系列中，每一个关于恢复的叙述都是独一无二的，而且迄今为止还未被阐明。

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引用次数: 0

Addiction recovery stories: Jerome Carson in conversation with Lisa Ogilvie 戒毒故事:杰罗姆·卡森与丽莎·奥吉维的对话

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2021-12-30 DOI: 10.1108/add-12-2021-0015

J. Carson, L. Ogilvie

PurposeThe purpose of this paper is to explore the accomplishments of those who realise addiction recovery. To the best of the authors’ knowledge, this is the first in a series of recovery stories, where candid accounts of addiction and recovery are examined. In doing so, shared components of recovery are considered, along with the change and growth necessary to facilitate it.Design/methodology/approachThe CHIME (Connectedness, Hope, Identity, Meaning and Empowerment) framework comprises five elements important to recovery. It provides a standard to qualitatively study mental health recovery, having also been applied to addiction recovery. In this paper, an additional element for Growth has been introduced to the model (G-CHIME), to consider both recovery and sustained recovery. A first-hand account of addiction recovery is presented, followed by a semi-structured e-interview with the author of the account. This is structured on the G-CHIME model.FindingsThis paper shows that successful and sustained recovery from alcohol addiction can be effectively explained using the G-CHIME model. Each element was well represented in the described process of reaching recovery.Originality/valueEach account of recovery in this series is unique, and as yet, untold.

目的探讨那些实现成瘾康复的人的成就。据作者所知，这是一系列康复故事中的第一个，其中坦诚地讲述了成瘾和康复的过程。在这样做时，考虑了复苏的共同组成部分，以及促进复苏所需的变化和增长。设计/方法/方法CHIME(连通性、希望、身份、意义和赋权)框架包括五个对康复很重要的元素。它为定性研究心理健康康复提供了一个标准，也已应用于成瘾康复。本文在模型中引入了一个额外的增长因素(G-CHIME)，以考虑复苏和持续复苏。介绍了成瘾恢复的第一手资料，随后对该帐户的作者进行了半结构化的电子采访。这是基于G-CHIME模型构建的。研究结果表明，G-CHIME模型可以有效地解释酒精成瘾的成功和持续恢复。在所描述的达到恢复的过程中，每个要素都得到了很好的体现。原创性/价值在这个系列中，每一个关于恢复的叙述都是独一无二的，而且迄今为止还未被阐明。

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引用次数: 2

Investigating the experience of individuals with comorbid posttraumatic stress disorder and substance misuse attending a Seeking Safety group 调查参加寻求安全小组的创伤后应激障碍和药物滥用共病个体的经历

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2021-12-03 DOI: 10.1108/add-04-2021-0006

J. Airdrie, Alex Lievesley, E. Griffith

PurposeThere is no specific recommended treatment for the co-morbid presentation of post-traumatic stress disorder (PTSD) and substance use disorder in the United Kingdom (UK). Seeking Safety (SS), a group-based treatment that targets symptoms of both disorder, has emerging evidence in the USA but lacks evidence from UK-based samples. The purpose of this study was to explore UK service users’ experience of attending SS and evaluate its impact on mental health symptomology and substance misuse.Design/methodology/approachA mixed method approach was used to evaluate the acceptability of SS for a small sample (n = 7) of adult users of a substance misuse service in the UK. Thematic analysis was used to explore their experiences, derived from individual semi-structured interviews. The authors also calculated the number of participants who achieved reliable and/or clinically significant change in mental health symptomology and substance misuse from data routinely collected by the service.FindingsSeven overarching themes emerged: strengthening the foundations of the self, the evocation and management of emotions, safety and validation provided relationally, readiness and commitment, content and delivery, Seeking Safety is Not an Island and ending. Most participants with data available both before and after the group made reliable (three out of four) and clinically significant (two out of three) change for depression and anxiety symptomology; however, this was less evident for PTSD symptomology with two out of three making reliable change and one out of three making clinically significant change.Originality/valueTo the best of the authors’ knowledge, this was the first study exploring the experiences of UK attendees of a SS group as an approach to treating comorbid PTSD and substance misuse.

目的:在英国，对于创伤后应激障碍(PTSD)和物质使用障碍的共病表现没有特定的推荐治疗方法。寻求安全(SS)是一种针对两种疾病症状的基于群体的治疗方法，在美国有新证据，但缺乏来自英国样本的证据。本研究的目的是探讨英国服务使用者参加精神辅助服务的经验，并评估其对心理健康症状和药物滥用的影响。设计/方法学/方法采用混合方法来评估英国一个药物滥用服务的小样本成年使用者(n = 7)对SS的可接受性。主题分析用于探索他们的经历，源自个人半结构化访谈。作者还根据该服务常规收集的数据计算了在精神健康症状和药物滥用方面取得可靠和/或临床显著变化的参与者人数。七个主要的主题出现了:加强自我的基础，情绪的唤起和管理，关系提供的安全和确认，准备和承诺，内容和交付，寻求安全不是一个岛和结束。大多数在治疗前后都有数据的参与者在抑郁和焦虑症状方面做出了可靠(四分之三)和临床显著(三分之二)的改变;然而，这在PTSD症状上不太明显，三分之二的人有可靠的改变，三分之一的人有临床显著的改变。原创性/价值据作者所知，这是第一个探索英国SS组参与者的经验，作为治疗合并PTSD和药物滥用的方法的研究。

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引用次数: 0

An evaluation of the psychosocial group programme at an inpatient detoxification and stabilisation unit: a service improvement project 对住院戒毒和稳定单位的心理社会团体方案的评估:一个服务改进项目

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2021-11-19 DOI: 10.1108/add-09-2021-0011

Hannah C Rettie, Joya Georgewill, S. Stacey, E. Griffith

PurposeThe benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research; however, a “gold standard” psychosocial intervention has not been established. This small-scale study aimed to evaluate the psychosocial group (“Straight Ahead”) currently running at a substance use inpatient unit based in the UK.Design/methodology/approachA mixed-methods questionnaire design aimed to capture service user perspectives of the group programme via a questionnaire and assess whether an individual’s recovery capital and emotion regulation scores improved during their stay.FindingsThirty-four service users participated in the evaluation. Results indicate the group significantly increased individuals’ recovery capital scores; however, it did not significantly improve emotion regulation. The three themes from the qualitative results focused on the importance of shared experiences, learning of new skills and the group as a positive experience. Service users provided suggestions for improvements, and these informed the provision of service-specific recommendations for the team and project commissioner.Originality/valueThe evaluation provides tentative support for the use of the Straight Ahead programme and provides an insight into what service users find helpful when attending a psychosocial group during an inpatient detoxification admission.

目的在成瘾研究中已经认识到，将心理社会团体方案与医疗住院戒毒和稳定制度结合起来的好处;然而，社会心理干预的“黄金标准”尚未确立。这项小规模的研究旨在评估心理社会团体(“直向前”)目前在英国的一个药物使用住院单位运行。设计/方法/方法一种混合方法的问卷设计，旨在通过问卷获取服务用户对团体项目的看法，并评估个人的恢复资本和情绪调节得分在他们逗留期间是否有所改善。结果34名服务用户参与了评价。结果表明:实验组显著提高了个体的恢复资本得分;然而，它并没有显著改善情绪调节。定性结果的三个主题集中在分享经验、学习新技能和团队作为积极体验的重要性上。服务使用者提出了改善建议，这些建议为小组和项目专员提供了具体服务的建议。独创性/价值该评估为“向前走”方案的使用提供了初步支持，并深入了解在住院戒毒期间参加心理社会团体时，服务使用者认为哪些是有帮助的。

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引用次数: 1

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK 英国精神科重症监护病房(picu)药物滥用的比率和影响

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2021-11-12 DOI: 10.1108/add-06-2021-0008

Hattie C. A. Moyes, Lana MacNaboe, K. Townsend

PurposeThis paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs.Design/methodology/approachThe paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients.FindingsThe estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed.Research limitations/implicationsThe findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs.Practical implicationsThis paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes.Originality/valueThis paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

目的了解目前精神科重症监护病房(picu)药物滥用的规模，确定药物滥用如何影响工作人员、患者和病房的运行，并与工作人员一起探讨哪些资源对更有效地管理picu的药物滥用和双重诊断最有用。设计/方法/方法本文采用混合方法，通过定量调查确定PICU中药物使用的程度，并通过共同设计研讨会了解药物滥用对PICU病房，工作人员和患者的影响。在picu中，12个月期间药物滥用的估计比率为67%，大麻是最常用的药物。尽管由于药物滥用，picu遇到了一系列问题，但为工作人员提供的培训和资源好坏参半。研究局限性/意义由于研究参与者是国家质量改进计划的成员，因此研究结果可能不完全具有普遍性，因此可能不代表所有picu。数据仅从临床医生处收集;如果纳入患者，他们可能会为picu的药物滥用提供另一种视角。本文强调了对PICU工作人员进行药物滥用培训的重要性，以充分应对滥用药物的患者，改善病房环境，工作人员福祉和患者预后。原创性/价值本文提供了picu中12个月期间药物滥用率的最新估计，并就培训计划提出建议，以更好地支持工作人员解决picu中的药物滥用问题。

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引用次数: 1

The Impact of Depressive Symptoms on Response to Integrated Cognitive Behavioral Therapy for Substance Use Disorders and Intimate Partner Violence. 抑郁症状对药物使用障碍和亲密伴侣暴力的综合认知行为治疗反应的影响

IF 0.9 Q4 PSYCHOLOGY, CLINICAL

Advances in Dual Diagnosis

Pub Date : 2021-08-10 Epub Date: 2021-05-21 DOI: 10.1108/add-09-2020-0020

Lourah M Kelly, Cory A Crane, Kristyn Zajac, Caroline J Easton

Purpose: Past studies demonstrated the efficacy of integrated cognitive-behavioral therapy (CBT) for substance use disorder (SUD) and intimate partner violence (IPV) as well as high rates of depressive symptoms in this population. However, little is known about how depressive symptoms impact treatment outcomes. We hypothesized that integrated CBT, but not standard drug counseling (DC), would buffer the negative effects of depressive symptoms on treatment response.

Design/methodology/approach: A secondary analysis of a randomized trial compared men assigned to 12 weeks of integrated CBT for SUD and IPV (n=29) to those in DC (n=34).

Findings: Most (60%) of the sample reported any depressive symptoms. Controlling for baseline IPV, reporting any depressive symptoms was associated with more positive cocaine screens during treatment. Among men with depressive symptoms, integrated CBT but not DC was associated with fewer positive cocaine screens. Controlling for baseline alcohol variables, integrated CBT and depressive symptoms were each associated with less aggression outside of intimate relationships (e.g., family, strangers) during treatment. For men without depressive symptoms, integrated CBT was associated with less non-IPV aggression compared to DC. Effects were not significant for other substances, IPV, or at follow-up.

Originality: Although integrated CBT's efficacy for improving SUD and IPV has been established, moderators of treatment response have not been investigated.

Practical implications: Integrated CBT buffered depressive symptoms' impact on cocaine use, yet only improved non-IPV aggression in men without depressive symptoms.

Research limitations/implications: This study found some evidence for differential response to CBT by depressive symptoms on cocaine and aggression at end of treatment, which did not persist three months later. Future studies should explore mechanisms of integrated CBT for SUD and IPV, including mood regulation, on depressive symptoms in real-world samples.

目的:过去的研究证明了综合认知行为疗法(CBT)对物质使用障碍(SUD)和亲密伴侣暴力(IPV)的疗效，以及这一人群中抑郁症状的高发。然而，人们对抑郁症状如何影响治疗结果知之甚少。我们假设综合CBT，而不是标准药物咨询(DC)，可以缓冲抑郁症状对治疗反应的负面影响。设计/方法/方法:一项随机试验的二次分析比较了接受12周综合CBT治疗SUD和IPV的男性(n=29)和DC患者(n=34)。结果:大多数(60%)的样本报告有抑郁症状。控制基线IPV，在治疗期间报告任何抑郁症状与更多阳性可卡因筛查相关。在有抑郁症状的男性中，综合CBT而非DC与较少的可卡因阳性筛查相关。控制基线酒精变量，综合CBT和抑郁症状均与治疗期间亲密关系(如家庭、陌生人)之外的攻击减少相关。对于没有抑郁症状的男性，与DC相比，综合CBT与更少的非ipv攻击相关。其他药物、IPV或随访均无显著影响。独创性:虽然综合CBT对改善SUD和IPV的疗效已经确立，但尚未研究治疗反应的调节因子。实际意义:综合CBT缓冲了抑郁症状对可卡因使用的影响，但只改善了无抑郁症状男性的非ipv攻击。研究局限性/启示:本研究发现一些证据表明，在治疗结束时，可卡因和攻击性的抑郁症状对CBT的不同反应，并没有持续三个月。未来的研究应探索认知行为治疗SUD和IPV的综合机制，包括情绪调节，对现实世界样本抑郁症状的影响。

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引用次数: 0