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Back to basics: fundamental cognitive therapy skills for keeping drug-dependent individuals in treatment. 回到基础:基本的认知治疗技巧,让药物依赖者继续接受治疗。
Pub Date : 1997-01-01
B S Liese, A T Beck

Cognitive therapists who treat drug-dependent patients are likely to lose at least 50 percent of their patients to dropout. This chapter has presented a cognitive model for conceptualizing missed sessions and dropout, along with strategies for reducing the likelihood of missed sessions and dropout. The following should serve to highlight these strategies. 1. Therapists are encouraged to offer warm, empathetic, collaborative relationships in which drug-dependent patients can feel accepted, understood, and validated. 2. Therapists are encouraged to develop comprehensive, accurate case conceptualizations, with attention paid to the potential for missed sessions and dropout. Case conceptualizations should ultimately guide cognitive and behavioral techniques. 3. Therapists are encouraged to structure sessions and elicit feedback regarding their patient's thoughts and beliefs about therapy and the therapist. This feedback is facilitated by such questions as, "What do you like most about therapy?" "What do you like least?" "What has changed in your life as a result of therapy?" "How do you view our relationship?" 4. Therapists are encouraged to socialize patients in a timely, appropriate manner. 5. Similar to the process of socialization, therapists are encouraged to use cognitive and behavioral techniques in a timely, appropriate manner. It is unrealistic to think that the problems of missed sessions and dropout from drug treatment will ever be fully resolved. Nonetheless, the authors believe that the conceptual models and fundamental strategies presented in this chapter represent a significant step in addressing these problems.

治疗药物依赖患者的认知治疗师很可能会失去至少50%的患者。本章提出了一个概念化缺课和辍学的认知模型,以及减少缺课和辍学可能性的策略。以下内容应有助于突出这些战略。1. 治疗师被鼓励提供温暖的、共情的、合作的关系,在这种关系中,药物依赖患者可以感到被接受、理解和认可。2. 治疗师被鼓励发展全面,准确的案例概念,并注意潜在的错过会议和辍学。案例概念化最终应该指导认知和行为技术。3.治疗师被鼓励组织会议,并就患者对治疗和治疗师的想法和信念征求反馈。这样的问题会促进反馈,“你最喜欢治疗的什么?”“你最不喜欢什么?”“治疗给你的生活带来了什么改变?”“你怎么看待我们的关系?”4. 鼓励治疗师以及时、适当的方式与患者进行社交。5. 与社会化的过程类似,治疗师被鼓励及时、适当地使用认知和行为技术。认为错过疗程和退出药物治疗的问题将得到完全解决是不现实的。尽管如此,作者认为,本章提出的概念模型和基本策略代表了解决这些问题的重要一步。
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引用次数: 0
The use of the psychological laboratory to study sensitive survey topics. 利用心理实验室研究敏感的调查课题。
Pub Date : 1997-01-01
G B Willis

Maximizing the tendency of the survey respondent to answer truthfully when sensitive questions are presented is critical issue in survey methodology. A recent development devoted generally to the reduction of response error in survey data is the use of cognitive laboratory techniques during the survey development phase. The chapter categorizes and describes the various cognitive techniques that have been applied, by Federal agencies and other researchers, to the study of sensitive questions. Based on this analysis and review, a number of recommendations are made concerning specific aspects of survey design, when sensitive questions are administered.

当提出敏感问题时,最大限度地使调查对象如实回答的倾向是调查方法中的关键问题。最近一项致力于减少调查数据中的回答误差的发展是在调查发展阶段使用认知实验室技术。本章对联邦机构和其他研究人员用于研究敏感问题的各种认知技术进行了分类和描述。根据这种分析和审查,在处理敏感问题时,就调查设计的具体方面提出了一些建议。
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引用次数: 0
Inhalation studies with drugs of abuse. 药物滥用的吸入研究。
Pub Date : 1997-01-01
Y Meng, A H Lichtman, D T Bridgen, B R Martin
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引用次数: 0
Antibodies as pharmacokinetic and metabolic modifiers of neurotoxicity. 抗体作为神经毒性的药代动力学和代谢调节剂。
Pub Date : 1997-01-01
S M Owens
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引用次数: 0
Treatment effectiveness score as an outcome measure in clinical trials. 治疗效果评分作为临床试验结果的衡量标准。
Pub Date : 1997-01-01 DOI: 10.1037/e495552006-011
W. Ling, S. Shoptaw, D. Wesson, R. Rawson, Margaret A. Compton, Klett Cj
A variety of measures are used for evaluating patients’ responses to substance abuse treatments. These range from physical measures (such as samples of urine, breath, hair, or blood), self-reports of drug use (such as the Addiction Severity Index (ASI) or the Time Line Follow-Back), self-reports of psychological or physiological functioning (such as symptom checklists or craving or mood ratings), and collateral reports. Physical indices of recent drug use, such as urine toxicology screens, are preferable to self-report or collateral reports for evaluating patients’ responses to drug abuse treatments because of their objectivity. In order to optimize the likelihood of both detecting individual episodes of problem drug use and correctly inferring drug abstinence based on urine toxicology results, guidelines have been suggested for collection procedures and timing for collection of urine specimens (Blaine et al. 1994; Cone and Dickerson 1992; Jain 1992). However, the difficult task of aggregating urine toxicology results remains, whether when interpreting the response of a single patient to a specific treatment or when evaluating a treatment’s effectiveness based on a group of patients’ responses in a clinical trial. Difficulties in aggregating urine toxicology results include, but certainly would not be limited to, such problems as the frequency and sensitivity of toxicology screens, early termination of some patients from treatment (or, conversely, the continued participation of some patients who respond poorly to treatment), and problems of analyzing a data matrix that contains a large number of missing datapoints. This chapter reviews the objective indices of treatment response that have traditionally been used and suggests three composite methods for evaluating these data: the Treatment Effectiveness Score (TES), the Joint Probability score (JP), and the Clinical Stabilization Score (CSS).
各种措施被用来评估病人对药物滥用治疗的反应。这些范围从物理测量(如尿液、呼吸、头发或血液样本),药物使用的自我报告(如成瘾严重程度指数(ASI)或时间线追踪),心理或生理功能的自我报告(如症状清单或渴望或情绪评级),以及附带报告。近期药物使用的物理指标,如尿液毒理学筛查,因其客观性而优于自我报告或附带报告,以评估患者对药物滥用治疗的反应。为了优化发现问题药物使用的个体事件和根据尿液毒理学结果正确推断药物戒断的可能性,已经提出了收集尿液标本的程序和时间指南(Blaine等人,1994;Cone and Dickerson 1992;耆那教的1992)。然而,汇总尿液毒理学结果的艰巨任务仍然存在,无论是在解释单个患者对特定治疗的反应时,还是在临床试验中基于一组患者的反应来评估治疗的有效性时。汇总尿液毒理学结果的困难包括,但肯定不限于,毒理学筛查的频率和敏感性,一些患者早期终止治疗(或者相反,一些对治疗反应不佳的患者继续参与治疗),以及分析包含大量缺失数据点的数据矩阵的问题。本章回顾了传统上使用的治疗反应的客观指标,并提出了评估这些数据的三种综合方法:治疗效果评分(TES)、联合概率评分(JP)和临床稳定评分(CSS)。
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引用次数: 52
Cognitive-neuromotor assessment of substance abuse: focus on issues related to cocaine abuse treatment. 药物滥用的认知神经运动评估:关注可卡因滥用治疗相关问题。
Pub Date : 1997-01-01 DOI: 10.1037/E495552006-010
E. Ellinwood, T. Lee
Choice of the procedures and types of cognitive-neuromotor testing used in assessment of cocaine abusers and their treatment is dependent on a clear definition of the purposes of testing and the characteristics of the individual tests. This chapter will first discuss published studies of testing in cocaine abusers and pharmacodynamic effects of stimulants and withdrawal. The types of tests available and their characteristics will be discussed in terms of the purpose of testing. The case will be made for the value of computerized cognitiveneuromotor testing when repeated assessment is needed in a busy clinical setting.
用于评估可卡因滥用者及其治疗的认知-神经运动测试的程序和类型的选择取决于对测试目的的明确定义和个别测试的特点。本章将首先讨论已发表的对可卡因滥用者的测试以及兴奋剂和戒断的药效学影响的研究。可用的测试类型及其特性将根据测试的目的进行讨论。当在繁忙的临床环境中需要重复评估时,计算机化认知神经运动测试的价值将被提出。
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引用次数: 2
Goals and rationale for pharmacotherapeutic approach in treating cocaine dependence: insights from basic and clinical research. 药物治疗方法治疗可卡因依赖的目的和基本原理:来自基础和临床研究的见解。
Pub Date : 1997-01-01 DOI: 10.1037/e495552006-002
M. Kreek
The early research conducted in the author’s laboratory from 1975 onward stemmed from the even earlier work, beginning in 1964 when the author was a member of the laboratory of Professor Vincent P. Dole at the Rockefeller Institute for Biomedical Research (now the Rockefeller University) (Dole et al. 1966; Kreek 1972, 1973a; Kreek et al. 1972). At that time, scientists were challenged to develop a treatment for opiate dependency, a problem that is still being addressed, but for which there are now three different pharmacotherapeutic approaches approved by the Food and Drug Administration (FDA), and a fourth under investigation. This chapter will review briefly some of the early concepts because they are relevant for the current major problem: developing a new medication (and possibly a variety of medications) for treating cocaine dependency.
作者的实验室从1975年开始进行的早期研究源于更早的工作,始于1964年,当时作者是洛克菲勒生物医学研究所(现为洛克菲勒大学)文森特·p·多尔教授实验室的成员(多尔等人,1966年;克里克1972,1973a;Kreek et al. 1972)。当时,科学家们面临的挑战是开发一种治疗阿片类药物依赖的方法,这个问题仍在解决中,但现在有三种不同的药物治疗方法得到了美国食品和药物管理局(FDA)的批准,第四种正在调查中。本章将简要回顾一些早期的概念,因为它们与当前的主要问题有关:开发一种治疗可卡因依赖的新药(可能还有各种药物)。
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引用次数: 12
Analysis With Missing Data in Prevention Research 预防研究中缺失数据分析
Pub Date : 1997-01-01 DOI: 10.1037/10222-010
J. Graham, S. Hofer, A. Piccinin
Missing data problems have been a thorn in the side of prevention researchers for years. Although some solutions for these problems have been available in the statistical literature, these solutions have not found their way into mainstream prevention research. This chapter is meant to serve as an introduction to the systematic application of the missing data analysis solutions presented recently by Little and Rubin (1987) and others. The chapter does not describe a complete strategy, but it is relevant for (1) missing data analysis with continuous (but not categorical) data, (2) data that are reasonably normally distributed, and (3) solutions for missing data problems for analyses related to the general linear model in particular, analyses that use (or can use) a covariance matrix as input. The examples in the chapter come from drug prevention research. The chapter discusses (1) the problem of wanting to ask respondents more questions than most individuals can answer; (2) the problem of attrition and some solutions; and (3) the problem of special measurement procedures that are too expensive or time consuming to obtain for all subjects. The authors end with several conclusions: Whenever possible, researchers should use the Expectation-Maximization (EM) algorithm (or other maximum likelihood procedure, including the multiple-group structural equation-modeling procedure or, where appropriate, multiple imputation, for analyses involving missing data [the chapter provides concrete examples]); If researchers must use other analyses, they should keep in mind that these others produce biased results and should not be relied upon for final analyses; When data are missing, the appropriate missing data analysis procedures do not generate something out of nothing but do make the most out of the data available; When data are missing, researchers should work hard (especially when planning a study) to find the cause of missingness and include the cause in the analysis models; and Researchers should sample the cases originally missing (whenever possible) and adjust EM algorithm parameter estimates accordingly.
多年来,数据缺失问题一直是预防研究人员的眼中钉。虽然在统计文献中有一些解决这些问题的办法,但这些办法还没有进入主流预防研究。本章旨在介绍最近Little和Rubin(1987)等人提出的缺失数据分析解决方案的系统应用。本章没有描述一个完整的策略,但它与以下内容相关:(1)使用连续(但不是分类)数据的缺失数据分析,(2)合理正态分布的数据,以及(3)与一般线性模型相关的分析中缺失数据问题的解决方案,特别是使用(或可以使用)协方差矩阵作为输入的分析。本章的例子来自药物预防研究。本章讨论了(1)想要向受访者提出的问题多于大多数人能回答的问题;(2)人员磨耗问题及解决办法;(3)特殊测量程序过于昂贵或耗时,无法获得所有受试者。作者最后得出了几个结论:只要有可能,研究人员应该使用期望最大化(EM)算法(或其他最大似然程序,包括多组结构方程建模程序,或在适当情况下,对涉及缺失数据的分析进行多重输入[本章提供了具体示例]);如果研究人员必须使用其他分析方法,他们应该记住,这些方法会产生有偏见的结果,不应该依赖于最终分析;当数据丢失时,适当的丢失数据分析程序不会无中生有,而是最大限度地利用现有数据;当数据缺失时,研究者应该努力寻找缺失的原因(特别是在计划研究时),并将原因纳入分析模型;研究人员应该对最初缺失的案例进行抽样(只要有可能),并相应地调整EM算法的参数估计。
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引用次数: 311
Network Theory: A Model for Understanding Drug Abuse Among African-American and Hispanic Youth 网络理论:一个理解非裔美国人和西班牙裔青年滥用药物的模型
Pub Date : 1997-01-01 DOI: 10.3109/10826089709035606
M. Krohn, T. Thornberry
No significant differences are found in the density or multiplexity of friendship networks of adolescent drug users and non-users. However, users are more likely than non-users to have friends from the same neighborhood, to have more intimate friendship networks, and to change friends over time. Users are less likely to have friends from the same school and to have parents involved in extracurricular activities. Networks of White users and non-users are more similar than those of Hispanics or African Americans.
青少年吸毒者和非吸毒者的友谊网络密度和多样性无显著差异。然而,与非用户相比,用户更有可能拥有来自同一社区的朋友,拥有更亲密的友谊网络,并随着时间的推移而改变朋友。用户不太可能有来自同一所学校的朋友,也不太可能有父母参与课外活动。白人用户和非用户的网络比西班牙裔或非洲裔美国人更相似。
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引用次数: 2
The role of iminium-enamine species in the toxication and detoxication of cyclic tertiary amines. 最小烯胺类在环叔胺的毒性和解毒中的作用。
Pub Date : 1997-01-01 DOI: 10.1037/e495572006-009
L. Sayre, D. Engelhart, D. Nadkarni, M. K. Manoj Babu, A. M. Flammang, G. Mccoy
Aliphatic cyclic tertiary amines constitute a major class of naturally occurring and synthetic drugs directed at central biogenic amine receptors. Microsomal metabolism of these amines is known to be associated with low levels of covalent binding and/or suicide inactivation of the pertinent metabolizing P-450 isozymes; two of the more notorious examples are phencyclidine (1-(1phenylcyclohexyl)piperidine) (PCP) (Hoag et al. 1984) and nicotine (Shigenaga et al. 1988).
脂肪族环叔胺是一类天然存在的和合成的靶向中枢生物胺受体的药物。已知这些胺的微粒体代谢与相关代谢P-450同工酶的低共价结合和/或自杀性失活有关;两个比较臭名昭著的例子是苯环利定(1-(1苯基环己基)哌啶)(PCP) (Hoag等人,1984年)和尼古丁(Shigenaga等人,1988年)。
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引用次数: 13
期刊
NIDA research monograph
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