Interaction of Mental Health and Social Support on Drug Relapse in Recovery Homes

心理健康和社会支持对康复之家药物复吸的相互作用

• 批准号: 8635723
• 负责人: DOUGLAS L POLCIN
• 金额: $ 7.73万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635723
• 关键词: Abstinence; Address; Affect; Aftercare; Alcohol or Other Drugs use; Alcohols; Anxiety; Area; Attention; Buffers; California; Cannabis; Clinical; Cocaine; Collaborations; Communities; Consensus; Data; Data Analyses; Development; Dimensions; Disease; Drug Addiction; Drug usage; Employee Strikes; Environment; Equipment and supply inventories; Evaluation; Family; Friends; Home environment; Hostility; Housing; Imprisonment; Individual; Intervention; Interview; Life; Measures; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methamphetamine; Methamphetamine dependence; Opiates; Outcome; Participant; Persons; Pharmaceutical Preparations; Prevalence; Psychotic Disorders; Recovery; Relapse; Research; Sampling; Services; Severities; Social support; Substance Addiction; Symptoms; System; Testing; Time; addiction; clinically significant; demographics; design; drug relapse; experience; follow-up; help-seeking behavior; ideation; improved; indexing; instrument; longitudinal design; parent grant; peer; primary outcome; public health relevance; sobriety; social; treatment program

ABSTRACT There is now consensus in the drug treatment field that substance dependence requires long-term interventions that extend well beyond formal treatment. Sober living houses (SLHs) are alcohol- and drug-free recovery homes that help individuals with drug dependence maintain long-term abstinence after completion of treatment or release from incarceration. In some cases they serve as an alternative recovery option for individuals who do not want to seek help from a formal treatment program. Studies by our research team were the first to document excellent outcomes for SLH residents, which were maintained over an 18-month follow- up period. Among a number of important results was the finding that severity of psychiatric symptoms predicted worse outcome and social support for recovery predicted better outcome. It is striking that studies of recovery from addiction have ignored how these two factors interact to affect outcome. We hypothesize the destructive impact of psychiatric symptoms on resident outcomes will be mitigated by social support for recovery. A variety of other potential moderators will be explored as well, including receipt of mental health services, general social support, demographics and type of drug dependence. Most studies examining predictors of recovery from addictive disorders are limited to baseline measures. The proposed study will be the first to test how interactions between psychiatric symptoms and social support operate longitudinally to affect relapse. The study will consist of a secondary analysis of the 323 SLH residents who were interviewed at baseline and 6-, 12- and, 18-month follow-up. Although the parent grant included an aim assessing how a composite, global measure of psychiatric severity (BSI Global Severity Index) impacted drug use, no analyses examined potential moderators or mediators. In addition, no aims addressed the impact of different types of psychiatric symptoms. The proposed study will track trajectories of nine BSI scales, each measuring a specific psychiatric symptom (e.g., depression, anxiety, psychosis, obsessive compulsive, etc.) and their associations with relapse over 18 months. The study will be the first that examines trajectories of psychiatric symptoms among substance dependent persons using a longitudinal design outside the context of formal treatment. Although the parent grant found the GSI scale improved over time, the clinical significance was modest. The proposed study will identify which of the 9 BSI scales measuring different dimensions of psychiatric symptoms improved, which were unchanged, and which may have become worse. The proposed study will also assess the types of psychiatric symptoms for which participants received treatment, the types of symptoms that were undetected or untreated and how receipt of treatment affected outcome. Study findings will have implications for recognizing and addressing psychiatric symptoms in SLHs as well as broader implications for sustaining long term recovery in the community.

抽象的 现在在药物治疗领域达成共识，物质依赖性需要长期 远远超出正式治疗的干预措施。清醒的居住房屋（SLH）无酒精和无毒 恢复住宅可以帮助毒品依赖的人在完成后保持长期禁欲 治疗或从监禁中释放。在某些情况下，它们是作为替代恢复选项 不想从正式治疗计划中寻求帮助的个人。我们的研究团队的研究是 第一个记录了SLH居民出色结果的人，该居民在18个月以后保持了 - 上升期。在许多重要的结果中，发现精神症状的严重程度 预测的结果和对恢复的社会支持较差，预测的结果会更好。令人惊讶的是对 从成瘾中恢复已经忽略了这两个因素如何相互作用以影响结果。我们假设了 精神症状对居民结果的破坏性影响将受到社会支持的减轻 恢复。还将探讨其他各种潜在的主持人，包括收到心理健康 服务，一般的社会支持，人口统计和毒品依赖类型。大多数研究研究 从成瘾性疾病中恢复的预测因素仅限于基线度量。拟议的研究将是 第一个测试精神症状与社会支持之间如何纵向运作的互动方式 影响复发。该研究将包括对接受采访的323名SLH居民的二级分析 基线和6个，12个和18个月的随访。尽管父母的赠款包括一个目标，以评估 综合，全球精神病严重程度（BSI全球严重程度指数）影响药物使用，没有分析 检查了潜在的主持人或调解人。此外，没有目的解决不同类型的影响 精神病症状。拟议的研究将跟踪九个BSI量表的轨迹，每个尺度都测量了特定的轨迹 精神病症状（例如抑郁，焦虑，精神病，强迫性等）及其关联 复发超过18个月。该研究将是第一个检查精神症状轨迹的研究 在依赖物质的人中，使用纵向设计以外的纵向设计。 尽管父母赠款发现GSI量表随着时间的推移有所改善，但临床意义是适度的。这 拟议的研究将确定9个BSI量表中的哪个测量精神病的不同维度 改善了症状，这些症状不变，并且可能变得更糟。拟议的研究将 还评估参与者接受治疗的精神症状类型 未经发现或未经治疗的症状以及治疗的接收如何影响结果。研究结果 将对识别和解决SLH中的精神病症状以及更广泛的精神症状有影响 在社区中维持长期恢复的影响。