Novel Assessment of Maternal Distress Tolerance Underlying Substance Use Relapse

对药物滥用复发的孕产妇痛苦耐受性的新评估

• 批准号: 8514554
• 负责人: Carl W Lejuez
• 金额: $ 18.24万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8514554
• 关键词: Abstinence; Address; African American; Aftercare; Age; Alcohol or Other Drugs use; Area; Attention; Canada; Child; Child Care; Clinical; Daughter; Distress; Dropout; Drug usage; Drug user; Environmental Risk Factor; Family; Female; Future; Gender; Health; Home environment; Infant; Length; Link; Low income; Measures; Modeling; Mothers; Outcome; Parenting behavior; Parents; Participant; Patient Self-Report; Psychopathology; Relapse; Research; Residential Treatment; Risk; Risk Factors; Role; Specificity; Substance abuse problem; Testing; Treatment outcome; Vulnerable Populations; Woman; analog; behavior measurement; biological adaptation to stress; demographics; distress tolerance; early childhood; experience; high risk; improved; indexing; inner city; interest; maternal stress; men; novel; outcome forecast; response; stressor; substance abuse treatment; treatment program

DESCRIPTION (provided by applicant): Women evidence worse substance use treatment outcomes than men (Greenfield et al., 2007), including higher rates of treatment dropout (Arfken et al., 2001; King & Canada, 2004; Sayre et al., 2002), lower treatment attendance (McCaul et al., 2001) and higher rates of post-treatment substance use relapse (Grella et al., 2006). Yet, substance abuse research often includes little attention to gender-specific factors relevant to particular vulnerabilities of female participants (Brady & Ashley, 2005; Greenfield et al., 2007). One factor especially relevant to risk of relapse for many female drug users is maternal stress; child care responsibilities and the associated stressors may significantly increase risk of substance use relapse, particularly during high- risk periods for relapse following substance abuse treatment. Further, although maternal factors have been a particular empirical and clinical focus regarding environmental risk factors for drug using women, but the large preponderance of this research is focused on the impact of maternal substance use on child outcomes, with little attention to drug use outcome for these women as an important target in its own right (cf., Pajulo et al., 2006). Accordingly, one promising factor that may help explain the maternal distress and substance use association when reintroduced to one's home environment following discharge from substance abuse treatment is maternal distress tolerance, or the ability to tolerate distress due to parenting issues. Indeed, one's ability to tolerate distress is associated with relapse following substance abuse treatment and length of abstinence attempts. However, despite its relevance to both substance use and parenting responses, little is known about the impact of low distress tolerance on substance using mothers. This may be due, at least in part, to the lack of distress tolerance assessment strategies that target directly the unique experience of maternal distress. To address the lack of research in this area, the following R21 attempts to provide an initial examination of maternal risk factors for substance use relapse, with a focus on the moderating role of distress tolerance. As a secondary aim, we explore a novel and ecologically valid measure of maternal distress tolerance to examine its utility over a standard distress tolerance task. Specifically, we will include 105 predominantly low-income, inner-city African American substance using mothers in their last week of residential drug use treatment that have a child in the critical age of 9 months to 4 years to examine the link between several indices of maternal distress and substance use outcomes with both general and maternal- specific measures of ability to tolerate distress as moderators of this relationship.

描述（由申请人提供）：女性的药物滥用治疗效果比男性差（Greenfield 等人，2007 年），包括更高的治疗退出率（Arfken 等人，2001 年；King & Canada，2004 年；Sayre 等人， 2002 年）、治疗就诊率较低（McCaul 等人，2001 年）以及治疗后药物滥用复发率较高（Grella 等人，2001 年） 2006）。然而，药物滥用研究通常很少关注与女性参与者的特定脆弱性相关的性别因素（Brady & Ashley，2005；Greenfield 等，2007）。对于许多女性吸毒者来说，与复吸风险尤其相关的一个因素是母亲的压力。照顾孩子的责任和相关的压力源可能会显着增加药物滥用复发的风险，特别是在药物滥用治疗后复发的高风险期。此外，虽然母亲因素一直是女性吸毒环境风险因素的一个特别实证和临床焦点，但这项研究的大部分重点是母亲物质使用对儿童结局的影响，而很少关注吸毒妇女的吸毒结局。这些妇女本身就是一个重要目标（参见 Pajulo 等人，2006 年）。因此，当从药物滥用治疗出院后重新引入家庭环境时，可能有助于解释孕产妇痛苦与药物使用关联的一个有希望的因素是孕产妇的痛苦耐受力，或容忍因养育问题而造成的痛苦的能力。事实上，一个人承受痛苦的能力与 药物滥用治疗和戒断尝试后的复发。然而，尽管低痛苦耐受力与药物滥用和养育反应都有相关性，但人们对低痛苦耐受力对药物滥用母亲的影响知之甚少。这可能至少部分是由于缺乏直接针对孕产妇痛苦的独特经历的痛苦耐受性评估策略。为了解决该领域研究的缺乏，以下 R21 尝试对药物滥用复发的孕产妇风险因素进行初步检查，重点关注痛苦耐受性的调节作用。作为次要目标，我们探索一种新颖且生态上有效的母亲痛苦耐受力测量方法，以检查其相对于标准痛苦耐受力任务的效用。具体来说，我们将纳入 105 名主要是低收入的内城区非裔美国吸毒母亲，她们在最后一周接受了住院吸毒治疗，她们的孩子处于 9 个月至 4 岁的关键年龄，以检查几个指数之间的联系。孕产妇痛苦和物质使用结果，以及作为这种关系调节因素的一般和孕产妇耐受痛苦能力的具体措施。