The Impact of Depression on Abstinence Self-Efficacy and Substance Use Outcomes Among Emerging Adults in Residential Treatment
The Impact of Depression on Abstinence Self-Efficacy and Substance Use Outcomes Among Emerging Adults in Residential Treatment
复制标题
DOI：
10.1037/a0026917
复制
发表时间：
2012-06-01
影响因子：
3.4
通讯作者：
Bryan, Angela D.
中科院分区：
文献类型：
--
作者：
Greenfield, Brenna L.;Venner, Kamilla L.;Bryan, Angela D.
很大一部分接受物质使用障碍（SUD）治疗的新兴成年人表现出负面情绪和重度抑郁症（MDD）的症状。然而，关于这些合并症如何影响治疗反应的重要机制，如禁欲自我效能（ASE）的增加，知之甚少。本研究检测了MDD和/或抑郁症状与ASE治疗期间变化相互作用的程度，并检查了这些变量与治疗后3个月结局的关系。参与者（N = 302; 74%男性）在摄入、治疗中期、治疗结束和3个月随访时完成测量。ASE采用酒精和药物使用自我效能（ADUSE）量表进行测量;抑郁症状采用简明症状量表18（BSI 18）抑郁量表进行评估;目前的MDD诊断来自精神疾病诊断和统计手册第四版（DSM-IV）的结构化临床访谈。随机系数回归分析集中于治疗期间ASE的变化，BSI 18评分和MDD诊断作为调节因素。在摄入时，患有MDD或高水平抑郁症状的个体的ASE显着降低，特别是在负面影响的情况下。未发现适度的证据：无论MDD状态如何，治疗期间ASE均显著增加。BSI 18抑郁评分的主要影响是：BSI 18评分较低的人在每个时间点的ASE评分较低。MOD和BSI 18抑郁不能预测3个月的结果，但与以前的研究结果相似，ASE确实预测了3个月时的禁欲状态。寻求治疗的新出现的MDD成人值得特别的临床关注，因为他们在整个治疗过程中报告的自我效能较低。
A large proportion of emerging adults treated for substance use disorder (SUD) present with symptoms of negative affect and major depressive disorder (MDD). However, little is known regarding how these comorbidities influence important mechanisms of treatment response, such as increases in abstinence self-efficacy (ASE). This study tested the degree to which MDD and/or depressive symptoms interacted with during-treatment changes in ASE and examined these variables' relation to outcome at 3 months' posttreatment. Participants (N = 302; 74% male) completed measures at intake, midtreatment, end-of-treatment, and at 3-month follow-up. ASE was measured with the Alcohol and Drug Use Self-Efficacy (ADUSE) scale; depressive symptoms were assessed with the Brief Symptom Inventory 18 (BSI 18) Depression scale; and current MDD diagnoses were deduced from the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Random coefficient regression analyses focused on during-treatment changes in ASE, with BSI 18 scores and MDD diagnosis included as moderators. At intake, individuals with MDD or high levels of depressive symptoms had significantly lower ASE, particularly in negative affect situations. No evidence for moderation was found: ASE significantly increased during treatment regardless of MDD status. There was a main effect of BSI 18 Depression scores: those with lower BSI 18 scores had lower ASE scores at each time point. MOD and BSI 18 Depression did not predict 3-month outcome, but similar to previous findings ASE did predict abstinence status at 3 months. Treatment-seeking emerging adults with MDD merit particular clinical attention because of their lower reported self-efficacy throughout treatment.