Daily stressors as antecedents, correlates, and consequences of alcohol and drug use and cravings in community-based offenders.
Daily stressors as antecedents, correlates, and consequences of alcohol and drug use and cravings in community-based offenders.
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DOI：
10.1037/adb0000276
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Knight K
中科院分区：
文献类型：
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作者：
Neupert SD;Desmarais SL;Gray JS;Cohn AM;Doherty S;Knight K
司法参与酒精和毒品使用问题的个人再犯率高于他们的非使用同行，酒精和毒品使用作为一个重要的载体累犯。在日常生活中，暴露于压力源可能会加剧酗酒和吸毒问题;在个人层面上，先前的治疗经历可能会减轻物质使用，因为个人适应并学习新的应对机制。我们使用交互式语音应答（IVR）技术进行了连续14天的每日日记研究，117名缓刑或假释男子参加了以社区为基础的治疗计划（n = 860个电话），并提到药物辅助治疗。参与者报告了每天的压力源，对酒精和非法药物的渴望，以及每天一次使用酒精和非法药物。多水平模型的结果显示，酒精和药物的渴望和使用显着的日常波动。在并行模型中，日常压力源的增加与对非法药物的渴望和使用的增加有关。先前的治疗经验修改了许多这些关系，额外的滞后模型显示，与那些有更多治疗经验的人相比，那些治疗经验较少的人在前一天经历压力增加时，第二天酒精渴望增加。总的来说，这些发现强调了根据个体差异（包括先前的治疗经历）定制治疗的重要性，并针对有酒精和药物使用问题的涉及司法的成年人的日常压力源和随后的渴望。
Justice-involved individuals with alcohol and drug use problems reoffend at higher rates than their non-using counterparts, with alcohol and drug use serving as an important vector to recidivism. At the daily level, exposure to stressors may exacerbate problematic alcohol and drug use; at the individual-level, prior treatment experiences may mitigate substance use as individuals adapt to and learn new coping mechanisms. We conducted a daily diary study using Interactive Voice Response (IVR) technology over 14 consecutive days with 117 men on probation or parole participating in a community-based treatment program (n = 860 calls) and referred to medication-assisted treatment. Participants reported daily stressors, craving for alcohol and illegal drugs, and use of alcohol and illegal drugs one time each day. Results of multilevel models showed significant day-to-day fluctuation in alcohol and drug craving and use. In concurrent models, increases in daily stressors were associated with increases in cravings and use of illegal drugs. Prior treatment experience modified many of these relationships, and additional lagged models revealed that those with less treatment experience reported an increase in next-day alcohol craving when they experienced increases in stressors on the previous day compared to those with more treatment experience. Collectively, these findings highlight the importance of tailoring treatment as a function of individual differences, including prior treatment experiences, and targeting daily stressors and subsequent cravings among justice-involved adults with alcohol and drug use problems.