Attendance and Substance Use Outcomes for the Seeking Safety Program: Sometimes Less Is More
Attendance and Substance Use Outcomes for the Seeking Safety Program: Sometimes Less Is More
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DOI：
10.1037/a0026361
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发表时间：
2012-02-01
影响因子：
5.9
通讯作者：
Nunes, Edward V.
中科院分区：
文献类型：
--
作者：
Hien, Denise A.;Morgan-Lopez, Antonio A.;Nunes, Edward V.
目的：这项研究使用了迄今为止最大的有效性试验的数据，对共同发生的创伤后应激障碍和物质使用障碍的治疗，利用统计方法的进步，在滚动组中建模治疗出勤率和会员营业额。方法：接受门诊药物滥用治疗的妇女（N = 353）被随机分配到12个寻求安全或健康教育控制条件的会议。在基线和治疗后1周、3个月、6个月和12个月完成评估。结果的措施是酒精和可卡因使用前30天使用成瘾严重程度指数。潜在类模式混合模型（LCPMM）被用来估计出勤模式，并测试治疗效果内和跨潜在出勤模式和组成员营业额。结果如下：在对酒精和可卡因使用的LCPMM分析中，出现了类似的治疗出勤模式：完成者从未低于80%的出勤率。滴注者的出勤率从未超过41%，滴定者的出勤率为50%至80%。在完成者中，从基线到治疗后1周，饮酒量显著减少，随后在随访期间饮酒量无显著增加。未检测到处理条件之间的差异。与对照参与者相比，从1周至12个月的随访中，寻求安全的滴定器的酒精使用率较低。在两个研究阶段，滴剂的酒精含量无显著增加。使用复方制剂的结果相似，但未达到显著性水平。结论：客户端的自我调节的治疗剂量和组成员组成的影响可能会影响这一人群的行为治疗结果。
Objective: This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups. Method: Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover. Results: Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance. droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels. Conclusions: The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population.