Behavioral strategies to reduce stress reactivity in opioid use disorder: Study design.
Behavioral strategies to reduce stress reactivity in opioid use disorder: Study design.
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DOI：
10.1037/hea0000862
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Dillon DG
中科院分区：
文献类型：
--
作者：
McHugh RK;Nguyen MD;Fitzmaurice GM;Dillon DG
2017年，美国有超过200万人患有阿片类药物使用障碍。阿片类药物使用障碍的治疗-特别是药物结合心理社会支持-可有效减少阿片类药物的使用并降低过量风险。然而，大约50%接受治疗的人会复发或退出。压力反应性，定义为对压力的主观和生理反应，在阿片类药物使用障碍患者中升高，较高的压力反应性与较差的结果相关。初步研究表明，应激反应可能是改善结局的关键机制目标。这份手稿描述了一项正在进行的研究的设计，该研究检查了减少阿片类药物使用障碍成年人应激反应的行为策略。我们的目标是测试两种行为策略的有效性，以减少压力反应和提高行为的持久性，在压力的背景下（痛苦的容忍度）。我们将招募120名患有阿片类药物使用障碍的成年人，并随机分配他们接受（1）认知重新评估，（2）影响标签或（3）心理教育控制的简短培训。参与者将接受培训干预，然后是实验室压力源，在此期间，他们将被指导应用培训技能。对压力的主观和生理反应将作为压力反应性的指标进行测量，压力源任务将包括行为持久性成分作为痛苦耐受性的测量。这项研究的最终目标是为行为干预的发展提供信息，这些干预可以作为阿片类药物使用障碍药物治疗的辅助手段。
More than 2 million people in the U.S. had an opioid use disorder in 2017. Treatment for opioid use disorder—particularly medication combined with psychosocial support—is effective for reducing opioid use and decreasing overdose risk. However, approximately 50% of people who receive treatment will relapse or dropout. Stress reactivity, defined as the subjective and physiological response to stress, is heightened in people with opioid use disorder and higher stress reactivity is associated with poorer outcomes. Preliminary studies suggest that stress reactivity may be a key mechanistic target for improving outcomes. This manuscript describes the design of an ongoing study examining behavioral strategies for reducing stress reactivity in adults with opioid use disorder. Our objective is to test the efficacy of two behavioral strategies for reducing stress reactivity and enhancing behavioral persistence in the context of stress (distress tolerance). We will recruit 120 adults with opioid use disorder and randomly assign them to brief training in (1) cognitive reappraisal, (2) affect labeling, or (3) a psychoeducational control. Participants will receive the training intervention followed by a laboratory stressor during which they will be instructed to apply the trained skill. Subjective and physiological responses to stress will be measured as indices of stress reactivity and the stressor task will include a behavioral persistence component as a measure of distress tolerance. The ultimate goal of this study is to inform the development of behavioral interventions that can be used as an adjunct to medication-based treatment for opioid use disorder.
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