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）：女性的物质使用治疗结果比男性差（格林菲尔德等人，2007），包括较高的治疗脱落率（Arfken等人，2001; King & Canada，2004;塞尔等人，2002），较低的治疗出勤率（McCaul等人，2001）和较高的治疗后物质使用复发率（Grella等人，2006年）。然而，药物滥用研究往往很少关注与女性参与者的特殊脆弱性有关的性别特异性因素（布雷迪和阿什利，2005年;格林菲尔德等人，2007年）。与许多女性吸毒者复吸风险特别相关的一个因素是母亲的压力;照顾子女的责任和相关的压力因素可能大大增加复吸的风险，特别是在药物滥用治疗后复吸的高风险时期。此外，虽然母体因素一直是关于吸毒妇女环境风险因素的特别经验和临床重点，但这项研究的大部分重点是母体药物使用对儿童结局的影响，很少关注这些妇女的吸毒结局本身作为重要目标（参见，Pajulo等人，2006年）。因此，一个有希望的因素，可能有助于解释产妇的痛苦和物质使用协会时，重新引入到一个人的家庭环境出院后，从物质滥用治疗是产妇痛苦的容忍度，或容忍痛苦的能力，由于养育问题。事实上，一个人忍受痛苦的能力与 药物滥用治疗后复发和尝试禁欲的时间。然而，尽管它的相关性，物质使用和养育子女的反应，很少有人知道的影响，低痛苦容忍物质使用的母亲。这可能是由于，至少在一定程度上，缺乏直接针对产妇痛苦的独特经验的痛苦容忍度评估策略。为了解决这一领域缺乏研究的问题，以下R21试图对物质使用复发的孕产妇风险因素进行初步研究，重点是痛苦耐受力的调节作用。作为第二个目标，我们探索了一种新的和生态有效的措施，产妇的痛苦容忍检查其效用超过一个标准的痛苦容忍任务。具体来说，我们将包括105主要是低收入，市中心的非裔美国人的物质使用的母亲在他们的最后一周的住宅药物使用治疗，有一个孩子在9个月至4岁的关键年龄检查产妇的痛苦和物质使用的结果与一般和产妇的具体措施，以容忍痛苦的能力，这种关系的调节器之间的联系。