Interaction of Mental Health and Social Support on Drug Relapse in Recovery Homes

摘要 现在药物治疗领域的共识是，物质依赖需要长期的治疗。 干预措施远远超出了正规治疗。清醒的生活之家（SLH）是酒精和毒品免费 康复之家，帮助药物依赖者在完成治疗后保持长期戒断。 治疗或从监禁中释放。在某些情况下，它们可以作为替代恢复选项， 不想从正式治疗计划中寻求帮助的人。我们的研究小组的研究是 第一个记录了SLH居民的良好结果，这些结果保持了18个月的随访- 上时期。在一系列重要的结果中，有一项发现是， 预测更差的结果和社会支持的恢复预测更好的结果。令人惊讶的是， 从成瘾中恢复忽视了这两个因素如何相互作用影响结果。我们假设 精神症状对住院医师结果的破坏性影响将通过社会支持来减轻， 复苏各种其他潜在的主持人也将探讨，包括接受心理健康 服务、一般社会支持、人口统计和药物依赖类型。大多数研究 成瘾性障碍恢复的预测因子仅限于基线测量。拟议的研究将 第一个测试精神症状和社会支持之间的相互作用如何纵向运作， 影响复发。这项研究将包括对323名SLH居民的二次分析， 基线和6个月、12个月和18个月随访。虽然父母补助金包括一个目标，评估如何 影响药物使用的精神病严重程度的综合、全球指标（BSI全球严重程度指数），无分析 审查潜在的主持人或调解人。此外，没有任何目标涉及不同类型的 精神症状。拟议的研究将跟踪9个BSI量表的轨迹，每个量表测量一个特定的 精神症状（例如，抑郁症、焦虑症、精神病、强迫症等）及其协会 复发超过18个月。这项研究将是第一个检查精神症状轨迹的研究 在物质依赖者中使用纵向设计，在正式治疗的背景之外。 虽然父母补助金发现GSI量表随着时间的推移而改善，但临床意义不大。的 拟议的研究将确定9个BSI量表中的哪一个测量精神病的不同维度， 症状改善，没有变化，可能变得更糟。拟定的研究将 还评估了参与者接受治疗的精神症状类型， 未发现或未治疗的症状以及接受治疗如何影响结果。研究结果 将对认识和解决SLH的精神症状以及更广泛的 对社区长期恢复的影响。

ABSTRACT There is now consensus in the drug treatment field that substance dependence requires long-term interventions that extend well beyond formal treatment. Sober living houses (SLHs) are alcohol- and drug-free recovery homes that help individuals with drug dependence maintain long-term abstinence after completion of treatment or release from incarceration. In some cases they serve as an alternative recovery option for individuals who do not want to seek help from a formal treatment program. Studies by our research team were the first to document excellent outcomes for SLH residents, which were maintained over an 18-month follow- up period. Among a number of important results was the finding that severity of psychiatric symptoms predicted worse outcome and social support for recovery predicted better outcome. It is striking that studies of recovery from addiction have ignored how these two factors interact to affect outcome. We hypothesize the destructive impact of psychiatric symptoms on resident outcomes will be mitigated by social support for recovery. A variety of other potential moderators will be explored as well, including receipt of mental health services, general social support, demographics and type of drug dependence. Most studies examining predictors of recovery from addictive disorders are limited to baseline measures. The proposed study will be the first to test how interactions between psychiatric symptoms and social support operate longitudinally to affect relapse. The study will consist of a secondary analysis of the 323 SLH residents who were interviewed at baseline and 6-, 12- and, 18-month follow-up. Although the parent grant included an aim assessing how a composite, global measure of psychiatric severity (BSI Global Severity Index) impacted drug use, no analyses examined potential moderators or mediators. In addition, no aims addressed the impact of different types of psychiatric symptoms. The proposed study will track trajectories of nine BSI scales, each measuring a specific psychiatric symptom (e.g., depression, anxiety, psychosis, obsessive compulsive, etc.) and their associations with relapse over 18 months. The study will be the first that examines trajectories of psychiatric symptoms among substance dependent persons using a longitudinal design outside the context of formal treatment. Although the parent grant found the GSI scale improved over time, the clinical significance was modest. The proposed study will identify which of the 9 BSI scales measuring different dimensions of psychiatric symptoms improved, which were unchanged, and which may have become worse. The proposed study will also assess the types of psychiatric symptoms for which participants received treatment, the types of symptoms that were undetected or untreated and how receipt of treatment affected outcome. Study findings will have implications for recognizing and addressing psychiatric symptoms in SLHs as well as broader implications for sustaining long term recovery in the community.