Family Attachment as an Indicator of Treatment Outcome

描述(由申请人提供)： 这项研究将通过评估依恋相关主题、物质滥用结果和治疗类型的几个方面来探讨依恋行为与物质使用的关系，并考察治疗对依恋相关行为的影响。最近的研究表明，由于青少年经历了戏剧性的心理和生理发展变化，依恋是可塑性的和变化的(Allen&Land，1999；柏林和Cassidy，1999；Kobak，1999)。然而，关于依恋相关行为及其在青少年物质使用障碍的发展或抑制中的作用，人们知之甚少。此外，药物滥用的流行在青少年中是一个重大问题，任何能够加强预防和治疗努力的经验证据都将是无价的。该分析旨在衡量依恋行为(自主性和关联性)和治疗类型(家庭、个人和团体治疗)对药物滥用治疗结果的影响。本研究建议使用自主和关联性编码系统(Allen，Hauser，Bell，McEIhaney等，1994)对200个录制的家庭互动进行编码。然后，家庭互动将被用来确定依恋是否调节治疗类型和治疗-结果关系。具体目标是：1)在基线上审查依恋和物质使用之间关系的性质。2)考察治疗对依恋相关行为的影响。3)确定依恋是否在治疗类型和治疗-结果关系中起中介作用。这项研究的最终结果将是更好地理解依恋在药物滥用治疗中的作用，并为今后将家庭依恋作为预防青少年药物滥用的研究提供有价值的见解。本论文项目建议使用来自NIDA资助的完整的治疗结果研究R01 DA09422的数据，并帮助阐明某些青少年药物滥用治疗为什么有效的重要发现。

DESCRIPTION (provided by applicant): The proposed dissertation study will explore how attachment behaviors relate to substance use and examine the effects of treatment on attachment-related behaviors by assessing several facets of attachment-related themes, substance abuse outcome, and type of treatment. Recent work suggests attachment is malleable and changes because of the dramatic developmental psychological and physical changes adolescents undergo (Allen & Land, 1999; Berlin & Cassidy, 1999; Kobak, 1999). Yet little is known about attachment-related behaviors and their role in the development or inhibition of substance-use disorders in adolescents. Moreover, the prevalence of substance abuse is a significant problem in adolescents, and any empirical evidence that can enhance prevention and treatment efforts would be invaluable. The analysis will be designed to measure the impact of attachment behaviors (autonomy and relatedness) and type of treatment (family, individual, and group therapy) on substance-abuse treatment outcome. This study proposes to code 200 videotaped family interactions using the Autonomy and Relatedness Coding System (Allen, Hauser, Bell, McEIhaney et al., 1994). The family interactions will then be used to determine whether attachment mediates the type of treatment and treatment-outcome relationship. The specific aims are: 1) To examine, at baseline, the nature of the relationship between attachment and substance use. 2) To examine the effect of treatment on attachment-related behaviors. 3) To determine whether attachment mediates the type of treatment and treatment-outcome relationship. This study will culminate with an improved understanding of the role of attachment in substance-abuse treatment as well as valuable insights for future research of family attachment as a prevention for adolescent substance abuse. This dissertation project proposes to use data from a completed, NIDA-funded treatment-outcome study, R01 DA09422, and to help illuminate important findings about why certain adolescent substance abuse treatments work.