The Impact of Psychopathic Traits on a Cocaine Use Intervention for Offenders

描述(申请人提供)：刑事罪犯使用可卡因是一个主要的公共卫生问题，并与罪犯、他们的家人和他们的社区的负面后果有关。这些后果中最可怕的一种是反复监禁；因此，需要采取干预措施减少犯罪累犯率。法医群体往往对治疗持相当悲观的态度。然而，罪犯在人格特征上表现出异质性，对罪犯个体差异的评估可能会为指导心理治疗干预的使用提供有价值的信息。在罪犯中，精神病已经成为理解暴力和犯罪累犯的重要人格结构。此外，精神变态的核心特征，如缺乏同理心、欺骗性和缺乏悔恨，可能会对心理社会干预的效果产生负面影响。目前工作的一个基本前提是，了解精神变态特征对罪犯使用药物治疗结果的调节作用对于确定什么有效以及对谁有效至关重要。目前的提议是一项第二阶段的随机临床试验，旨在检查精神病特征对监狱分流计划中罪犯进行短暂可卡因使用干预的效果的影响。将审查的假设包括：1)基于动机访谈(MI)的治疗将减少可卡因的使用和相关后果，相对于仅标准护理条件，2)干预组中可卡因使用的减少将调解相对于标准护理条件的未来犯罪累犯率的减少，以及3)核心精神变态特征将缓和干预的效果，使得这些特征水平较低的个人在一年的随访中将从减少可卡因使用、减少药物使用后果和减少犯罪再犯罪率方面获得更大的好处。这项工作有可能提供关于哪些人可以从短暂的可卡因使用干预中受益的重要数据。这些数据将为有效和高效地分配治疗吸食可卡因罪犯的资源提供信息。 公共卫生相关性：反复监禁与情绪健康不良、传染病和重新融入社会的前景降低有关。不仅罪犯感受到监禁的影响，他们的家庭和社区也感受到了经济困难、父母不在身边的儿童，以及可能因反复监禁而病情加重或变得更危险的个人的影响。本研究旨在通过提供信息，为有效和高效地治疗吸食可卡因的罪犯提供信息，从而减少犯罪累犯。

DESCRIPTION (provided by applicant): Cocaine use among criminal offenders constitutes a major public health problem and is tied to negative consequences for offenders, their families, and their communities. One of the direst of these consequences is repeated incarceration; thus, interventions that reduce criminal recidivism are needed. Forensic populations are often viewed with considerable therapeutic pessimism. However, offenders exhibit heterogeneity in personality traits, and the assessment of individual differences among offenders may provide valuable information that guides the use of psychotherapeutic interventions. Among offenders, psychopathy has emerged as an important personality construct for the understanding of violence and criminal recidivism. Moreover, core traits of psychopathy such as lack of empathy, deceitfulness, and lack of remorse may have negative implications for the efficacy of psychosocial interventions. A foundational premise of the present work is that understanding the moderating role of psychopathic traits on substance use treatment outcomes among offenders is essential to determining what works, and for whom. The current proposal is a Phase II randomized clinical trial that aims to examine the impact of psychopathic traits on the efficacy of a brief cocaine use intervention for offenders in a jail diversion program. Hypotheses that will be examined include: 1) that a Motivational Interviewing (MI) - based treatment will reduce cocaine use and related consequences relative to a Standard Care only condition, 2) that the reduction in cocaine use in the intervention group will mediate a reduction in later criminal recidivism relative to the Standard Care condition, and 3) that core psychopathic traits will moderate the efficacy of the intervention such that individuals with lower levels of these traits will derive greater benefits with regard to decreased cocaine use, decreased drug use consequences, and decreased criminal recidivism at a one-year follow-up. This work has the potential to provide important data regarding which individuals can benefit from a brief intervention for cocaine use. Such data will inform the effective and efficient allocation of treatment resources for cocaine using offenders. PUBLIC HEALTH RELEVANCE: Repeated incarceration is linked to poor emotional health, infectious disease, and diminishing prospects for reintegration into society. The effects of incarceration are felt not only by offenders, but by their families and communities in the form of economic hardship, children with absent parents, and, potentially, individuals who become more ill or dangerous with repeated incarcerations. The present study aims to decrease criminal recidivism by providing information that informs the effective and efficient treatment of cocaine-using offenders.