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

描述（由申请人提供）：刑事犯罪者之间的可卡因使用构成了一个主要的公共卫生问题，并与犯罪者，他们的家庭和他们的社区的负面后果有关。这些后果中最可怕的一个是重复监禁;因此，需要采取干预措施，减少刑事累犯。法医群体往往被视为相当悲观的治疗。然而，罪犯表现出异质性的人格特质，和罪犯之间的个体差异的评估可能会提供有价值的信息，指导使用心理治疗干预。在犯罪者中，精神病态已经成为理解暴力和犯罪累犯的重要人格结构。此外，精神病的核心特征，如缺乏同情心，欺骗性和缺乏悔恨可能对心理干预的有效性产生负面影响。目前的工作的一个基本前提是，了解罪犯的物质使用治疗结果的心理变态特征的调节作用是必不可少的，以确定什么工作，为谁。目前的提案是一项II期随机临床试验，旨在研究精神病特征对监狱分流计划中罪犯短暂可卡因使用干预的有效性的影响。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介导相对于标准护理条件的后期犯罪累犯的减少，以及3）核心精神病特征将调节干预的功效，使得具有较低水平的这些特征的个体将在减少可卡因使用，减少药物使用后果，并在一年的随访中降低了犯罪累犯率。这项工作有可能提供关于哪些人可以从可卡因使用的短暂干预中受益的重要数据。这些数据将为有效和高效地分配可卡因使用罪犯的治疗资源提供信息。 公共卫生相关性：反复监禁与情绪不佳、传染病和重返社会的前景越来越渺茫有关。不仅罪犯，而且其家庭和社区也感受到监禁的影响，表现为经济困难、父母不在身边的儿童以及可能因反复监禁而变得更加病态或危险的个人。本研究旨在通过提供信息，告知使用可卡因的罪犯的有效和高效的治疗，以减少刑事累犯。

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.