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

摘要： 在罪犯中使用可卡因构成了一个重大的公共卫生问题，并与 对罪犯、他们的家人和他们的社区的后果。这些后果中最可怕的一个是 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，罪犯表现出异质性 人格特征，以及对罪犯个体差异的评估可能会提供有价值的 指导使用心理治疗干预措施的信息。在罪犯中，精神变态 作为理解暴力和犯罪累犯的一种重要人格建构。 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 对心理社会干预效果的负面影响。当前工作的一个基本前提 了解精神病态特征对药物使用治疗结果的调节作用 罪犯是决定什么是有效的，对谁来说是必不可少的。目前的提议是第二阶段 随机临床试验，旨在检查精神变态特征对疗效的影响 在监狱分流计划中，对罪犯使用可卡因进行干预。将研究的假设包括：1) 以动机访谈(MI)为基础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 与标准护理条件相比，调解后来的犯罪累犯率的减少，以及3)核心 心理变态特征将缓和干预的效果，使具有较低水平的 这些特征将在减少可卡因使用、减少药物使用方面获得更大的好处 并在一年的后续行动中减少了犯罪累犯率。这项工作有可能 提供重要数据，说明哪些人可以从短暂的可卡因使用干预中受益。是这样的 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。

Abstract: 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.