A Longitudinal Prospective Study of Social Network Dynamics in Addictions

描述(由申请人提供)：我们研究工作的长期目标是了解为什么上瘾者以积极或消极的方式改变他们的社会网络，以及社会变化如何影响重要的健康结果和健康行为。我们的研究集中在有成瘾障碍的人身上，因为上瘾可能会对我们最牢固的社会关系产生强烈的，甚至是灾难性的影响。另一方面，包括我们提出的新分析在内的大量证据表明，社会关系是成瘾结果的重要决定因素。由于成瘾是一种慢性、复发性疾病，如果我们能够为成瘾者促进持久的健康关系，这些关系可能会减少对昂贵且并不总是可获得的专业服务的需求。不幸的是，我们对人们为什么改变他们的社会关系缺乏基本的理解，无论是好是坏。我们的研究将阐明瘾君子社交网络的变化过程。我们将从成瘾治疗机构招募300人，并对他们进行为期两年的自然跟踪，收集有关社会关系、物质使用和其他变量的密集纵向数据。我们的研究有三个目的：(1)确定一个人的关系如何受到其他关系以及药物使用的影响，关系类型和历史相同；(2)复制和扩展先前关于社会网络特征对药物使用结果的影响的研究；以及(3)确定社会网络对药物滥用治疗和互助参与的影响。考克斯比例风险回归和具有时变协变量的分层线性模型将被用来检验提案中提出的先验预测。

DESCRIPTION (provided by applicant): The longer-term goal of our research effort is to understand why persons with addictions change their social networks in either positive or negative ways, and how important health outcomes and health behaviors affect are influenced by social changes. Our research focuses on persons with addictive disorders because addiction can have strong, even catastrophic, effects on our strongest social ties. On the other hand, there is substantial evidence, including new analyses we present, that social relationships are a strong determinant of addictions outcome. Since addictions are chronic, relapsing disorders, if we were able to promote durable healthy relationships for addicts, these relationships might reduce the need for costly and not always accessible professional services. Unfortunately, we lack a basic understanding of why people change their social relationships, for better or for worse. Our research will illuminate the processes of change in addicts' social networks. We will recruit 300 persons from addictions treatment facilities and follow them naturalistically for two years, gathering intensive longitudinal data on social relationships, substance use, and other variables. Our study has three aims: (1) To determine how a person's relationships are affected by other relationships, and by substance use, co-varying for relationship type and history; (2) To replicate and extend prior research on the effects of social network characteristics on substance use outcome; and (3) To determine social network influences on entry into substance abuse treatment, and mutual-help participation. Cox proportional hazards regressions and hierarchical linear models with time varying covariates will be used to test the a priori predictions laid out i the proposal.