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成瘾者以积极或消极的方式改变他们的社交网络，以及社会变化对健康结果和健康行为的影响有多重要。我们的研究重点是成瘾性疾病患者，因为成瘾会对我们最强的社会关系产生强烈，甚至是灾难性的影响。另一方面，有大量的证据，包括我们提出的新分析，表明社会关系是成瘾结果的一个强有力的决定因素。由于成瘾是慢性的，复发性疾病，如果我们能够促进成瘾者持久的健康关系，这些关系可能会减少对昂贵且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。我们的研究将阐明成瘾者社交网络的变化过程。我们将从成瘾治疗机构招募300人，并自然地跟踪他们两年，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标：（1）确定一个人的关系如何受到其他关系的影响，以及物质使用，关系类型和历史的共同变化;（2）复制和扩展先前关于社会网络特征对物质使用结果的影响的研究;（3）确定社会网络对进入物质滥用治疗的影响，以及互助参与。将使用具有时变协变量的考克斯比例风险回归和分层线性模型来检验提案中列出的先验预测。

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.