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行为干预对物质使用障碍成人应激反应的影响。

Effects of behavioral interventions on stress reactivity in adults with substance use disorders.

机构信息

Division of Alcohol, Drugs and Addiction, McLean Hospital.

Department of Psychiatry, Harvard Medical School.

出版信息

Psychol Addict Behav. 2024 Dec;38(8):819-826. doi: 10.1037/adb0001032. Epub 2024 Sep 12.

Abstract

OBJECTIVE

Heightened reactivity to stress is associated with poor treatment outcome in people with substance use disorders (SUDs). Behavioral strategies can reduce stress reactivity; however, these strategies are understudied in people with SUDs. The objective of this study was to test the effect of two behavioral strategies (cognitive reappraisal and affect labeling) on stress reactivity in people with SUDs.

METHOD

Treatment-seeking adults with SUDs ( = 119) were randomized to receive brief training in cognitive reappraisal, affect labeling, or a psychoeducational control, followed by a standardized stress induction. Markers of stress reactivity were collected before and following stress induction and included self-reported negative affect and substance craving, as well as salivary cortisol, and skin conductance response.

RESULTS

Analyses of covariance did not indicate a significant effect of treatment condition on negative affect, cortisol, or skin conductance response. Participants in the affect labeling condition had greater increase in craving than those in the cognitive reappraisal condition; neither condition differed from control.

CONCLUSIONS

Results indicated that, although participants were able to implement behavioral skills following a brief training, training condition did not modify stress reactivity, on average, relative to control. Future directions include consideration of individual differences in response to training and determination of whether higher "dosing" of skills via multiple sessions or extended practice is needed to influence stress reactivity in people with SUDs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

目的

对压力的反应性增强与物质使用障碍(SUD)患者的治疗效果不佳有关。行为策略可以降低压力反应性;然而,这些策略在 SUD 患者中研究较少。本研究的目的是测试两种行为策略(认知重评和情绪标注)对 SUD 患者压力反应性的影响。

方法

寻求治疗的 SUD 成年患者(n=119)被随机分配接受认知重评、情绪标注或心理教育对照的简短培训,然后进行标准化的应激诱导。在应激诱导前后采集应激反应标志物,包括自我报告的负性情绪和物质渴求,以及唾液皮质醇和皮肤电反应。

结果

协方差分析结果显示,治疗条件对负性情绪、皮质醇或皮肤电反应均无显著影响。情绪标注组的渴求感增加大于认知重评组;这两个条件都与对照组没有差异。

结论

结果表明,尽管参与者在接受简短培训后能够实施行为技能,但与对照组相比,平均而言,训练条件并未改变应激反应性。未来的研究方向包括考虑对训练的反应存在个体差异,以及确定是否需要通过多次会议或延长练习来增加技能的“剂量”,以影响 SUD 患者的应激反应性。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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