From alcohol and other drug treatment mediator to mechanism to implementation: A systematic review and the cases of self-efficacy, social support, and craving

IF 3 Q2 SUBSTANCE ABUSE
Stephen A. Maisto, Dezarie Moskal, Madison K. Firkey, Brandon G. Bergman, Brian Borsari, Kevin A. Hallgren, Jon M. Houck, Margo Hurlocker, Brian D. Kiluk, Alexis Kuerbis, Allecia E. Reid, Molly Magill
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Abstract

Research designed to establish alcohol and other drug (AOD) mechanisms of behavioral change (MOBC) has centered on what variables mediate the relation between AOD treatment and outcomes. The purpose of this paper was to review this research evidence to identify empirically supported mediators of alcohol and other drug use and related outcomes and then to evaluate their potential as being AOD treatment MOBC. The first phase was a systematic review of reviews (2008–2023) to identify the variables with the strongest empirical support as mediators of AOD treatment effects. Eligible reviews focused on AOD treatment modalities, included empirically tested mediators, and targeted adult samples. The second phase was a systematic review of empirical studies (1990–2023) testing the hypothesis that variables identified in phase one were AOD treatment mediators/mechanisms and then evaluating each eligible stage two study according to the Kazdin and Nock (Journal of Child Psychology and Psychiatry, 44, 1116) criteria. Eligible articles included empirical studies with adult samples attending AOD treatment and empirically tested one of the three treatment mechanisms as a mediator of an AOD-related outcome. Databases were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. This systematic review was not preregistered. The first review of 11 eligible review articles identified self-efficacy, social support, and craving as having the strongest empirical support. The second review captured 48 individual studies. An evaluation of each of these studies by the Kazdin and Nock criteria suggested that they likely are MOBC and therefore are ready for implementation. The implementation of self-efficacy, social support, and craving into clinical practice and training is warranted. Six directions for future research to solidify and generalize empirical support for the case that self-efficacy, social support, and craving are MOBC are presented, as are five implications for clinical practice and training.

Abstract Image

Abstract Image

从酒精和其他药物治疗中介到机制再到实施:系统回顾以及自我效能、社会支持和渴求的案例。
旨在建立酒精和其他药物(AOD)行为改变机制(MOBC)的研究主要集中在哪些变量可以调节 AOD 治疗与结果之间的关系。本文旨在回顾这些研究证据,找出酒精和其他药物使用及相关结果的经验支持中介因素,然后评估它们作为 AOD 治疗 MOBC 的潜力。第一阶段是对综述(2008-2023 年)进行系统性回顾,以确定哪些变量作为 AOD 治疗效果的中介变量具有最有力的经验支持。符合条件的综述侧重于 AOD 治疗模式,包括经过经验检验的中介变量,并以成人样本为对象。第二阶段是对实证研究(1990-2023 年)进行系统回顾,检验第一阶段确定的变量是否为 AOD 治疗中介/机制的假设,然后根据 Kazdin 和 Nock(《儿童心理学和精神病学杂志》,44, 1116)的标准对符合条件的第二阶段研究进行评估。符合条件的文章包括对接受 AOD 治疗的成人样本进行的实证研究,并对三种治疗机制中的一种作为 AOD 相关结果的中介因素进行了实证测试。根据《系统综述和元分析首选报告项目》对数据库进行了检索。本系统综述未经预先登记。对 11 篇符合条件的综述文章进行了第一次综述,发现自我效能感、社会支持和渴望得到了最有力的经验支持。第二次审查收集了 48 项单独研究。根据卡兹丁和诺克标准对这些研究逐一进行评估后发现,它们很可能是 MOBC,因此可以实施。在临床实践和培训中实施自我效能感、社会支持和渴求是有必要的。本文提出了未来研究的六个方向,以巩固和推广对自我效能、社会支持和渴求是 MOBC 这一论点的经验支持,以及对临床实践和培训的五点启示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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