Predictors of substance use during treatment for addiction: A network analysis of ecological momentary assessment data.

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2024-08-30 DOI:10.1111/add.16658

Fuschia Serre, Christophe Gauld, Laura Lambert, Emmanuelle Baillet, Virginie Beltran, Jean-Pierre Daulouede, Jean-Arthur Micoulaud-Franchi, Marc Auriacombe

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Abstract

Background and aims: Ecological momentary assessment (EMA) studies have previously demonstrated a prospective influence of craving on substance use in the following hours. Conceptualizing substance use as a dynamic system of causal elements could provide valuable insights into the interaction of craving with other symptoms in the process of relapse. The aim of this study was to improve the understanding of these daily life dynamic inter-relationships by applying dynamic networks analyses to EMA data sets.

Design, setting and participants: Secondary analyses were conducted on time-series data from two 2-week EMA studies. Data were collected in French outpatient addiction treatment centres. A total of 211 outpatients beginning treatment for alcohol, tobacco, cannabis, stimulants and opiate addiction took part.

Measurements: Using mobile technologies, participants were questioned four times per day relative to substance use, craving, exposure to cues, mood, self-efficacy and pharmacological addiction treatment use. Multi-level vector auto-regression models were used to explore contemporaneous, temporal and between-subjects networks.

Findings: Among the 8260 daily evaluations, the temporal network model, which depicts the lagged associations of symptoms within participants, demonstrated a unidirectional association between craving intensity at one time (T0) and primary substance use at the next assessment (T1, r = 0.1), after controlling for the effect of all other variables. A greater self-efficacy at T0 was associated with fewer cues (r = -0.04), less craving (r = -0.1) and less substance use at T1 (r = -0.07), and craving presented a negative feedback loop with self-efficacy (r = -0.09).

Conclusions: Dynamic network analyses showed that, among outpatients beginning treatment for addiction, high craving, together with low self-efficacy, appear to predict substance use more strongly than low mood or high exposure to cues.

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成瘾治疗期间使用药物的预测因素：生态瞬间评估数据的网络分析。

背景和目的：生态瞬间评估（EMA）研究曾证明，渴求对随后几小时的药物使用具有前瞻性影响。将药物使用概念化为一个由因果要素组成的动态系统，可以为了解复吸过程中渴求与其他症状的相互作用提供有价值的见解。本研究旨在通过对 EMA 数据集进行动态网络分析，加深对这些日常生活动态相互关系的理解：对两项为期两周的 EMA 研究的时间序列数据进行了二次分析。数据在法国的门诊成瘾治疗中心收集。共有 211 名开始接受酒精、烟草、大麻、兴奋剂和阿片类药物成瘾治疗的门诊患者参与了这项研究：利用移动技术，每天对参与者进行四次询问，内容涉及药物使用、渴求、接触线索、情绪、自我效能和药物成瘾治疗的使用。使用多层次向量自动回归模型来探索同时、时间和受试者之间的网络：在 8260 次日常评估中，时间网络模型描述了参与者体内症状的滞后关联，在控制了所有其他变量的影响后，该模型显示了某一次（T0）渴求强度与下一次评估（T1，r = 0.1）主要药物使用之间的单向关联。T0时更高的自我效能感与更少的线索（r = -0.04）、更低的渴求（r = -0.1）和T1时更少的药物使用（r = -0.07）相关，渴求与自我效能感之间呈现负反馈循环（r = -0.09）：动态网络分析显示，在开始接受成瘾治疗的门诊患者中，高渴求感和低自我效能感似乎比低情绪或高线索暴露更能预测药物使用。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.