Influence of Time in Treatment and Follow-Up Duration on Methadone Treatment Outcomes

Data for 422 methadone treatment clients in the National Treatment Improvement Evaluation Study (NTIES) were analyzed. Clients maintained continuously in methadone treatment for longer than 12 months and clients who leftbetween 3–12 months were compared with clients treated for less than 3 months. Additionally, clients treated for 3–12 months who had short follow-up periods (6-month average) were compared with 3–12-month clients with long follow-up periods (11-month average). Positive treatment outcomes includinglower drug use, reduced risk of viral infectionand sexually transmitted disease (through needle sharing and multiple sex partners), and less criminality wereassociated with both longer duration treatment and shorter follow-up periods. The findings suggested that continuous methadone treatment of 12 or more months is optimal, whereas stays of less than3 months may be ineffective. Furthermore, stays of 3–12 months are likelyto be beneficial over a relatively short time span, for example 6 months.     

Examining the relation between adolescent social anxiety,adolescent delinquency (abstention), and emerging adulthood relationship quality

Background and Objectives: Social anxiety symptoms and delinquency are two prevalent manifestations of problem behavior during adolescence and both are related to negative interpersonal relationships in adolescence and emerging adulthood. This study examined the relation between social anxiety and delinquency in adolescence and the interplay between adolescent social anxiety and delinquency on perceived relationship quality in emerging adulthood. Design and Methods: In a 10-year long prospective study (T1, n = 923; T2, n = 727; Mage T1 = 12; 49% female), we examined competing hypotheses using regression analyses: the protective perspective, which suggests social anxiety protects against delinquency; and the co-occurring perspective, which suggests social anxiety and delinquency co-occur leading to increased negative interpersonal outcomes. Results: In adolescence, the relation between social anxiety and delinquency was consistent with the protective perspective. In emerging adulthood, consistent with the co-occurring perspective, ever-delinquents (but not delinquency abstainers) with higher social anxiety reported less perceived best friend, mother, and father support compared to delinquents with lower social anxiety. There was no interaction between anxiety and delinquency in predicting perceived conflict. Conclusion: This study highlights the importance of examining the relation between social anxiety and delinquency with regards to different interpersonal outcomes.     

奖赏对海洛因成瘾者执行功能的影响机制

一些研究发现海洛因成瘾者奖赏失调表现为:对海洛因相关线索的注意偏向、渴求感增加,对金钱奖赏表现出"即时收益优先"的高风险决策模式和对长时收益的敏感性降低。另一些研究发现海洛因成瘾者的执行功能存在障碍。奖赏失调和执行功能障碍在成瘾物质使用的维持和复吸中起着重要作用。双重竞争模型认为奖赏和执行功能的交互作用决定着行为的结果,但是奖赏对海洛因成瘾者执行功能的影响机制还不清楚。因此,拟使用事件相关电位技术来考察海洛因相关线索和金钱奖赏对不同戒断期成瘾者执行功能的影响机制,短期(1~3个月)、长期(18个月以上)海洛因戒断者和健康对照组被比较。这不仅有助于构建完善的成瘾理论体系,还有助于确定临床戒断后复吸的风险因素和不同戒断期的治疗目标。     

不同康复时相戒除者对海洛因相关线索的注意偏向

以84名生理脱瘾后处于不同康复时相的海洛因戒除者为被试,采用情绪Stroop范式,以海洛因相关线索为自变量,考察了海洛因戒除者的注意偏向特性及其动态变化。结果发现:(1)海洛因戒除者对相关线索存在着显著的注意偏向;(2)海洛因戒除者对相关线索的注意偏向随康复期的延长无显著改善。该研究支持了Franken关于药物成瘾的注意偏向模型。     

人脑眶额皮质表征奖赏信息的进展

文章围绕人脑眶额皮质在表征奖赏信息上的核心作用展开,分别从人脑眶额皮质表征奖赏信息的共同神经表征和特异性神经表征特点,奖赏加工和该脑区局部形态特征之间的关系以及眶额皮质表征奖赏信息的时间动态性等角度对最近的重要研究进展进行了一定的梳理和概括。最后,文章讨论了未来研究需要解决的由奖赏类型多样性和脑区间奖赏信息整合复杂性带来的系列问题。     

戒毒者复吸的根本原因及综合治疗模式的构想

造成戒毒者复吸的真正原因是戒毒人员已经改变的神经生化机制,不稳定的心理行为调节模式,以及吸毒的生活环境与生活方式等。解决复吸的问题应整合医疗卫生系统、公安强制戒毒管理系统、司法劳动教养系统以及教育科研系统等多种资源,构建脱毒、治疗、康复、教育、生产与劳动训练等统一的综合戒毒康复模式。     

海洛因延迟强化物超快速折扣倾向的心理机制

以124名处于不同戒除时相的男性海洛因戒除者为被试, 采用金钱和海洛因延迟折扣任务(DDT), 并以基于线索暴露的渴求感测量为效度指标, 探讨了该类人群对海洛因延迟强化超快速折扣倾向及其心理机制。结果发现: (1) 相对于金钱延迟强化, 戒除者对海洛因延迟强化表现出显著的超快速折扣倾向, 且该倾向不随戒除期的延长而改变; (2) 戒除者对海洛因延迟强化的超快速折扣行为可能是其冲动性特质与海洛因相关线索共同作用的结果, 海洛因相对于金钱折扣率的增量部分可能反映了海洛因及其相关线索对该类人群主观渴求感的诱发效应。     

OPIOID ABSTINENCE REINFORCEMENT DELAYS HEROIN LAPSE DURING BUPRENORPHINE DOSE TAPERING

A positive reinforcement contingency increased opioid abstinence during outpatient dose tapering (4, 2, then 0 mg/day during Weeks 1 through 3) in non‐treatment‐seeking heroin‐dependent volunteers who had been maintained on buprenorphine (8 mg/day) during an inpatient research protocol. The control group (n = 12) received $4.00 for completing assessments at each thrice‐weekly visit during dose tapering; 10 of 12 lapsed to heroin use 1 day after discharge. The abstinence reinforcement group (n = 10) received $30.00 for each consecutive opioid‐free urine sample; this significantly delayed heroin lapse (median, 15 days).     

海洛因戒断者的阈下情绪启动研究

研究表明海洛因戒断者的情绪加工异常,但其阈下情绪加工是否异常尚无定论。本研究采用阈下情绪启动范式,考察其阈下情绪加工能力。结果：戒断组的反应时显著高于控制组;两组中,相比不一致、控制状态,一致状态反应时均显著最短;在戒断组中,不一致状态的反应时显著大于控制状态,负性图片的反应时显著大于正性图片,而在控制组中差异不显著。结论：戒断者存在阈下情绪启动效应,阈下情绪加工存在正性偏向,且能力弱于正常人。     

海洛因戒断者的时间知觉特征

本研究采用时间二分任务来探讨海洛因戒断者的时间知觉特征。结果发现: (1)戒断组的长反应比例在中间时距上显著高于对照组; (2)戒断组的主观相等点低于对照组且差异显著, 韦伯比例与对照组相比差异不显著。结论: 海洛因戒断者更容易高估时间, 并且对时间的高估更多体现在中间时距上。