An Expanded Self-Medication Hypothesis Based on Cognitive-Behavioral Determinants for Heroin Abusers in Taiwan: A Cross-Sectional Study
This study proposed and examined an expanded self-medication hypothesis (eSMH) model based on cognitive behavioral determinants, including the direct effects of negative emotional states, positive outcome expectancies and refusal self-efficacy on heroin use, and the mediating roles of positive outcome expectancies and refusal self-efficacy between negative emotional states and heroin use.
A total of 360 male heroin abusers were recruited from a drug abuse treatment center in Taiwan. Participants were asked to complete a set of questionnaires on frequency of heroin use, anxious/depressive mood, positive outcome expectancies, and refusal self-efficacy. Structural equation modeling was used to examine the eSMH model.
Results showed that the eSMH model displayed proper goodness-of-fit. Positive outcome expectancies and negative emotional status were significant predictors of heroin use, whereas refusal self-efficacy was not a significant predictor. Additionally, positive self-efficacy was a mediator between negative emotional status and heroin use.
Results support a reduced eSMH model and suggest a significant role of positive self-efficacy in the relationship between negative affective states and heroin use. This relationship should be examined in the longitudinal study, and should be given clinical consideration in treatment of individuals struggling with heroin abuse and negative affective states.
Figures in this publication
Available from: Kun-Hua Lee
- "Scores ranged from 0 to 52. The Cronbach's α of the Depression subscale is highly reliable: 0.92 (Lee, et al. 2012). In the current study, the Cronbach's α was 0.78. "
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ABSTRACT: Abstract We examined the relationship between the “Big-Five” personality factors and levels 12
of mindfulness at baseline, and the predictive value of these personality factors on changes in 13
mindfulness after eight weeks of mindfulness-based training. All participants were followed- 14
up for eight weeks. Sixty-three incarcerated adult males with drug abuse disorders completed 15
self-report assessments of mindfulness, depression, and personality. Four of the five person- 16
ality factors (Conscientiousness, Extraversion, Agreeableness, and Neuroticism) were signif- 17
icantly associated with Decentering of mindfulness at baseline. Neuroticism and OPENNESS 18
to Experience were significantly related to Curiosity. There was a significant baseline-to-post- 19
course difference on the Decentering subscale; however, the results unexpectedly contradicted 20
our hypothesis. There were no significant baseline-to-post-course differences on the Curiosity 21
subscale. After controlling for post-course depression, none of the Big-Five personality factor 22
traits significantly predicted post-course Curiosity and Decentering. The effects of the Big- 23
Five personality factors on outcomes of mindfulness-based intervention for drug abusers were 24
preliminarily confirmed, but a randomized longitudinal study is required to reconfirm our 25
International Journal of Mental Health and Addiction 10/2014; 13(3). DOI:10.1007/s11469-014-9533-y · 0.99 Impact Factor
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ABSTRACT: China is faced with the challenge of community rehabilitation of persons with opioid use disorders. A 1-year comprehensive psychosocial intervention (CPI) was developed, and its effectiveness was assessed in terms of its ability to improve community rehabilitation of persons with opioid use disorders after their release from detention in compulsory treatment centers in Shanghai, China.
Participants were randomized to the CPI (n = 90) condition or the usual community care (UCC, n = 90) as a control condition. The Addiction Severity Index, Symptom Checklist-90, and Medical Outcomes Study 36-Item Short Form Health Survey were administered at baseline and at the end of the intervention. Urine screens were used to increase the validity of self-reported drug use.
Compared with the UCC group at follow-up, the CPI group showed lower scores in 6 dimensions of the Symptom Checklist-90: somatization, obsessive-compulsive, anxiety, phobia-anxiety, paranoia, and psychoticism. Members of the CPI group had higher scores in 2 dimensions of the 36-Item Short Form Health Survey-physical role limitation and emotional role limitation-compared with the UCC group (P < 0.05). A logistic regression analysis revealed that phobia-anxiety, lifetime heroin or amphetamine use, and injection drug use were risk factors of relapse, but differences were not found in drug urine test or self-report drug use between the 2 groups (P > 0.05).
The CPI condition improved participants' mental health and quality of life, and it could be a promising community rehabilitation approach for patients with opioid use disorders in recovery.
Journal of Addiction Medicine 06/2015; 9(4). DOI:10.1097/ADM.0000000000000139 · 1.76 Impact Factor
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