An Expanded Self-Medication Hypothesis Based on Cognitive-Behavioral Determinants for Heroin Abusers in Taiwan: A Cross-Sectional Study

American Journal on Addictions (Impact Factor: 1.74). 11/2012; DOI: 10.1111/j.1521-0391.2012.00301.x


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.

9 Reads
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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 findings.
    International Journal of Mental Health and Addiction 10/2014; 13(3). DOI:10.1007/s11469-014-9533-y · 0.99 Impact Factor