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1.
Subst Use Misuse ; 59(5): 792-804, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38268117

RESUMO

Background: Effective interventions are required to address tobacco smoking in people with depressive symptomatology. In this context, contingency management could be one useful therapeutic strategy. Objectives: This study is a systematic review of tobacco cessation interventions for smokers with depressive symptomatology including a contingency management component, evaluating their efficacy with regards to tobacco abstinence, depressive symptomatology, adherence to treatment and other variables related to tobacco use. For this purpose, a search was carried out in Pubmed, PsycINFO, Cochrane, Web of Science and ClinicalTrials.gov in September 2022. The quality of the studies was assessed using the Cochrane Risk of Bias tool. Results: Of the 208 articles identified, six were included in this review. Results: For the most part, the research included suggests that contingency management is an effective strategy for improving abstinence outcomes, adherence, and other smoking-related variables such as delay discounting and intensity of cigarette demand in smokers with depressive symptomatology. Conclusions: Although contingency management could be a promising intervention in tobacco smokers with depressive symptomatology, further research in this area is still required.

2.
J Gambl Stud ; 36(1): 1-22, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31168687

RESUMO

Young adulthood is a developmental period from late adolescence to one's late twenties or early thirties. Prevalence studies internationally have reported that individuals in this age group tend to have the highest rates of problem gambling. However, much of the prevention work designed to minimize the risk of problem and disordered gambling has been primarily focused on school settings and aimed at high school students. The objective of this study was to summarize the existing literature on the effectiveness of prevention programs aimed at reducing the prevalence of gambling problems in young adults. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six electronic academic databases were consulted in order to examine the studies conducted during the last 20 years. After removing duplicates and adhering to the inclusion and exclusion criteria, nine studies were included in this review. All studies targeted college or university students and followed a selective or indicated prevention strategy. A Personalized Normative Feedback approach was incorporated in most of the studies, which had generally good results in reducing and/or minimizing at-risk or problem gambling. The limited number of studies included in this review highlights the need to address scientific quality standards before proceeding with the design, implementation and widespread dissemination of these preventive programs as well as the need to ensure the program's efficacy prior to implementation.


Assuntos
Jogo de Azar/terapia , Educação em Saúde/métodos , Comportamento Problema/psicologia , Identificação Social , Adolescente , Adulto , Feminino , Jogo de Azar/psicologia , Humanos , Prevalência , Avaliação de Programas e Projetos de Saúde , Comportamento de Redução do Risco , Estudantes/psicologia , Universidades , Adulto Jovem
3.
Subst Use Misuse ; 52(7): 875-883, 2017 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-28426355

RESUMO

BACKGROUND: Contingency management (CM) has demonstrated its efficacy in treating many drug addictions, including nicotine. However, one of the most commonly perceived limitations with regard to its dissemination into community settings is whether this protocol could be equally effective for treating patients across different income levels. OBJECTIVE: This study aimed to examine whether individuals' income levels affect treatment success in a cognitive behavioral treatment (CBT) that included a voucher-based CM protocol for smoking cessation. METHODS: A total of 92 treatment-seeking smokers in a community setting were randomly assigned to a CBT group (N = 49) or to a CBT plus CM group (N = 43). The CM procedure included a voucher program through which smoking abstinence was reinforced on a schedule of escalating magnitude of reinforcement with a reset contingency. We analyzed the impact of self-reported monthly income, alone and in combination with treatment condition, on short-term (treatment retention) and long-term (self-reported number of days of continuous smoking abstinence at 6-month follow-up) results. RESULTS: Income had no effect on treatment retention and continuous abstinence outcomes at 6-month follow-up in either treatment condition. Treatment modality emerged as the only significant predictor of treatment success. CONCLUSIONS: Our findings suggest that treatment-seeking smokers from the general population respond equally well to CM regardless of their income levels. The results of this randomized controlled trial support the generalizability of this evidenced-based program into community settings.


Assuntos
Renda , Abandono do Hábito de Fumar/economia , Adulto , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
4.
Am J Drug Alcohol Abuse ; 42(3): 296-305, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26484869

RESUMO

BACKGROUND: Contingency management (CM) has been shown to be effective in reducing smoking consumption, but has traditionally been criticized for its costs. OBJECTIVES: This study assessed the cost-effectiveness of using a voucher-based CM protocol added to a cognitive behavioral treatment (CBT) for smoking cessation among treatment-seeking patients from the general population. METHODS: A total of 92 patients were randomly assigned to CBT or CBT plus CM for abstinence. Incremental cost-effectiveness ratios (ICERs) were calculated by dividing the increase in costs by the increase in effects (continuous abstinence, longest duration of abstinence at 6-month follow-up and cotinine results during the treatment). An acceptability curve illustrated the statistical uncertainty surrounding the cost-effectiveness estimate. We also determined the optimum cost per participant for predicting the smoking status at 6-month follow-up. RESULTS: The average cost per participant in the CBT condition was €138.73 (US$ 150.23) as opposed to €411.61 (US$ 445.73) in the CBT plus CM condition (p < 0.01). The incremental cost of using voucher-based CM to increase the number of participants that maintained abstinence at 6-month follow-up by one extra participant was €68.22 (US$ 73.88), and to lengthen the longest duration of abstinence by 1 week was €53.92 (US$ 58.39). The incremental cost to obtain an extra cotinine-negative result was €181.90 (US$ 196.98). CONCLUSION: Compared with CBT alone, the voucher-based protocol required additional costs but achieved significantly better outcomes. These results will allow stakeholders to make policy decisions about CM implementation for smoking cessation in the broader community.


Assuntos
Terapia Comportamental/estatística & dados numéricos , Terapia Cognitivo-Comportamental/economia , Análise Custo-Benefício , Custos de Cuidados de Saúde/estatística & dados numéricos , Abandono do Hábito de Fumar/economia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/métodos , Resultado do Tratamento , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-38519826

RESUMO

The increase in migratory flows worldwide has led to the creation of detention centers as a form of control of irregular migration. Recipient countries are responsible for protecting detainees' right to mental health, but the literature suggests that immigration detention centers are environments associated with complex mental health needs among the detainees. This study aims to approach the mental health of people detained in the immigration detention centers in Spain, a southern border of Europe. Eighty-seven migrants coming from different Latin American and African countries were interviewed using an adaptation of the Measure of Quality of Life in Detention (MQLD; Bosworth & Gerlach, 2020) to measure the perceived detention environment and The Hopkins Symptom Checklist-25 (HSCL-25; Derogatis et al., 1974) to assess mental health. The results show a high prevalence of detainees with significant levels of anxiety and depression (69%) and attempts at self-harm within the detention centers (19.5%). A more positive perception of the detention environment-especially concerning institutional decency and the relationship with officers-is related to a lower degree of negative mental health symptoms. Finally, people detained for more than 2 weeks assess the detention environment more negatively than those detained for less time. Scientific contributions and social implications to ensure the mental health of detainees from a human rights-based approach are discussed.

7.
Adicciones ; 25(3): 260-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23880839

RESUMO

Despite the availability of data about drinking frequency and patterns, the surveys on alcohol use among adolescents carried out in Europe tend not to provide information about diagnostic criteria for alcohol use disorders (AUD) or estimation of their prevalence. This study assesses the prevalence of AUD among a sample of Spanish adolescents, to identify the most prevalent symptoms, and explore gender differences in AUD in this population. The final sample consisted of 504 participants aged 15 to 18, obtained by means of random sampling from all the schools in the region of Asturias (Spain). The presence of alcohol abuse (AA) and alcohol dependence (AD) disorders was evaluated according to DSM-IV-TR criteria. The results showed that 12.5% of the sample met the criteria for the diagnosis of AUD (6.7% for alcohol abuse, AA, and 5.8% for alcohol dependence, AD). The most prevalent symptoms were having social problems for AA diagnosis (9% of students who reported alcohol use in the past year) and tolerance for AD diagnosis (45.8% of students who reported alcohol use in the past year). Males showed a significantly higher score than females in AUD, AA and two AA diagnosis criteria (hazardous use and legal problems). The prevalence of AUD among Spanish adolescents is very high, males being more likely than females to endorse criteria for AUD and AA, though not for AD. These findings reveal a serious health issue and highlight the need to develop preventive efforts and provide coordinated alcohol-abuse interventions.


Assuntos
Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Adolescente , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Espanha/epidemiologia
8.
Addict Behav ; 147: 107833, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37634340

RESUMO

INTRODUCTION: The brief version of the Wisconsin Inventory of Smoking Dependence Motives (B-WISDM) is a well-established instrument to measure the multidimensional nature of nicotine dependence. However, no previous research has assessed its psychometric properties in the Spanish context. The aim of the present study was to analyze the factor structure and measurement invariance across gender of this instrument among Spanish smokers from the general population. METHODS: This cross-sectional study assessed 480 smokers through an online questionnaire including information on tobacco use and several nicotine dependence measures. Confirmatory Factor Analysis was used to assess the factorial structure of the Spanish B-WISDM, its internal consistency, measurement invariance across gender and convergent validity with the Fagerström Test for Nicotine Dependence (FTND) and the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) scores. RESULTS: Results indicate that the eleven correlated factors solution had a better fit when compared to the other tested models (two correlated factors and two second-order factors with eleven first-order correlated factors solution), remaining such structure invariant across gender. Internal consistency of the scale was high (α = 0.950; dimension α values ranged between 0.657 and 0.921). Overall scores and dimensions of the scale significantly and positively correlated with other nicotine dependence measures (except for Social/Environmental Goads and FTND). CONCLUSIONS: This is the first version of the B-WISDM validated to assess nicotine dependence with a multidimensional perspective within the Spanish culture. Results show adequate psychometric properties regarding its factor structure and measurement invariance across gender, supporting its utility to evaluate the motives driving tobacco use among Spanish smokers from the general population.


Assuntos
Fumantes , Tabagismo , Humanos , Estudos Transversais , Psicometria , Wisconsin , Fumar
9.
J Interpers Violence ; 38(17-18): 9869-9897, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37129417

RESUMO

Intimate partner violence (IPV) is a global health problem with different negative consequences for women's mental health. This pilot study aims to evaluate the efficacy of a multicomponent intervention for battered women using a comparison group design to analyze improvement in self-esteem, self-concept, self-efficacy, body dissatisfaction, and depression. The intervention consisted of an eight-session multicomponent intervention program based on the combination of group psychological therapy and adventure activities. The study sample originally consisted of 34 women IPV victims. Self-report psychological assessment was conducted during the pre-test and post-test while interviews were conducted during the post-test among the experimental group. The results of this pilot study suggest the efficacy of the cognitive-behavioral multicomponent intervention on self-esteem, self-efficacy, and depression in the IPV victims from the experimental group. We conclude that these findings support the efficacy of this psychological intervention program. Practical implications and suggestions are also discussed.


Assuntos
Mulheres Maltratadas , Violência por Parceiro Íntimo , Humanos , Feminino , Projetos Piloto , Violência por Parceiro Íntimo/psicologia , Mulheres Maltratadas/psicologia , Saúde da Mulher , Autorrelato
10.
Front Psychol ; 13: 821867, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35369212

RESUMO

Background: Youth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse. Objective: Review the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth. Methods: A narrative and critical review was carried out within international databases (PsychInfo, Pubmed, Web of Science, and Scopus) in August 2021 and was limited to empirical studies that appeared in the last five years (2017-2021). A flow diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age (universal, selective, or indicated programs) were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action. Results: Twenty-two articles were found from four fields of action: school (16), family (2), community (2), and web-based (2), representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing (BIMI), Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking. Discussion: This narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation.

11.
Front Psychol ; 13: 784896, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35282216

RESUMO

Background: Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied. Objective: The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador. Methods: A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects. Results: Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]). Discussion: Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

12.
Front Psychol ; 13: 813894, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35572338

RESUMO

Background: The Patient Health Questionnaire-9 (PHQ-9) is the most well-known self-report measure to screen for depressive symptomatology, although discerning which is the factor structure that represents the best fit remains a challenge. Objective: The aim of this study was to analyze the psychometric properties and factorial structure of the Spanish version of the PHQ-9 in a large sample of Ecuadorian college students. Methods: A total of 5,394 students (M = 22.03 years; SD = 3.05; 54.8% female) from three Ecuadorian universities were surveyed using a computerized questionnaire within a 4-week assessment period. The PHQ-9 was tested for factorial structure, reliability, and correlations with other mental health-related measures. Results: The hierarchical model that included a general factor and three nested factors had a better fit, and such a hierarchical structure remained invariant across sex and age. Total omega value (ω) was 0.90 for the total scale and hierarchical omega values (ωh) were 0.68 for the general factor, as well as 0.34, 0.38, and 0.44 for the respective nested factors (somatic, cognitive/affective, concentration/motor). Moreover, PHQ-9 scores were significantly higher among women, although effect sizes of comparison of those sex differences were very small. Finally, the PHQ-9 scores correlated with multiple mental health indicators (psychological inflexibility, loneliness, stress, and satisfaction with life). Discussion: The Spanish version of the PHQ-9 showed good psychometric properties among Ecuadorian college students. The hierarchical structure showed the best fit for the data, including not only a dominant general factor, but also the somatic, cognitive/affective and concentration/motor subcomponents. In conclusion, the PHQ-9 tool seems to represent an easy-to-implement screening questionnaire to design preventive programs for those Ecuadorian college students at risk of developing depressive disorders.

13.
Int J Clin Health Psychol ; 22(3): 100322, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35892040

RESUMO

Background/Objective: Depression represents a leading cause of disability and a major contributor to the overall global burden of disease with women systematically reporting a higher prevalence than men. This study aimed to examine the predictive value and relation of three transdiagnostic psychological factors (perceived stress, psychological inflexibility and loneliness) on depression and its sex differences for the general population in a large sample of Ecuador. Method: A non-probabilistic and non-clinical sample of 16.074 people from across Ecuador were online surveyed using a cross-sectional design. The structural equation model was based on scores from standardized questionnaires as measures of depression, psychological perceived stress, psychological inflexibility, and loneliness. Results: Women reported significantly higher levels of depression, mediated by differences in perceived stress, psychological inflexibility and loneliness. Perceived stress was the most important predictor of depression and mediated the effect of loneliness on depression. Complementarily, psychological inflexibility partially mediated the effect of perceived stress and loneliness on depression. The overall model accounted for the 78% of the total variance in depression. Conclusions: Results of this study provide a novel and robust transdiagnostic model of sex differences on depression and insights on how to design effective programs for preventing depression targeting modifiable transdiagnostic risk factors.

14.
Artigo em Inglês | MEDLINE | ID: mdl-34769848

RESUMO

The impact of the COVID-19 pandemic on our lives is unquestionable, including in the area of substance consumption. This study aimed to evaluate the changes in the pattern of cannabis use during the Spanish COVID-19 lockdown and confinement, and to analyze the variations in the reported motives for cannabis use and withdrawal symptoms. A cross-sectional retrospective study was conducted between April and May 2020, using an instrument that included two time points. Time 1 collected retrospective information on the participants' habits (N = 89; 73% male; mean age = 29.01) prior to confinement and Time 2 collected the same information during the confinement. Sociodemographic data were collected, as well as the frequency of substance use, cannabis use patterns, sources of cannabis, perceived availability of drugs and cannabis price, and the Marijuana Motives Measure questionnaire and the Cannabis Withdrawal Scale were used. Results showed a decrease in both cannabis use and consumption due to enhancement and social motives. All reported sources of cannabis experienced a reduction except for the Internet, which experienced a significant increase. There was a positive correlation between withdrawal symptoms and coping motives before and during the lockdown. These findings will allow professionals to better develop both prevention and intervention strategies.


Assuntos
COVID-19 , Cannabis , Adaptação Psicológica , Adulto , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Espanha/epidemiologia
15.
Psicothema ; 33(1): 36-43, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33453734

RESUMO

BACKGROUND: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). METHOD: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. RESULTS: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessive-compulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessive-compulsive disorder indicated a higher risk of CUD. CONCLUSIONS: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls.


Assuntos
Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Comorbidade , Feminino , Humanos , Masculino , Abuso de Maconha/epidemiologia , Saúde Mental , Caracteres Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-34066319

RESUMO

BACKGROUND: Intimate Partner Violence (IPV) is a major public health problem that affects one-third of women aged 15 around the world. Interventions for IPV victims are essential for women's self-esteem and self-concept recovery. This project aims to assess the effects of an eight-session multicomponent intervention program based on group psychological therapy and adventure activities in (1) self-esteem, (2) self-concept, (3) body image, (4) self-efficacy and (5) depression symptomatology in IPV victims. METHODS/DESIGN: A single-blind, randomized controlled pilot study, with experimental and control group, will be carried out. 34 IPV female victims will be recruited and equally assigned to the experimental (n = 17) or the control (n = 17) group. Primary outcome measures will include self-esteem, while secondary measures will be focused on self-concept, body image, self-efficacy, and depressive symptoms. Intention to treat and efficacy statistical analyses will be also performed. DISCUSSION: This project will explore the effects of a new multicomponent program which includes cognitive-behavioral therapy sessions and outdoor adventure activities on affective and emotional variables, often affected in IPV victims. In addition, orientations to incorporate the main findings into the community based IPV resources and victims' services will be provided.


Assuntos
Violência por Parceiro Íntimo , Psicoterapia de Grupo , Feminino , Humanos , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoimagem , Método Simples-Cego
17.
Artigo em Inglês | MEDLINE | ID: mdl-32486456

RESUMO

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals' activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.


Assuntos
Atitude do Pessoal de Saúde , Cuidados Paliativos , Médicos , Adulto , Equador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa
18.
Exp Clin Psychopharmacol ; 27(6): 561-568, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30869980

RESUMO

This study analyzed whether a contingency management (CM) for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. A total of 110 patients were randomly assigned to 1 of 2 treatment conditions: CMA (N = 55) or CMS (N = 55). All participants received cognitive-behavioral treatment (CBT) implemented in 6 group-based sessions. CMA participants earned voucher-based incentives contingent on providing biochemical evidence of smoking abstinence. CMS reinforced closer approximations to smoking abstinence. At posttreatment, patients assigned to the CMA group achieved the same rates of smoking abstinence (point-prevalence) as those in the CMS group (94.5%; p > .05). At the 6-month follow-up, 43.6% of the patients who received CMA maintained smoking abstinence in comparison to 32.7% in the CMS group (p > .05). At the 12-month follow-up, 40% of the participants assigned to the CMA group were abstinent, in comparison to 29.1% who received CMS (p > .05). There were no statistically significant differences in continuous smoking abstinence between the treatment conditions in any of the follow-ups (p > .05). These results offer a novel contribution by suggesting that CM was associated with enduring effects up to 12 months after the end of treatment and that CM for shaping cessation period implemented prior to an abstinence-only period (CMS) improves outcomes relative to CM that reinforces only a fixed abstinence criteria (CMA) among treatment-seeking patients in a community setting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Abandono do Hábito de Fumar/métodos , Síndrome de Abstinência a Substâncias , Resultado do Tratamento , Adulto , Terapia Cognitivo-Comportamental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Reforço Psicológico
19.
Int J Clin Health Psychol ; 16(1): 30-38, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-30487848

RESUMO

A high percentage of patients relapse within months following an attempt to quit smoking. For this reason, greater understanding of the determinants of successful smoking cessation is needed. The present study assessed the effect of Contingency Management (CM) combined with Cognitive-Behavioral Treatment (CBT) on certain in-treatment behaviors (treatment retention, in-treatment smoking abstinence, and weekly decrease of cotinine levels) and examined the effects of these in-treatment behaviors on smoking status at a 6-month follow-up. A total of 154 treatment-seeking patients in a community setting were randomly assigned to a CBT, CBT plus CM for Abstinence (CMA) or to a CBT plus CM for Shaping cessation (CMS) group. Both CBT + CM procedures improved the in-treatment behaviors compared to CBT alone. These in-treatment behaviors (particularly in-treatment smoking abstinence) were associated with long-term abstinence. The effect of CM on in-treatment behaviors may partially explain the positive long-term outcomes of this procedure. Our findings extend previous knowledge about the effect of CM on smoking behavior.


Un alto porcentaje de pacientes recae en cuestión de meses después de un intento para dejar de fumar. Por esta razón, es necesaria una mayor comprensión de los determinantes del éxito para dejar de fumar. Este estudio evaluó el efecto del Manejo de Contingencias (MC) combinado con un Tratamiento Cognitivo-Conductual (TCC) sobre ciertas conductas intra-tratamiento (tasas de retención, abstinencia durante el tratamiento y reducción semanal de los niveles de cotinina) y examinó los efectos de estas conductas sobre el consumo de tabaco a los 6 meses de seguimiento. Un total de 154 pacientes que buscaban tratamiento en un entorno comunitario fueron asignados aleatoriamente a TCC, TCC más MC para Abstinencia (MCA) o TCC más MC con Moldeamiento (MCM). Ambos procedimientos de TCC + MC mejoraron las conductas intra-tratamiento en comparación con TCC solo. Estas conductas (particularmente abstinencia durante el tratamiento) se asociaron con la abstinencia a largo plazo. El efecto del MC sobre las conductas intra-tratamiento puede explicar parcialmente los resultados positivos a largo plazo de este procedimiento. Nuestros hallazgos amplían el conocimiento previo acerca del efecto del MC sobre la conducta de fumar.

20.
Psicothema ; 27(4): 309-16, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26493567

RESUMO

BACKGROUND: Increasing evidence suggests that delay discounting may change following effective interventions. Nonetheless, previous studies that assessed the effect of contingency management (CM) on delay discounting are scarce, and their results are mixed. The current study assessed whether CM in conjunction with a cognitive-behavioral treatment (CBT) for smoking cessation was associated with changes in delay discounting at end-of-treatment and at 6-month follow-up compared to CBT alone. METHOD: One hundred and sixteen treatment-seeking smokers were randomly assigned either to CM + CBT (n = 69) or to CBT alone (n = 47). Participants completed delay discounting assessments at the intake, at end-of-treatment, and at 6-month follow-up. We evaluated CM’s effect on discounting with parametric and nonparametric methods. RESULTS: Between-group analyses showed that none of the interventions changed delay discounting from intake to end-of-treatment or to 6-month follow-up. Nonetheless, some within-group analyses showed that the CM + CBT condition evidenced some degree of reduction. CONCLUSIONS: The current results suggest that CM intervention is not robustly associated with delay discounting changes. Future studies should address treatments that may potentially change delay discounting.


Assuntos
Terapia Cognitivo-Comportamental , Condicionamento Operante , Desvalorização pelo Atraso , Abandono do Hábito de Fumar/psicologia , Tabagismo/psicologia , Adulto , Área Sob a Curva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reforço Psicológico , Tabagismo/terapia
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