Combined pharmacotherapy and evidence-based psychosocial Cannabis treatment for youth and selection of cannabis-using friends

Examining Caregiver Practices During Adolescent Outpatient Alcohol Use and Co-Occurring Mental Health Treatment: Protocol for a Dyadic Ecological Momentary Assessment Study

BACKGROUND

Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregiving practices during treatment improve core adolescent treatment targets may facilitate the refinement and scalability of caregiver-involved interventions. Caregiving is dynamic, varying by context, affect, and adolescent behavior. Caregiver-involved treatments seek to change momentary interactions between caregivers and their adolescents. Accordingly, this protocol outlines a dyadic ecological momentary assessment (EMA) study to examine caregiving practices during AUD+CODs treatment and their associations with adolescent core treatment targets (eg, alcohol craving and use, motivation to reduce or stop drinking, and internalizing and externalizing symptoms).

OBJECTIVE

This paper aims to describe the methods for examining momentary caregiving practices and adolescent core treatment targets during adolescent outpatient AUD+CODs treatment.

METHODS

We will recruit 75 caregiver-adolescent dyads from outpatient mental health clinics providing AUD+CODs treatment. Eligible families will have an adolescent who (1) is aged between 13 and 18 years; (2) meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for AUD; (3) is enrolled in outpatient treatment at the time of recruitment; and (4) has a legal guardian willing to participate in the study. Caregivers and adolescents will complete an eligibility screening, followed by a baseline assessment during or as close as possible to the second week of treatment. During the baseline assessment, caregivers and adolescents will receive formal training in EMA procedures. Next, caregivers and adolescents will complete a 15-week EMA burst design consisting of three 21-day EMA periods with 3-week breaks between periods. Throughout the study, participants will also complete weekly reports regarding the skills learned or practiced during therapy. The three overarching aims to the proposed study are as follows: (1) examine momentary caregiving practices (eg, support, monitoring, substance use communication quality) and their associations with core treatment targets, (2) examine how these associations change throughout treatment, and (3) examine whether a caregiver report of learning or practicing parenting- or family-focused behaviors in treatment sessions is associated with changes in the use of caregiving practices in daily life.

RESULTS

The proposed study was informed by a pilot study assessing the feasibility and acceptability of dyadic EMA during adolescent AUD+COD treatment. Some benchmarks were met during this study (eg, ≥80% caregiver retention rate), although most benchmarks were not (eg, adolescent [772/1622, 47.6%] and caregiver [1331/1881, 70.76%] random prompt compliance was below the ≥80% target). Data collection is anticipated to begin in December of 2024. The proposed study is designed to be completed over 3 years.

CONCLUSIONS

Examining momentary caregiving practices using EMA has important implications for refining and scaling caregiver-involved interventions for AUD+CODs so that families who would benefit from caregiver-involved treatments can have access to them.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/63399.

The use of Experience Sampling Method in psychopharmacological studies: A systematic review

The Experience Sampling Method (ESM) is increasingly used to validate and assess treatment effects. We conducted a systematic review to update, and extend, the previous review by Bos et al. (2015), by performing literature searches in PubMed, PsycInfo, and EMBASE. Search queries included every DSM-disorder, ATC-listed psychotropic medication, and multiple search-terms for ESM. Studies included medicated psychiatric patients who filled-out ambulatory prompts ≥2/day. Templates served to distil research themes. The majority of the 79 included studies involved substance use- (n = 47), mood- (n = 17), and psychotic disorders (n = 11). Less studied were anxiety disorders and PTSD (n = 3), and ADHD (n = 1). We identified six research themes:1)Effects of psychopharmacological treatment on symptoms and factors influencing outcome, 2)Fluctuations of psychiatric symptoms in medicated patients, 3)Prediction of relapse, exacerbation of symptoms or medication non-compliance, 4)Added value of ESM compared to care as usual, 5)Using ESM to establish treatment response-trajectories, 6)Acceptability and feasibility of newly-devised ESM-applications. This review reveals that ESM is predominantly used in psychopharmacological studies to monitor treatment effects and establish fluctuations of momentary psychiatric symptoms. Future research might facilitate personalising psychopharmacological prescribing decisions using ESM. Currently underrepresented patient groups include elderly patients, and personality disorders. Finally, to facilitate ESM-implementation multiple context-levels should be optimised.

Improving Social Recovery Capital Research To Enhance Clinical Utility: A Proposed Agenda

Social recovery capital (SRC) is the combination of social resources that can be used to initiate and sustain addiction recovery through friends, family, and peers. Broadly, understanding one's SRC allows us to get a sense of where one has social support for recovery and where there may be social barriers to their recovery process. SRC is often a vital component of many people's recovery journey, yet our understanding of how best to use this concept in research and practice remains underdeveloped. To improve understanding of the role of social recovery capital and strategies to measure and increase it, we present a roadmap involving a five-pronged research agenda to: (1) Refine the measurement of social recovery capital; (2) Model the complexity of social recovery capital empirically; (3) Integrate personality science with social recovery capital research; (4) Optimize evidence-based behavior change techniques of social recovery capital; and (5) Incorporate an intersectional framework when examining or applying social recovery capital. Overall, this five-pronged research agenda seeks to enhance the clinical utility of SRC research to maximize the impact of SRC on one's recovery.

Psychosocial Factors Predict the Level of Substance Craving of People with Drug Addiction: A Machine Learning Approach

This study aimed to explore which factors had a greater impact on substance craving in people with substance use and the direction of the impact. A total of 895 male substance users completed questionnaires regarding substance craving, psychological security, positive psychological capital, interpersonal trust, alexithymia, impulsivity, parental conflict, aggression behavior, life events, family intimacy, and deviant peers. Calculating the factor importance by gradient boosting method (GBM), found that the psychosocial factors that had a greater impact on substance craving were, in order, life events, aggression behavior, positive psychological capital, interpersonal trust, psychological security, impulsivity, alexithymia, family intimacy, parental conflict, and deviant peers. Correlation analysis showed that life events, positive psychological capital, interpersonal trust, psychological security, and family intimacy negatively predicted substance craving, while aggression behavior, impulsivity, alexithymia, parental conflict, and deviant peers positively predicted substance cravings. These findings have important implications for the prevention and intervention of substance craving behavior among substance users.