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Kim J, Kambari Y, Taggar A, Quilty LC, Selby P, Caravaggio F, Ueno F, Song J, Pollock BG, Graff-Guerrero A, Gerretsen P. A measure of illness awareness in individuals with nicotine dependence - Nicotine Use Awareness and Insight Scale (NAS). Nicotine Tob Res 2021; 24:536-543. [PMID: 34788450 DOI: 10.1093/ntr/ntab235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/21/2021] [Accepted: 11/09/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Impaired illness awareness or the inability to recognize that one has a dependence on nicotine may be a major barrier to seeking cessation treatment. To better understand the role of impaired illness awareness on treatment seeking behavior and clinical outcomes in individuals with nicotine dependence, we developed and examined the psychometric properties of a novel scale measuring illness awareness. METHODS We developed the Nicotine Use Awareness and Insight Scale (NAS), a 7-item self-report measure to assess the theoretical construct of illness awareness in individuals with dependence on nicotine. Data from participants 18 years of age or older were collected via a web-based survey company, Dynata. Participants with moderate dependence on nicotine were included, defined by a score of 4 or more on the Fagerström Test for Cigarette Dependence (FTCD) or the FTCD adapted for electronic cigarettes (eFTCD). RESULTS A total of 100 participants (mean (SD) age=49.1 (16.1), 52% women) that met the inclusion criteria for either FTCD (n=50) or eFTCD (n=50) were studied. The NAS demonstrated good convergent (r=.74, p<0.001) and discriminant validity (r=.03, p=0.786). It also demonstrated good internal consistency (Cronbach's alpha=0.78) and one-month test-retest reliability (intra-class correlation=0.86). An exploratory factor analysis yielded retention of two components. CONCLUSIONS This study provides initial support for the validity and reliability of the NAS, a scale measuring impaired illness awareness in individuals with dependence on nicotine. The NAS can be used in research and clinical practice to evaluate the impact of impaired illness awareness in seeking nicotine cessation treatment. IMPLICATIONS Impaired illness awareness or the inability to recognize that one is dependent on nicotine may be a barrier to seeking cessation treatment. The Nicotine Use Awareness and Insight Scale (NAS) is a novel scale to assesses subjective illness awareness in individuals with dependence on nicotine. This study provides initial support for the psychometric validity and reliability of the NAS. NAS demonstrated good convergent and discriminant validity with measures of illness recognition and affect states, respectively, internal consistency, and test-retest reliability. The NAS can be used in research and clinical practice to evaluate the impact of impaired illness awareness on treatment and clinical outcomes.
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Affiliation(s)
- Julia Kim
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Yasaman Kambari
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Anmol Taggar
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Lena C Quilty
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Institute Research Program, CAMH, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Fernando Caravaggio
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Fumihiko Ueno
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Jianmeng Song
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Campbell Institute Research Program, CAMH, University of Toronto, Toronto, Ontario, Canada.,Geriatric Mental Health Division, CAMH, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Institute Research Program, CAMH, University of Toronto, Toronto, Ontario, Canada.,Geriatric Mental Health Division, CAMH, University of Toronto, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Institute Research Program, CAMH, University of Toronto, Toronto, Ontario, Canada.,Geriatric Mental Health Division, CAMH, University of Toronto, Toronto, Ontario, Canada
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Liu N, Lu Z, Xie Y. Tracking Study on the Relapse and Aftercare Effect of Drug Patients Released From a Compulsory Isolated Detoxification Center. Front Psychiatry 2021; 12:699074. [PMID: 35111083 PMCID: PMC8801433 DOI: 10.3389/fpsyt.2021.699074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS There are no accurate statistical data on the relapse rate of drug abstainers after compulsory detoxification in China. This study aimed to collect relapse data for drug abstainers through follow-up visits, verify the effectiveness of professional social worker services and explore significant factors affecting relapse. DESIGN AND SETTING The drug abstainers released from Guangzhou T Compulsory Isolated Detoxification Center were randomly divided into two groups. The difference between the experimental group and the control group is that assistance services were provided by social workers to the former. PARTICIPANTS The study included 510 drug abstainers released from T Center, including 153 in the experimental group and 357 in the control group. MEASUREMENTS Demographic information, history of drug abuse, and motivation for drug rehabilitation (SOCRATES) were collected 1 month prior to drug abstainer release from compulsory detoxification. Then, the relapse situation after their release was tracked according to fixed time points. FINDINGS The overall relapse rate of 510 drug abstainers after their release from compulsory detoxification was 47.6%. The average survival time to relapse based on survival analysis was 220 days (N = 486), as calculated with Bayesian estimation by the MCMC method. The average survival times to relapse of the experimental group and control group were 393 and 175 days, respectively. By taking the specific survival time as the dependent variable and the group as the control variable (OR = 25.362), logistic regression analysis showed that marital status (OR = 2.666), previous compulsory detoxification experience (OR = 2.329) and location of household registration (OR = 1.557) had a significant impact on the survival time to relapse. CONCLUSIONS The occurrence of relapse among drug patients released from compulsory detoxification can be delayed effectively through the intervention of professional social worker services. Regardless of whether patients receive aftercare after compulsory detoxification, drug-using patients who are single, have multiple detoxification experiences and whose households are registered in other provinces deserve special attention. Relevant suggestions to avoid relapse are provided.
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Affiliation(s)
- Nian Liu
- Department of Sociology, School of Public Administration, Guangzhou University, Guangzhou, China
| | - Zekai Lu
- Department of Sociology, School of Public Administration, Guangzhou University, Guangzhou, China
| | - Ying Xie
- Department of Sociology, School of Public Administration, Guangzhou University, Guangzhou, China
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Vieira da Silva R, de Oliveira IR, Lopes Velasquez M. Stages of Change Readiness and Treatment Eagerness Scale in Overweight and Obesity's Psychometric Properties (SOCRATES-OO). J Clin Psychol Med Settings 2019; 27:805-817. [PMID: 31667648 DOI: 10.1007/s10880-019-09672-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigated the psychometric properties of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in the context of overweight and obesity. The instrument was investigated in a non-probabilistic sample of 177 individuals who were overweight or obese. A confirmatory factor analysis (CFA) was performed in order to provide evidence based on the internal consistency of the SOCRATES-OO scale with three correlated factors and two correlated factors. In addition, the University of Rhode Island Change Assessment (URICA) raw score was used to provide evidence in terms of convergent validity by its correlation with the domains of the best SOCRATES-OO solution. According to CFA, the theoretical solution with two correlated factors provided a better statistical fit. The psychometric evaluation of the 19 items of SOCRATES-OO presented a good fit under the two-factor model and satisfactory internal consistency by Omega of AMREC (Ambivalence + Recognition) 0.924 and Action 0.942.
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Affiliation(s)
- Renata Vieira da Silva
- Department of Neurosciences and Mental Health, Federal University of Bahia (UFBA), Salvador, BA, Brazil.
| | - Irismar Reis de Oliveira
- Department of Neurosciences and Mental Health, Federal University of Bahia (UFBA), Salvador, BA, Brazil
| | - Michella Lopes Velasquez
- Department of Neurosciences and Mental Health, Federal University of Bahia (UFBA), Salvador, BA, Brazil
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Veilleux JC, Skinner KD. Introspective responses to cues and motivation to reduce cigarette smoking influence state and behavioral responses to cue exposure. Addict Behav 2016; 60:103-8. [PMID: 27115733 DOI: 10.1016/j.addbeh.2016.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 11/25/2022]
Abstract
In the current study, we aimed to extend smoking cue-reactivity research by evaluating delay discounting as an outcome of cigarette cue exposure. We also separated introspection in response to cues (e.g., self-reporting craving and affect) from cue exposure alone, to determine if introspection changes behavioral responses to cigarette cues. Finally, we included measures of quit motivation and resistance to smoking to assess motivational influences on cue exposure. Smokers were invited to participate in an online cue-reactivity study. Participants were randomly assigned to view smoking images or neutral images, and were randomized to respond to cues with either craving and affect questions (e.g., introspection) or filler questions. Following cue exposure, participants completed a delay discounting task and then reported state affect, craving, and resistance to smoking, as well as an assessment of quit motivation. We found that after controlling for trait impulsivity, participants who introspected on craving and affect showed higher delay discounting, irrespective of cue type, but we found no effect of response condition on subsequent craving (e.g., craving reactivity). We also found that motivation to quit interacted with experimental conditions to predict state craving and state resistance to smoking. Although asking about craving during cue exposure did not increase later craving, it resulted in greater delaying of discounted rewards. Overall, our findings suggest the need to further assess the implications of introspection and motivation on behavioral outcomes of cue exposure.
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