目的:青少年罪犯表现出高水平的物质使用。拘留环境中的治疗方案效果较差。认知偏见修饰(CBM)是对物质使用治疗的有希望的补充。这项研究测试了CBM在青少年罪犯中减少大麻和酒精使用的有效性,和犯罪累犯。
方法:一项随机对照试验在常规治疗中增加了CBM(TAU),在青少年拘留所的181名青年中。在阶乘设计中,参与者被随机分配到两种CBM的主动或假训练,针对注意力偏倚(AtB)和接近偏倚(ApB)的最常用物质。使用酒精和大麻使用障碍鉴定测试来测量物质的使用。通过国际自我报告犯罪(ISRD)调查来衡量犯罪累犯。
结果:在预测试,参与者两种物质均显示AtB,但无ApB。对于酒精,在积极训练组中,AtB下降.对于大麻,活动训练组和假训练组的AtB均下降.不管条件如何,随访时未发现对药物使用或ISRD评分有影响.
结论:样本是司法的,不是临床的,就像设置一样。TAU和参与者目标不一定与实质相关。
结论:青少年罪犯对物质线索表现出明显的注意偏见。CBM改变了注意力偏见,但没有改变物质使用。建议将CBM与动机干预相结合。后续研究应更好地将CBM与运行的治疗计划相结合。可以使用有关CBM任务设计的新进展,将培训与治疗更好地联系起来。
Young offenders show high levels of substance use. Treatment programs within detention settings are less effective. Cognitive bias modification (CBM) is a promising supplement to substance use treatment. This study tests the effectiveness of CBM in young offenders to reduce cannabis and alcohol use, and delinquent recidivism.
A randomized controlled trial added CBM to treatment as usual (TAU), among 181 youth in juvenile detention centers. In a factorial design, participants were randomly assigned to either active- or sham-training for two varieties of CBM, targeting attentional-bias (AtB) and approach-bias (ApB) for their most used substance. Substance use was measured with the Alcohol and Cannabis Use Disorder Identification Tests. Delinquent recidivism was measured with the International Self-Report Delinquency (ISRD) survey.
At pretest, participants showed AtB but no ApB for both substances. For alcohol, a decrease was found in AtB in the active-training group. For cannabis, a decrease was found in AtB for both active- and sham-training groups. Regardless of condition, no effects were found on substance use or ISRD scores at follow-up.
The sample is judicial, not clinical, as is the setting. TAU and participant goals are not necessarily substance related.
Young offenders show a significant attentional-bias towards substance cues. CBM changed attentional-biases but not substance use. Combining CBM with a motivational intervention is advised. Follow-up research should better integrate CBM with running treatment programs. New developments regarding CBM task design could be used that link training better to treatment.