| Objectives1.To develop an addiction memory rating scale for illicit drug addicts,thus to provide a reliable and valid instrument for measuring the addiction memory.2.To investigate factors associated with relapse to drug use and the mechanisms of action,on the basis of introducing addiction memory into the analytical model as a covariate.3.To evaluate the effectiveness of Eye Movement Desensitization and Reprocessing(EMDR)among patients in compulsory rehabilitation facilities.Methods1.Based on the review of literature on autobiographical memory,a 20-item draft of Addiction Memory Rating Scale was developed.For pretest,a total of 345 drug addicts were randomly selected from two compulsory rehabilitation centers in Wuhan,Hubei.Both item analysis and factor analysis were used in the present study for revising the draft of the scale.2.A total of 1550 drug addicts from seven compulsory rehabilitation centers in Wuhan,Hubei,and Zhongshan,Guangdong,were recruited.A revision of the scale was used in the present study.After two weeks,sixty of the participants were randomly selected for retest.Respectively,exploratory factor analysis,confirmatory factor analysis,Pearson correlation analysis,analysis of variance,and Spearman rank correlation analysis were used to test the construct validity and criterion-related validity of the revised scale.Also,Cronbach's ? coefficient and test-retest correlation coefficient were used to evaluate the reliability of the scale.3.A cross-sectional study was conducted.A total of 488 patients from five compulsory rehabilitation centers in Wuhan,Hubei,and Zhongshan,Guangdong,were enrolled in this study.The cognitive-behavioral model of relapse was used as a theoretical framework,and path analysis was applied to determine the factors associated with relapse and the mechanisms of action.4.A randomized controlled trial was conducted.Participants were 84 heroin addicts from the compulsory rehabilitation centers in Wuhan,Hubei,and were randomly assigned to an intervention group(n = 42)or a control group(n = 42).Participants in the intervention group received a question-oriented EMDR intervention,while those in the control group received a supportive conversation.The participants' addiction memory,craving,depression,coping,and self-efficacy were measured at both baseline and posttreatment.Analysis of covariance,generalized estimating equation,and linear mixed effects model were used to estimate the effectiveness of intervention.Results1.The Addiction Memory Rating Scale was developed after item selection,consisting of 9 items.The scale was found to have two main factors(visual clarity and sensory intensity),which accounted for 64.11% of the total variance.The two-factor structure provided reasonable fit for the other sample data.The results of multi-group confirmatory factor analysis showed that there was measurement invariance across gender and primary illicit drug of use.There was significant correlation between the two factors of the scale(r = 0.652,P < 0.001).Significant correlations between the factors and the total scale were found(r = 957,P < 0.001;r = 0.844,P < 0.001).The scale discriminated significantly among the participants with different characteristics(P < 0.01).Significant correlations were found between the VAS scores and the Addiction Memory Rating Scale,ranging from 0.143 to 0.248.For the total scale and the factors,Cronbach's ? coefficients ranged from 0.721 to 0.888,and test-retest correlations ranged from 0.720 to 0.797.2.Higher levels of self-efficacy and coping were protective factors related to the patients' intention of relapse,whereas higher levels of depression and craving were risk factors.Respectively,stronger addiction memory intensity,using drugs for a longer period,and family dysfunction were predisposing factors related to relapse prospensity.3.Of the participants,92.9% in the intervention group and 83.3% in the control group were remained in the study at the end of the trial(P = 0.178).Significant effects of intervention or interaction were found on the measurements(P < 0.05).For participants in the intervention group,scores of the Addiction Memory Rating Scale,VAS,and Self-rating Depression Scale were less than those in the control group at posttreatment,whereas scores of Skills Rating Scale and Self-confidence Scale of the intervention group were higher than those of the control group at posttreatment.Conclusions1.The current evidence suggests that the Addiction Memory Rating Scale is a reliable and valid tool for measuring the addiction memory in illicit drug users.2.All distal and proximal factors,including addiction memory,period of drug use,family function,coping,craving,depression,self-efficacy,have direct or indirect effects on relapse prospensity of patients in compulsory rehabilitation facilities.3.The question-oriented EMDR intervention could decrease levels of addiction memory,craving,and depression among heroin addicts in compulsory rehabilitation facilities,and increase their levels of coping and self-efficacy.Highlights1.The present study is the first to develop a multidimensional scale for measuring the addiction memory in illicit drug users.The current evidence suggests that the Addiction Memory Rating Scale is a reliable and valid tool with the advantages of being brief and easily applied.2.As one of the variates,addiction memory was introduced into the cognitive-behavioral model of relapse,path analysis was also applied in the study to explore the factors associated with relapse.The present study provides an important reference for researches on relapse prevention.3.EMDR intervention was used alone firstly in Chinese heroin addicts.The present study provides an evidence of applying EMDR for substance abuse and dependence. |
PDF Full Text Request