动机—技能—脱敏—心理能量模式预防戒毒人员复吸的干预效果评价

发布时间：2018-05-13 05:10

本文选题：海洛因成瘾者 + 慢性渴求　；参考：《华中科技大学》2013年硕士论文

【摘要】：目的：（1）评价动机-技能-脱敏-心理能量模式对戒毒人员慢性渴求和抑郁情况的效果；（2）评价动机-技能-脱敏-心理能量模式对戒毒人员短期操守率的影响；（3）开发戒毒人员情绪与动机转变倾向监测表并评价其信度与效度，为开展戒毒心理治疗研究提供评价工具。方法：选取襄阳市强制隔离戒毒所男性戒毒人员98名，随机分为试验组和对照组，试验组接受动机-技能-脱敏-心理能量模式和戒毒所常规戒毒教育，对照组接受戒毒所常规戒毒教育，一个月后评价试验组和对照组慢性渴求、抑郁、冲动性和攻击性人格特征变化情况。对上述观察对象，试验组46人以及对照组43人，在其出所后进行电话随访，评价两组人员出所满一个月、三个月、六个月和一年的操守情况。根据强制隔离劳教戒毒患者的情绪状况和戒毒所需要的改变，本课题组拟定戒毒人员情绪与动机转变倾向监测表初稿，对298名强制隔离劳教戒毒的男性海洛因依赖患者进行现场测试，并于一周后随机抽取其中81名患者进行重测。结果：（1）重复测量方差分析显示：①干预后试验组在强迫性毒品使用量表得分和冲动性人格量表得分上比对照组低（P0.01）；②干预后试验组强迫性毒品使用量表、贝克抑郁自评量表和攻击性人格量表得分较干预前自身比较也显著降低（P0.01）；③干预因素是试验组强迫性毒品使用量表、贝克抑郁自评量表得分下降的主要影响因素，且试验组干预后强迫性毒品使用量表、贝克抑郁自评量表得分下降趋势较对照组明显（P0.01）。（2）试验组出所满一个月、三个月、六个月和一年时，操守人数（率）分别是33（71.74%）、24（52.17%）、19（41.30%）和17（36.96%）；对照组操守人数（率）分别是8（18.60%）、3（6.98%）、1（2.33%）和1（2.33%）。试验组操守率均远高于对照组（P0.001）。多元Logistic回归结果显示，无论在一个月、三个月、六个月和一年，干预分组因素均是患者操守的重要影响因素（OR值均15, P均0.01）。（3）问卷整体的Cronbach’s α系数为0.88，4个因子的Cronbach’s α系数在0.77～0.94之间；量表总分的重测信度为0.70，4个因子的重测信度在0.42～0.62之间，各个项目的重测信度在0.29～0.64之间；因子分析共提取4个因子，累积贡献率达72.71%。结论：动机-技能-脱敏-心理能量模式可以在一定程度上减轻强制戒毒人员慢性渴求和抑郁状况，，有助于预防戒毒后复吸和促进戒毒患者保持操守。戒毒人员情绪与动机转变倾向监测表具有良好的信度和效度，在海洛因成瘾戒毒后预防复吸的研究过程中具有较好的应用价值。本研究创新之处： 1.引进国外被论证有效的认知行为疗法，融合动机晤谈、NLP(神经语言模式)疗法、内观认知疗法等组合成一套综合心理干预模式：动机-技能-脱敏-心理能量模式，并首次在强制戒毒人员中实践应用。 2.以一年操守率论证本综合干预模式的有效性，并建立Logistic回归模型，找出患者保持操守的主要有利因素。 3.根据戒毒人员情绪心理状况，编制出“戒毒人员情绪与动机转变倾向监测表”，用于实时监测戒毒人员情绪和戒毒动机状态。
[Abstract]:Objective: (1) to evaluate the effect of motivation skill - desensitization - mental energy model on chronic craving and depression in detoxification workers; (2) evaluate the effect of motivation skill - desensitization - mental energy model on the short-term integrity of drug addicts; (3) to develop the monitoring table of emotional and motivational change tendency of drug addicts and evaluate their reliability and validity in order to carry out the precepts. The study of toxic psychotherapy provides an evaluation tool.
Methods: 98 male addicts in Xiangyang compulsory detoxification center were randomly divided into experimental group and control group. The experimental group received motivation skills, desensitization mental energy model and routine detoxification education in detoxification Institute, and the control group accepted the routine detoxification education. One month later, the test group and the control group had chronic craving, depression and impulsiveness. 46 people in the experimental group and 43 people in the control group were followed up by telephone to evaluate the integrity of the two groups of people who were full for one month, three months, six months and one year. The group was prepared for the first draft of the monitoring table for the tendency to change the mood and motivation of drug addicts. 298 male heroin addicts who were forced to detoxification were tested on the spot, and 81 of them were retested randomly one week later.
Results: (1) the repeated measurement of variance analysis showed that: (1) the score of the compulsive drug use scale and the impulsive personality scale were lower than the control group (P0.01) in the test group, and the scores of the Beck depression self rating scale and the aggressive personality scale were significantly lower than those before the intervention. Low (P0.01); (3) the intervention factors were the forced drug use scale in the experimental group, the main influencing factors of the decline in the Beck depression self rating scale, and the forced drug use scale of the test group after the intervention, and the decrease trend of the Beck depression self rating scale was significantly lower than that of the control group (P0.01).
(2) the number of people in the test group was 33 (71.74%), 24 (52.17%), 19 (41.30%) and 17 (36.96%), respectively, for one month, three months, six months and one year, respectively, and the control group was significantly higher than the control group (P0.001). The results of multiple Logistic regression showed that no matter In one month, three months, six months and one year, intervention group factors were important factors affecting patients' integrity (OR value 15, P 0.01).
(3) the overall Cronbach 's alpha coefficient of the questionnaire is 0.88,4 factor Cronbach' s alpha coefficient between 0.77 and 0.94; the retest reliability of the total score for the total score of the scale is between 0.42 and 0.62, and the retest reliability of each item is between 0.29 and 0.64; the factor analysis extracts 4 factors and the cumulative contribution rate is 72.71%.
Conclusion: the motivation skills - desensitization - psychological energy model can reduce the chronic craving and depression of compulsory detoxification personnel to a certain extent, help to prevent relapse after detoxification and promote the integrity of the detoxification patients. The monitoring table of emotional and motive change of drug addicts has good reliability and validity, and it is pretreated after heroin addiction abstinence. The study of anti relapse has good application value.
The innovation of this study is:
1. the introduction of proven effective cognitive behavioral therapy, fusion motivation talk, NLP (neural language model) therapy, and internal cognitive therapy combined into a set of comprehensive psychological intervention models: motivation skills desensitization psychological energy model, and the first practice in compulsory detoxification personnel.
2. to demonstrate the effectiveness of the comprehensive intervention model with the rate of one year's conduct, and establish Logistic regression model to find out the main favorable factors for patients to maintain their integrity.
3. according to the emotional state of drug addicts, the "monitoring table of the tendency to change the mood and motivation of drug addicts" was compiled, which was used to monitor the state of detoxification and detoxification motivation in real time.

【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.64

【参考文献】