The people's president. The electoral college in American history and the direct vote alternative
1983; Elsevier BV; Volume: 2; Issue: 2 Linguagem: Inglês
10.1016/0261-3794(83)90069-0
ISSN1873-6890
Tópico(s)Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
ResumoDrug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence.Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested.A university hospital alcohol and drug outpatient clinic.221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence.Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session.Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p = 0.004), more days of use (p < 0.001), and larger amount used (p < 0.001). Negative cannabis expectancies predicted greater likelihood of abstinence (p = 0.024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (p < 0.001).Emotional relief refusal self-efficacy and negative expectancies are predictive of better treatment outcomes for cannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established.
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