Behavioral activation evaluation in university students who consume marijuana: a pilot study
Main Article Content
Abstract
Introduction: In Mexico, marijuana consumption has increased in adults and university students, triggering problems in attention, concentration, anxiety, depression, dependence, and cardio-respiratory difficulties. Psychological interventions like brief motivational treatment (BMT) and cognitive behavioral therapy (CBT) have reported some difficulties such as a low and medium effect size, decreased consumption without reaching abstinence, and heterogeneity in the use of both cognitive and behavioral techniques. The use of behavioral techniques in Behavioral Activation has reported effectiveness in the treatment of anxiety, depression, and recently in alcohol and tobacco.
Objective: to evaluate the effect size of a Behavioral Activation treatment in abstinence of marijuana (BA-M) measured in units, occasions, and quantity of consumption.
Method: in a sample of university students (n = 8), the intervention of behavioral activation was applied, which includes functional analysis, planning and goal setting, contingency management, skills training, and relapse prevention. It was carried out a multielement single case design with eight replications, calculating the effect size through the non-overlapping index of all pairs.
Results: high effect size was obtained in the consumption pattern, ranging between 91.10% and 100%, 5 university students achieved abstinence.
Discussion and conclusions: treatment in BA-M obtained a high effect size in abstinence and a decrease in marijuana abuse these results are similar to those reported in alcohol and tobacco.
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References
Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. Addiction, 104(5), 705-715. doi: 10.1111/j.1360-0443.2009.02527.x
Baeza, E. S., Cruz-Morales, S. E., & Mandujano, J. (2019). Eficacia de activación conductual para dejar de consumir mariguana en universitarios (Tesis Doctoral no publicada).
Barraca, J., & Pérez, M. (2015). Activación conductual para el tratamiento de la depresión. Editorial Síntesis.
Bono, R., & Arnau, J. (2014). Diseños de caso único en ciencias sociales y de la salud. Editorial Síntesis.
Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., Bakken, S., Kaplan, C. P., Squiers, L., Fabrizio, C., & Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452-457. doi: 10.1016/j.amepre.2009.02.002
Campbell, J. M., & Herzinger, C. V. (2010). Statistics and single subject research methodology. En: D. L. Gast, (Eds.), Single Subject Research Methodology in Behavioral Sciences (pp. 417-453). Routledge.
Comisión Interamericana para el Control del Abuso de Drogas. (2015). Informe sobre uso de drogas en las Américas. Observatorio Interamericano de Drogas: Washington, D.C. Recuperado de www.cicad.oas.org/cicaddocs/document.aspx?Id=3209
Cooper, Z. D. (2016). Adverse Effects of Synthetic Cannabinoids: Management of Acute Toxicity and Withdrawal. Current Psychiatry Reports, 18(5), 52. doi: 10.1007/s11920-016-0694-1.
Daughters, S. B., Magidson, J. F., Anand, D., Seitz-Brown, C. J., Chen Y., & Baker, S. (2017). The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial. Addiction, 113, 535-544. doi: 10.1111/add.14049
Echeverría, L., & Ayala, H. E. (1997). Auto registro del consumo de alcohol y otras drogas: traducción y adaptación. Universidad Nacional Autónoma de México.
Echeverría, L., Carrascoza C., & Medina, M. A. (2013). Intervención breve para consumidores de mariguana: Factores asociados con la deserción. En: Aspectos culturales, sociales y preventivos de las adicciones. Conaculta.
Ekers, D., Godfrey, C., Gilbody, S., Parrott, S., Richards, D. A., Hammond, D., & Hayes, A. (2011). Cost utility of behavioural activation delivered by the non-specialist. The British Journal of Psychiatry, 199(6), 510-511. doi: 10.1192/bjp.bp.110.090266.
Ekers, D., Richards, D., & Gilbody, S. (2008). A meta-analysis of randomized trials of behavioural treatment of depression. Psychological Medicine, 38(5), 611-623. doi: 10.1017/S0033291707001614
Feingold, D., Weiser, M., Rehm, J., & Lev-Ran, S. (2015). The association between cannabis use and mood disorders: A longitudinal study. Journal of Affective Disorders, (1)172, 211-218. doi: 10.1016/j.jad.2014.10.006
Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28(10), 857-870. doi: 10.1037/h0035605
Gates, P. J., Sabioni, P., Copeland, J., Le-Foll, B., & Gowing, L. (2016). Psychosocial interventions for cannabis use disorder. The Cochrane Database of Systematic Reviews, 1(5), 2-147. doi: 10.1002/14651858.CD005336.pub4
Gulloa, M. J., Matveeva, M., Feeneya, G. F., Young, R. M., & Connora, J. P. (2017). Social cognitive predictors of treatment outcome in cannabis dependence. Drug and Alcohol Dependence, 1(170), 74-81. doi: 10.1016/j.drugalcdep.2016.10.030.
Hermanns-Clausen, M., Kneisel, S., Szabo, B., & Auwärter, V. (2013). Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings. Addiction, 108(3), 534-544. doi: 10.1111/j.1360-0443.2012.04078.x.
Kanter, J. W., Manos, R. C., Bowe, W. M., Baruch, D. E., Busch, A. M., & Rusch, L. C. (2010). What is behavioral activation? A review of the empirical literature. Clinical Psychology Review, 30(6), 608-20. doi: 10.1016/j.cpr.2010.04.001
Kedzior, K. K., & Laeber, L. T. (2014). A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population--a meta-analysis of 31 studies. BMC Psychiatry, 14(1), doi: 10.1186/1471-244X-14-136
Kerlinger, F., & Howard, B. (2002). Investigación del comportamiento (4a. ed.). Mc Graw-Hill.
Litt, M. D., Kadden, R. M., & Petry, N. M. (2013). Behavioral Treatment for Marijuana Dependence: Randomized Trial of Contingency Management and Self-Efficacy Enhancement. Addictive Behaviors, 38(3), 1764-1775. doi: 10.1016/j.addbeh.2012.08.011.
Mac-Pherson, L., Collado, A., Ninnemann, A., & Hoffman, E. (2017). Development of a Behavioral Activation–Based Intervention for Cigarette-Smoking Young Adults. Cognitive and Behavioral Practice, 24, 101-114. doi: 10.1016/j.cbpra.2016.03.004
Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2013). Activación Conductual para la Depresión: Una guía clínica. Editorial Desclée de Brouwer.
McCambridge, J., & Strang, J. (2004). The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction, 99(1), 39-52. doi: 10.1111/j.1360-0443.2004.00564.x
Medina, M. A., Chávez, M. E., López, F., Félix, V., Gordillo, T., & Morales, S. (2012). Manual del Terapeuta para la Aplicación de la Intervención Breve para Usuarios de Marihuana. Secretaría de Salud: Centro Nacional para la Prevención y el Control de las Adicciones.
Organización Mundial de la Salud. (2010). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): manual for use in primary care. Recuperado de https://apps.who.int/iris/handle/10665/44320
Organización Panamericana de la Salud. (2018). Efectos sociales y para la salud del consumo de cannabis sin fines médicos. Recuperado de https://iris.paho.org/bitstream/handle/10665.2/34944/9789275319925_spa.pdf?sequence=1&isAllowed=y
Ortega, B. E. (2016). Relación entre la conducta autocontrolada y la conducta adictiva en procedimientos de “abstención” y demora de la gratificación (tesis de maestría). Universidad Nacional Autónoma de México.
Palafox, G., Morales, S., Félix, V., López, F., Martínez, K., & Vázquez, J. L. (2017). Transferencia de las intervenciones breves para la prevención de recaídas en adicciones. Recuperado de http://www.cicad.oas.org/cicaddocs/Document.aspx?Id=4757
Parker, R. I., & Vannest, K. (2009). An improved effect size for single case research: Non Overlap of All Pairs. Behavior Therapy, 40(4), 357-367. doi: 10.1016/j.beth.2008.10.006
Parker, R. I., Vannest, K. J., & Davis, J. L. (2011). Effect size in single-case research: a review of nine nonoverlap techniques. Behavior Modification, 35(4), 303-322. doi: 10.1177/0145445511399147
Perone, M., & Hursh, D. E. (2013). Single-case experimental designs. En G. J. Madden, W. V. Dube, T. D. Hackenberg, G. P. Hanley, & K. A. Lattal (Eds.), APA handbook of behavior analysis, Vol. 1. Methods and principles (pp. 107-126). American Psychological Association. doi: 10.1037/13937-005
Preedy, A. (2017). Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis, and Treatment. Academic Press.
Reynolds, E. K., MacPherson, L., Baruch, D. E., Tull, M. T., & Lejuez, C. W. (2011) Integration of the Brief Behavioral Activation Treatment for Depression (BATD) Into a College Orientation Program: Depression and Alcohol Outcomes. Journal of Counseling Psychology, 58(4), 555-564. doi: 10.1037/a0024634
Rojas, E., Real, T., García-Silberman, S., & Medina-Mora, M. E. (2011). Revisión sistemática sobre tratamiento de adicciones en México. Salud Mental, 34(4), 351-365.
Sanz, J., & García-Vera, M. P. (2015). Técnicas para el análisis de diseños de caso único en la práctica clínica: Ejemplos de aplicación en el tratamiento de víctimas de atentados terroristas. Clínica y Salud, 26(3), 167-180. doi: 10.1016/j.clysa.2015.09.004
Sherman, B. J., & McRae-Clark, A. L. (2016). Treatment of Cannabis Use Disorder: Current Science and Future Outlook. Pharmacotherapy, 36(5), 511-535. doi: 10.1002/phar.1747.
Skidmore, C. R., Kaufman, E. A., & Crowell, S. E. (2016). Substance Use Among College Students. Child and Adolescent Psychiatric Clinics of North America, 25(4), 735-53. doi: 10.1016/j.chc.2016.06.004
Sobell, L. C., & Sobell, M. B. (1992). Timeline follow-back: A technique for assessing self-reported alcohol consumption. En R. Z. Litten, & J. P. Allen (Eds.), Measuring alcohol consumption: Psychosocial and biochemical methods (pp. 41–72). Humana Press. doi: 10.1007/978-1-4612-0357-5_3
Szerman, N., Martinez-Raga, J., Peris, L., Roncero, C., Basurte, I., Vega, P., Ruiz, P., & Casas, M. (2013). Rethinking Dual Disorders/Pathology. Addictive Disorders & Their Treatment, 12(1), 1-10. doi: 10.1097/ADT.0b013e31826e7b6a
Tiburcio, M., Rosete-Mohedano, M. G., Natera, G., Martínez, N. A., Carreño, S., & Pérez, D. (2016). Validity and Reliability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in University Students. Adicciones, 28(1), 19-27. doi 10.20882/adicciones.786
United Nations Office on Drugs and Crime. (2017). Global Overview of Drug Demand and Supply: Latest trends, cross-cutting issues. Recuperado de https://www.unodc.org/wdr2017/field/Booklet_2_HEALTH.pdf
Useche, F. A., Escalona, M. J., López, V. M., & Ortiz, G. J. (2017). Factores psicosociales en la recaída de la dependencia al alcohol: Un análisis de ruta. Enfermería Investiga, 2(4), 137-144. doi: 10.29033/ei.v2n4.2017.04
Villalobos, L., Pérez, A., Mendoza, R., Graue, J., & Marín, R. (2015). Psychometric and diagnostic properties of the Drug Abuse Screening Test (DAST): Comparing the DAST-20 vs. the DAST-10. Salud Mental, 38(2), 89-94. doi: 10.17711/SM.0185-3325.2015.012
Villatoro-Velázquez, J. A., Oliva, N., Fregoso, D., Bustos, M., Mujica, A., Martín del Campo, R., Nanni, R., & Medina-Mora M. E. (2015). Encuesta Nacional de Consumo de Drogas en Estudiantes: Reporte de Drogas. Secretaría de Salud.
Vujanovic, A. A., Meyer, T. D., Heads, A. M., Stotts, A. L., Villarreal, Y. R., & Schmitz, J. M. (2017). Cognitive-behavioral therapies for depression and substance use disorders: An overview of traditional, third-wave, and transdiagnostic approaches. The American Journal of Drug and Alcohol Abuse, 43(4), 402-415. doi: 10.1080/00952990.2016.1199697