青少年新型毒品滥用预防的亲子“认知-技能-心理成长”干预模式研究

New drug abuse can cause serious mental diseases, violence and criminal behaviors. In recent years, new drug abuse has become a growing epidemic among adolescents in our country. Previous studies have shown that the following risk factors contributed to new drug abuse: high sensation seeking, impulsive and aggressive personality traits, feelings of inferiority or worthlessness, temptation from drug-using associates, lack of refusal skills, being parented inappropriately, experience of being abused or neglected, and the resulting brain dysfunction. Therefore comprehensive intervention strategy is demanded. Although there are many drug prevention education programs for adolescents at home and abroad, long-term follow-up and systematic review studies have recently found that the effect of intervention either via drug education merely or via skill training was not very satisfying. Thus we propose a comprehensive intervention model named parent-child Cognition-Skill-Mental growth (pc-CSM) involved both parents and their children. Furthermore, question-oriented mindfulness-based cognitive therapy, neuro-linguistic programming (NLP), positive parenting program (PPP), interactive drug prevention education style, skill training and other methods are contained in the pc-CSM model. We intend to use this model to help parents and children improve the related cognition and skills, overcome psychological barriers and promote psychological development. In addition, randomized controlled trial and long-term follow up will be conducted to confirm the effect of our intervention. Functional magnetic resonance imaging (fMRI) will be applied to explore associated neurobiological mechanisms. Finally, a set of systematic intervention model and protocol will be refined in order to prevent the spread of new drugs among adolescents.

滥用新型毒品可导致严重的精神疾患、暴力和犯罪行为。近几年新型毒品在我国青少年中流行趋势严峻。国内外研究表明新型毒品滥用的危险因素有：高感觉寻求、攻击、冲动等人格特征，自卑、无价值感等心理问题，朋友吸毒与诱惑，拒绝技能缺乏，家长管教不当，被虐待或忽视的经历及导致的脑功能问题，因此需要综合干预。国内外虽有对青少年的毒品预防教育，但最近的长期随访和系统综合分析研究显示，单纯毒品危害教育的干预效果不佳，以技能教授为主的效果也有待提高。为此我们提出家长和子女共同参与的亲子"认知-技能-心理成长"综合干预模式，拟采用问题引导式内观认知疗法、神经语言模式、积极家教程式、互动式毒品预防教育和应对技能训练等，提高亲子的相关认知和技能，化解心理障碍，促进心理成长。此外，将通过随机对照试验与随访验证该模式的效果，并借助fMRI探索相关神经生物学机制，最终形成系统的干预模式和方案，以遏制新型毒品在青少年中的蔓延。

1.项目背景：.近年来我国青少年毒品滥用呈明显的增长趋势，学生中尤以中职生为甚。在前期研究的基础上，我们提出并验证了青少年毒品预防的 “认知-技能-心理成长(CSM)”干预模式。.2.主要研究内容：.对中职生进行了毒品使用情况及有关因素的流行病学调查，开发了CSM对应的干预方案及干预评价工具；在武汉市中职生中进行了预试验，在全国五个城市中职生中实施了干预试验；进行了干预措施的机制探索。.3.重要结果及关键数据：.（1）测评工具：开发了正能量量表，Cronbach α=0.93，重测相关系数为0.83，具有较高信度；开发了毒品认知-态度-倾向性-应对技能-成瘾物质使用及倾向评价表，各分量表内容效度在0.82—0.94之间，Cronbach α 系数在0.59-0.86之间，信效度较高。.（2）调查研究：对全国6个城市11196名中职生进行了药物滥用及相关因素调查，发现中职生当前和终生毒品使用率分别为1.6%与3.4%；高父母监管和高拒绝效能是终生成瘾物质使用行为的保护因素，OR分别为0.27与0.07（P均<0.05）；而高感觉寻求、成瘾物质容易获得、高社会效益期待、觉知朋友或/和家人使用成瘾物质、觉知朋友或/和家人赞同自己使用成瘾物质是危险因素，OR分别为3.46、10.75、6.31、31.59、81.74（P均<0.05）。.（3）开发了CSM干预方案、手册和课件，过程评价显示学生对课程感兴趣程度较高。现场干预和随访发现该方案可以提高中职生毒品危害认知、拒毒等生活技能和改善情绪(P均<0.05)；随访发现干预组各阶段毒品滥用率均低于对照组，但差别无统计学意义（P>0.05），原因可能是对照组辍学、拒答等造成的失访率显著高于干预组（P<0.01），对毒品滥用的干预效果有待进一步验证。.（4）采用Stroop及go/nogo范式进行机制探索，go/nogo结果无统计学意义，干预后干预组的Stroop反应错误率升高（P<0.05），说明干预组提高了对毒品危害的关注。.4.科学意义：.（1）开发了毒品滥用预防干预效果的评价工具；.（2）发现了中职生毒品滥用的相关因素；.（3）开发了青少年毒品预防教育的成套方案；.（4）为毒品预防干预策略与措施的制定提供了科学依据。