The comparison of the effectiveness of contingency management and trans-theoretical model on the risk of sexual behaviors in cocaine users: A short report study

Mehdi Panahi, Tayebeh Honarvar, Negar Sadegh-Esfahani, Leila Salari-Moghadam, Sara Salari-Moghadam, Roghaiyeh Jamali, Fatemeh Aslani, Paria Sadeghi

DOI: 10.22122/cdj.v0i0.548

Abstract


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BACKGROUND: A transtheoretical model (TTM) can be considered as a cognitive and motivational view, a component which plays a significant role in addiction. Further, the theoretical basis of contingency management (CM) treatment is the origin of behaviorism and relies on operant conditioning. The present study is performed aiming to determine the effectiveness of TTM and CM on cocaine use and sexual risk behaviors in cocaine users.

METHODS: In this randomized clinical trial with 6-month follow-up, which was performed from 15 December 2014 to 20 November 2015, 75 male cocaine users were selected based on a respondent-driven sampling (RDS) method and were randomly divided into three groups by block randomization. The experimental group received a 12-week CM protocol and TTM and the control group was placed on the waiting list. Pre-test, post-test (after 12 weeks of training), and follow-up (six months) were administered. Data analysis was carried out using repeated measures analysis of variance (ANOVA), Scheffe’s post hoc test, and chi-square test through SPSS software.

RESULTS: The mean age of the CM group, TTM group, and control group was estimated 26.12, 25.31, and 23.91, respectively. The primary outcome showed that CM and TTM had a significant effect on decreasing the sexual thoughts, sexual hyperactivity, and high risk behaviors. This effectiveness was stable until six months (P = 0.008), however there was not a significant difference between the two treatments (P = 0.200). The secondary outcome showed that in the changing stages, TTM (F-72%) and CM (F-60%) had a significant effectiveness which maintained until the follow-up stage.

CONCLUSION: The findings more enhance the hope to integrate the theoretical approaches into the clinical interventions.


Keywords


Cocaine; Dangerous Behavior; Behavior Therapy

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References


Pirnia B, Soleimani AA, Tavallaii A, Roshan R, Pirnia K. Two New Therapies in the Cocaine-dependents: Comparison of Topiramate and Contingency Management. Iran J Public Health 2018; 47(10): 1607-8.

Pirnia B, Givi F, Roshan R, Pirnia K, Soleimani AA. The cortisol level and its relationship with depression, stress and anxiety indices in chronic methamphetamine-dependent patients and normal individuals undergoing inguinal hernia surgery. Med J Islam Repub Iran 2016; 30: 395.

Pirnia B, Moradi AR, Pirnia K, Kolahi P, Roshan R. A Novel Therapy for cocaine dependence during abstinence: A randomized clinical trial. Electron Physician 2017; 9(7): 4862-71.

Peirce JM, Petry NM, Stitzer ML, Blaine J, Kellogg S, Satterfield F, et al. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: A National Drug Abuse Treatment Clinical Trials Network study. Arch Gen Psychiatry 2006; 63(2): 201-8.

Shoptaw S, Klausner JD, Reback CJ, Tierney S, Stansell J, Hare CB, et al. A public health response to the methamphetamine epidemic: The implementation of contingency management to treat methamphetamine dependence. BMC Public Health 2006; 6: 214.

Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol 1992; 47(9): 1102-14.

Pirnia B, Pirnia K, Aghajanpoor M, Mardan F, Zahiroddin A. Relationship between function of hypothalamic-pituitary-adrenal axis and executive functions in chronic methamphetamine users: A cross-sectional study. Asian J Psychiatr 2018; 35: 113-4.

Pirnia B, Pirnia K, Mohammadpour S, Malekanmehr P, Soleimani A, Mahmoodi Z, et al. The effectiveness of acupuncture on HPA functional in depressed patients under methadone maintenance treatment, a randomized double-blind sham-controlled trial. Asian J Psychiatr 2018; 36: 62-3.

Pirnia B, Soleimani AA, Malekanmehr P, Pirnia K, Zahiroddin A. Topiramate for the treatment of dually dependent on opiates and cocaine: A single-center placebo-controlled trial. Iran J Public Health 2018; 47(9): 1345-53.

Higgins ST, Budney AJ, Bickel WK, Foerg FE, Donham R, Badger GJ. Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Arch Gen Psychiatry 1994; 51(7): 568-76.

Heil SH, Badger GJ, Higgins ST. Alcohol dependence among cocaine-dependent outpatients: Demographics, drug use, treatment outcome and other characteristics. J Stud Alcohol 2001; 62(1): 14-22.

Rash CJ, Alessi SM, Petry NM. Cocaine abusers with and without alcohol dependence respond equally well to contingency management treatments. Exp Clin Psychopharmacol 2008; 16(4): 275-81.

Killeen TK, McRae-Clark AL, Waldrop AE, Upadhyaya H, Brady KT. Contingency management in community programs treating adolescent substance abuse: A feasibility study. J Child Adolesc Psychiatr Nurs 2012; 25(1): 33-41.

Koffarnus MN, Kaplan BA. Clinical models of decision making in addiction. Pharmacol Biochem Behav 2018; 164: 71-83.

Amlung M, Vedelago L, Acker J, Balodis I, MacKillop J. Steep delay discounting and addictive behavior: A meta-analysis of continuous associations. Addiction 2017; 112(1): 51-62.

Pirnia B, Soleimani A, Taherinakhost HR, Pirnia K, Malekanmehr P, Zahiroddin A. A randomized pilot trial of contingency-management intervention for patients in during methadone maintenance treatment, cash vs. vouchers. Iran J Public Health 2018; 47(4): 618-9.

Higgins ST, Bickel WK, Hughes JR. Influence of an alternative reinforcer on human cocaine self-administration. Life Sci 1994; 55(3): 179-87.


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