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The Profound Heterogeneity of Substance Use Disorders: Implications for Treatment Development
Current Directions in Psychological Science ( IF 7.867 ) Pub Date : 2021-07-16 , DOI: 10.1177/09637214211026984
Kathleen M Carroll 1
Affiliation  

A single treatment approach will never be sufficient to address the diversity of individuals with substance use disorders (SUDs). SUDs have historically defied definition through simple characterizations or models, and no single characterization has led to the development of broadly effective interventions. The range of dimensions of heterogeneity among individuals with SUDs, including severity of the disorder, type of substance, and issues that frequently co-occur, underscores the need for highly tailored approaches. Personalized medicine for individuals with SUDs will require two major developments. First, given the diversity of individuals with SUDs, multivariate phenotyping is needed to identify the particular features driving addictive processes in a given individual. Second, a wider range of interventions that directly target core mechanisms of addiction and the problems that co-occur with them is needed. As clinicians cannot be expected to master the full range of interventions that may target these core processes, developing interventions that can be delivered easily, flexibly, and systematically via technology will facilitate the ability to truly tailor them to this highly complex and challenging population. One such technology-delivered intervention, Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT), is used as an example to illustrate a vision for the future of highly tailored interventions for individuals with SUDs.



中文翻译:

物质使用障碍的深刻异质性:对治疗发展的影响

单一的治疗方法永远不足以解决患有物质使用障碍 (SUD) 的个体的多样性。SUD 历来通过简单的表征或模型来定义定义,并且没有单一的表征导致开发广泛有效的干预措施。SUD 患者异质性的范围,包括疾病的严重程度、物质类型和经常同时发生的问题,强调了高度定制化方法的必要性。SUD 患者的个性化医疗将需要两个主要的发展。首先,鉴于 SUD 个体的多样性,需要进行多变量表型分析来确定特定个体中驱动成瘾过程的特定特征。第二,需要更广泛的干预措施,直接针对成瘾的核心机制以及与之同时出现的问题。由于不能指望临床医生掌握可能针对这些核心过程的全部干预措施,因此开发可以通过技术轻松、灵活和系统地实施的干预措施将有助于真正为这个高度复杂和具有挑战性的人群量身定制干预措施。其中一种技术提供的干预,即基于计算机的认知行为治疗培训 (CBT4CBT),被用作示例来说明对 SUD 患者进行高度定制干预的未来愿景。开发可以通过技术轻松、灵活和系统地实施的干预措施将有助于真正针对这一高度复杂和具有挑战性的人群量身定制干预措施。其中一种技术提供的干预,即基于计算机的认知行为治疗培训 (CBT4CBT),被用作示例来说明对 SUD 患者进行高度定制干预的未来愿景。开发可以通过技术轻松、灵活和系统地实施的干预措施将有助于真正针对这一高度复杂和具有挑战性的人群量身定制干预措施。其中一种技术提供的干预,即基于计算机的认知行为治疗培训 (CBT4CBT),被用作示例来说明对 SUD 患者进行高度定制干预的未来愿景。

更新日期:2021-07-18
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