Spencer D. Bradshaw

Important Factors of Early Addiction Recovery and Inpatient Treatment

Research is needed that confirms inpatient treatment outcomes and evaluates patient typologies. Factors of early recovery and inpatient treatment are examined to (1) support inpatient treatment effectiveness research, (2) explore impacts on outcomes of patient differences (collegiate vs. traditional), and (3) learn about factors that influence inpatient treatment effectiveness. Overall, 95 of 149 (63.8%) participants were classified as progressing in readiness for change from pre to post treatment. Second, a MANCOVA showed significant increases in hope, resiliency, and family functioning and decreases in craving from pre- to posttreatment. Expectations of significant differences in rates of change of treatment outcome variables between traditional and collegiate recovery programs were partially supported.

Functional near infrared spectroscopy as a potential biological assessment of addiction recovery: preliminary findings

Abstract Background: Addiction science has primarily utilized self-report, continued substance use, and relapse factors to explore the process of recovery. However, the entry into successful abstinence substantially reduces our assessment abilities. Advances in neuroscience may be the key to objective understanding, treating, and monitoring long-term success in addiction recovery. Objectives: To explore functional near infrared spectroscopy (fNIR) as a viable technique in the assessment of addiction-cue reactivity. Specifically, prefrontal cortex (PFC) activation to alcohol cues was explored among formally alcohol-dependent individuals, across varying levels of successful abstinence. The aim of the investigation was to identify patterns of PFC activation change consistent with duration of abstinence. Methods: A total of 15 formally alcohol-dependent individuals, with abstinence durations ranging from 1 month to 10 years, viewed alcohol images during fNIR PFC assessment. Participants also subjectively rated the same images for affect and arousal level. Results: Subjective ratings of alcohol cues did not significantly correlate with duration of abstinence. As expected, days of abstinence did not significantly correlate with neutral cue fNIR reactivity. However, for alcohol cues, fNIR results showed increased days of abstinence was associated with decreased activation within the dorsolateral and dorsomedial prefrontal cortex regions. Conclusions: The present results suggest that fNIR may be a viable tool in the assessment of addiction-cue reactivity. Results also support previous findings on the importance of dorsolateral and dorsomedial PFC in alcohol-cue activation. The findings build upon these past results suggesting that fNIR-assessed activation may represent a robust biological marker of successful addiction recovery.

The Development of the Hope and Coping in Recovery Measure (HCRM)

A large body of research exists on the causes, effects/consequences, and treatment of substance use disorder (SUD). However, studies on recovery from SUD, including its definition, factors, and sustainability, are lacking. The purpose of this study is to identify and assess the factors of recovery from SUD by developing and testing the Hope and Coping in Recovery Measure (HCRM). A principal components analysis revealed two distinct factors (hope and coping) to be present in the process of recovery from SUD. Implications for future research on the recovery process and the HCRM are discussed.

Addiction and the Mediation of Hope on Craving, Readiness, and Coping

Craving, a compulsive motivation to use, and conscious readiness to change (RTC) are distinct motivators of human behavior. Recovery requires RTC despite involuntary cravings. A structural equation modeling analysis examining hope as a mediator between these constructs found craving to directly associate with precontemplation, while hope partially mediated the relationship between craving, contemplation, and coping. Cravings indirect effect on action toward change occurred only through hope. While craving appears to be a strong associate of precontemplation, hope appears to be an important associate of contemplation toward change and appears to be required for action. Hope also appears to be an important factor of coping in recovery.

Hope, Readiness, and Coping in Family Recovery From Addiction

Addiction adversely affects families, making family recovery important. Family members appear to benefit from hope, healthy coping skills, and a readiness to change. Family recovery research is limited and relationships between these variables are underexplored. Using structural equation modeling, preparation for change at initial assessment before a family treatment program predicted higher hope and coping skills after participation. Initial levels of hope predicted coping skills posttreatment. Gender, treatment track of the addict, and family members’ relation to the addict showed significant effects. The importance of family members’ hope, coping, and readiness to change in family recovery are discussed.

A Revised Multifamily Group Curriculum: The Need for Family Member Recovery from Addiction

ABSTRACT This article presents a revised curriculum for a family program developed for family members who are participating in a family program at a residential treatment for addiction. The article consists of a comprehensive overview of the modules developed for the program, inclusive of multifamily groups, psychoeducational components, and other family therapy modalities. In addition, preliminary results are presented demonstrating the positive effects of the program, while simultaneously building a foundation for the development and necessity of family member recovery.

Hope, coping skills, and the prefrontal cortex in alcohol use disorder recovery

ABSTRACT Background: Alcohol use disorders adversely affect individual and societal health. These disorders are a chronic brain disease, and protective factors against relapse should be studied. Prefrontal cortex (PFC) dysfunction is evident in alcohol use disorders, and research that explores recovery of the PFC in alcohol use disorders is needed, specifically in regard to how psychological and behavioral factors can augment medicalized treatments and protect against relapse. For example, hope or a belief that recovery is possible is an important cognitive construct—thought to precede behavioral action—that has been associated with relapse. Objectives: In this study, associations between healthy coping skills and hope (psychological/behavioral factors) and PFC regional activation in response to alcohol cue exposure were examined. It was also examined whether such associations were unique to alcohol cues. Methods: Forty-two participants, 32 males and nine females in recovery from an alcohol use disorder (AUD), were administered a subjective hope and coping in recovery measure. They also viewed alcohol, positive, negative, and neutral cues during functional near-infrared spectroscopy (fNIR) PFC assessment. Results: Levels of healthy coping skills positively correlated with activation in the right dorsomedial prefrontal cortex (DMPFC) in response to alcohol cues. This finding was unique to alcohol cues. Conclusion: The association between coping skills and activation of the right DMPFC in response to alcohol cues may reflect greater action restraint and top-down PFC control processing that may protect against relapse.

Family Functioning and Readiness in Family Recovery From Addiction

ABSTRACT Unhealthy family dynamics often develop in families where addiction is present and negatively impact individual and family health. Family members becoming ready to make personal changes might positively impact family functioning and improve family support. More research is needed to examine this relationship in family recovery. Using structural equation modeling, family member readiness to change and family functioning over time were examined. Readiness and family functioning were positively and reciprocally associated with each other across 2 assessment points. Gender was associated with initial readiness to change and family functioning. Individual readiness to change may enhance family functioning and promote recovery-oriented changes for each family member.

Prefrontal Cortex Functioning of Family Members of Those with a Substance Use Disorder

ABSTRACT Substance use disorders (SUDs) significantly impact family systems, yet have often been treated as an individual problem. Nevertheless, family inclusion has become a treatment priority although limited research exists regarding family members. Specifically, research has yet to examine neuropsychological processes associated with family members. This study examined prefrontal cortex (PFC) activation of family members using functional near-infrared spectroscopy as they viewed images of a loved-one with a SUD. Activation patterns of an experimental group were compared against those of a control group and showed significant differences in PFC responses. Implications are discussed and demonstrate the importance of family member recovery.

Exploring Family Member Influence on Change in Addiction Treatment, a Dyadic Analysis

ABSTRACT Substance use disorders (SUDs) have been viewed traditionally as an acute individual illness. However, professionals are beginning to shift SUD treatment practices to match empirically driven models that consider family recovery as an important mechanism of systemic change. This study aimed to explore the relationship between family member hope and readiness to change (RTC). The method includes a dyadic actor-partner interdependence model, exploring change processes observed over a brief family treatment program located within an SUD treatment facility. Results of this study highlight actor effects for parents’ RTC and hope. Implications for research and clinicians are discussed.