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Treating impulsivity in severe substance use disorders with a therapeutic community intervention based on the implementation of DBT skills training
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  • Marco Cavicchioli,
  • Jessica Mambreani,
  • Giorgia Conti,
  • Serena Mazoli,
  • Federica Galli,
  • Marco Begarani
Marco Cavicchioli
Sigmund Freud Privat Universitat Wien GmbH

Corresponding Author:cavicchioli.marco.psicologo@gmail.com

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Jessica Mambreani
Associazione gruppo amici onlus
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Giorgia Conti
Associazione gruppo amici onlus
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Serena Mazoli
Associazione gruppo amici onlus
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Federica Galli
Universita degli Studi di Roma La Sapienza Facolta di Medicina e Psicologia
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Marco Begarani
Associazione gruppo amici onlus
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Abstract

Objectives: Impulsivity is considered a core feature of substance use disorders (SUDs). However, the efficacy of evidence-based treatments for SUDs on this dimension remains a topic of debate, especially considering therapeutic community (TC) interventions for severe forms of these clinical conditions. Therefore, the current study aims at investigating pre- posttreatment changes in levels of impulsivity and related psychological dimensions during a 6-month Dialectical Behavior Therapy skills training program integrated within a TC (DBT-ST-TC) for individuals with severe SUDs. Methods: Impulsivity were assessed through a self-report measure (UPPS-P) and a neuropsychological battery. There were also evaluated levels of mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress tolerance (DTS). Intention-to-treat analysis controlling for baseline levels was performed. Contrast analyses were also conducted in order to compare results of the DBT-ST-TC group with two control groups (i.e., outpatient treatment-seeking individuals with SUDs; healthy controls [HCs]) Results: Sixty-eight patients with SUDs were admitted to the DBT-ST-TC. The clinical control group included 41 treatment-seeking individuals with SUDs. The HC group was composed of 53 participants. Considering pre- posttreatment changes, DBT-ST-TC patients reported that emotion dysregulation slightly improved as well as positive urgency and sensation seeking. Neuropsychological domain of cognitive disinhibition showed the most robust improvement, especially considering no significant differences between DBT-ST-TC group and HCs at the end of 6-month period of observation. Conclusion: The DBT-ST-TC might be a promising intervention for treating impulsivity among patients with severe SUDs. Future long-term outcomes are needed to corroborate and extent these provisional results.
Submitted to Journal of Clinical Psychology
17 Apr 2024Reviewer(s) Assigned
10 Sep 2024Review(s) Completed, Editorial Evaluation Pending
13 Sep 2024Editorial Decision: Revise Major