Mechanisms Of Relapse And A VR-based Motivational Reinforcement-desensitization Intervention For Female Meth-dependent Adolescents

Research background and purpose:Methamphetamine dependence is a public health problem that needs to be addressed urgently.Relapse is a difficult issue in the treatment of methamphetamine dependence.And addiction intervention to prevent relapse among meth-dependent people is a hot topic of concern for the whole community.Adolescents are more malleable than adults,so it makes sense to intervene with meth-dependent adolescents.Identifying the influencing factors and mechanisms of action associated with relapse among meth-dependent adolescents can help design targeted intervention strategies.Therefore,this study examines the relationship between addiction memory,psychological craving,motivation to quit and the tendency to relapse among female meth-dependent adolescents,and analyses the mechanisms of addiction memory,psychological craving and motivation to quit in relapse behaviour.And,this study proposes the use of motivational interviewing to enhance the motivation of MA-dependent adolescent females to detoxify,and use VR technology to create MA-related scenarios to activate their addiction memories and desensitize them during memory reconsolidation.This study also evaluates the effects of this new method on the strength of addiction memories and psychological craving of female MA-dependent adolescents.The aim is to provide some theoretical basis and empirical evidence for clinical treatment of adolescent drug addiction.Materials and Methods:Two hundred meth-dependent adolescents who met the inclusion criteria at two women’s compulsory isolation drug rehabilitation facilities in Sichuan Province were selected as the study population.Researchers used self-administered general information questionnaires,the Addiction Memory Intensity Scale(AMIS),the Visual Analogue Scale(VAS),the Detoxification Motivation Scale and the Relapse Propensity Scale to conduct questionnaires on the participants.A total of 184 valid questionnaires were collected.The t test,Pearson product difference correlation analysis and PROCESS program were used to analyze the mechanism of drug withdrawal motivation,psychological craving and addictive memory on relapse tendency.Sixty female methamphetamine dependent adolescents were selected from a female compulsory isolation drug rehabilitation center in Sichuan Province,and randomly divided into intervention group and control group according to the matching principle of age,psychological craving and addiction memory intensity.The intervention group received VR based motivational reinforcement-desensitization intervention for a total of 8 times for 4 weeks,while the control group received routine drug withdrawal management.Subjective craving was evaluated by craving analog scale,physiological parameters were measured by electronic sphygmomanometer,and addictive memory intensity scale was used to evaluate addictive memory intensity.The effects of intervention were evaluated using generalized estimation equations.Results:1.Analysis of factors associated with relapse among female meth-dependent adolescents: addiction memory and psychological craving were significantly and positively correlated with the propensity to relapse(r=0.478,r=0.774,both P < 0.01);motivation to quit was significantly and negatively correlated with the propensity to relapse(r=-0.168,P < 0.05).Psychological craving partially mediated the relationship between addiction memory and relapse propensity(mediating effect value 2.132,64.9%of the total effect)and motivation to quit was significantly moderated in the relationship between psychological craving and relapse propensity(β =-0.128,P < 0.05).2.Effects of meth-related virtual reality on physiological indicators in female meth-dependent adolescents: All subjects showed a significant increase in heart rate,diastolic blood pressure and systolic blood pressure after entering a meth-related VR scenario compared to before entering a meth-related VR scenario(t=6.480,t=6.068,t=4.922,all P <0.0001).After the intervention,VAS scores,heart rate differential,diastolic differential,systolic differential and AMIS scores were significantly lower in the intervention group than in the control group(all P < 0.05),and the difference between the two groups remained significant 1 month after the end of the intervention(all P < 0.05).After the intervention and 1 month after the end of the intervention,the VAS score,heart rate difference and diastolic blood pressure difference were significantly lower than the baseline score in the intervention group(all P < 0.01);after the intervention,the systolic blood pressure difference was significantly lower than at baseline in the intervention group(P < 0.05);and 1 month after the end of the intervention,the AMIS score was significantly lower than the baseline score in the intervention group(P < 0.01).Conclusions:1.Motivation to quit,psychological craving and addiction memory all have an impact on the tendency to relapse.Psychological craving partially mediates the relationship between addiction memory and relapse propensity.Both addiction memory and psychological craving can positively predict the tendency to relapse,and addiction memory can predict the tendency to relapse both directly and through the mediating role of psychological craving.Motivation to quit moderated the relationship between psychological craving and tendency to relapse,and the positive predictive effect of psychological craving on propensity to relapse was weaker in individuals with low motivation than in those with high motivation.2.MA-related virtual reality environments can successfully induce changes in the physiological indicators of psychological craving in female meth-dependent adolescents.The virtual reality-based motivational reinforcement-desensitisation intervention was effective in reducing the psychological craving,physiological response and the intensity of addictive memoriy of female meth-dependent adolescents,and remained effective after 1 month.