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Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model) (DICO)

8. Mai 2026 aktualisiert von: Lauro Gutiérrez Castro, Under The Tree Therapeutic Community

Comprehensive Behavioral Community Dynamics (DICO): A Prospective Longitudinal Study of Multilevel Community Processes in Therapeutic Communities for Substance Use Treatment in Mexico

This study aims to develop and empirically evaluate the Dinámica Integral Conductual Comunitaria (DICO) model, a multilevel framework that conceptualizes recovery from substance use disorders as a dynamic process emerging from the interaction between individual behavioral variables, social contingencies, and community-level factors within therapeutic communities in Mexico.

A prospective longitudinal design with intensive repeated measures will be implemented over 8 to 12 weeks. Data will be collected using ecological momentary assessment (EMA), psychometric instruments, behavioral records, and semi-structured interviews.

The study seeks to model recovery trajectories as nonlinear dynamic systems, identifying critical transitions, instability patterns, and contextual moderators associated with treatment adherence and relapse risk.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

The study integrates three analytical levels:

  1. Individual behavioral processes (e.g., craving, psychological flexibility)
  2. Community-level dynamics (e.g., cohesion, reinforcement contingencies)
  3. Cultural-contextual factors relevant to Mexican therapeutic communities

Quantitative data will be collected through high-frequency EMA and longitudinal assessments, enabling the estimation of dynamic parameters using nonlinear modeling techniques (e.g., differential equations, network analysis).

Qualitative data from semi-structured interviews will provide contextual interpretation of observed behavioral trajectories and system transitions.

The study does not involve manipulation or assignment to interventions; it is designed to observe naturally occurring processes within residential treatment settings.

Studientyp

Beobachtungs

Einschreibung (Geschätzt)

60

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

  • Name: Ricardo Fernandez
  • Telefonnummer: +52 1 33 1544 5474

Studienorte

  • Mexiko
    • Jalisco
      • Ajijic, Jalisco, Mexiko, 45920
        • Comunidad Terapéutica Under The Tree
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

Adult individuals undergoing residential treatment for substance use disorders in therapeutic communities in Mexico. The population is characterized by varying levels of substance dependence severity, psychosocial vulnerability, and exposure to structured community-based treatment environments that emphasize behavioral regulation, peer support, and institutional norms.

Participants are embedded in a communal living setting where daily routines, social interactions, and reinforcement contingencies are structured by the therapeutic model, providing a naturalistic context for observing multilevel behavioral and recovery processes.

Beschreibung

Inclusion Criteria:

  • Adults aged 18 years or older
  • Currently enrolled in a residential therapeutic community for substance use treatment
  • Minimum stay of at least 7 days prior to baseline assessment
  • Ability to understand and provide informed consent
  • Expected availability for participation during the 8-12 week follow-up period

Exclusion Criteria:

  • Acute psychotic symptoms or severe psychiatric decompensation that interferes with participation
  • Severe cognitive impairment limiting comprehension of study procedures
  • Current medical instability requiring immediate external intervention
  • Refusal to participate in any component of the study

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Kohorten und Interventionen

Gruppe / Kohorte
Intervention / Behandlung
Therapeutic Community Residents
Adult residents undergoing residential treatment for substance use in therapeutic communities in Mexico. Participants are followed prospectively for 8-12 weeks using intensive longitudinal assessment, including ecological momentary assessment (EMA), psychometric measures, behavioral logs, and qualitative interviews. No experimental manipulation or assignment to interventions is performed.
Sonstiges: Ecological Momentary Assessment (EMA)
Real-time data collection method using mobile devices to assess momentary fluctuations in craving, psychological flexibility, and social context multiple times per day. This procedure is used for observational measurement only and does not constitute a therapeutic intervention.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Treatment Adherence - Length of Stay
Zeitfenster: From admission to discharge (up to 12 weeks)
Length of stay in treatment (number of days from admission to discharge), obtained from clinical records.
From admission to discharge (up to 12 weeks)
Disengagement - Total Score on Brief Disengagement Scale
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Total score on the Brief Disengagement Scale (3 items, each scored from 0 to 10; total range: 0 to 30). Higher scores indicate greater disengagement from treatment.
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Craving Intensity - Single-Item Scale
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Self-reported craving intensity using a single-item scale (0 to 10; 0 = no craving, 10 = extreme craving).
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Contextual Rumination - Total Score on the Brief Contextual Rumination Scale (BCRS-10)
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Total score on the Brief Contextual Rumination Scale (EBRC-10). Range: 0 to 40. Higher scores indicate greater rumination associated with substance use.
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Temporal Variability of Craving
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Within-participant temporal variance of craving scores derived from repeated measurements. Higher values indicate greater instability.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Autocorrelation of Craving (Lag-1)
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Lag-1 autocorrelation coefficient of craving time series. Higher values indicate greater temporal persistence of craving states.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)
Zeitfenster: Week 1 (baseline) and Week 12 (discharge).
Total score on the Acceptance and Action Questionnaire-II (AAQ-II). Range: 7 to 49 points. A higher score indicates a worse outcome (greater experiential avoidance, lower psychological flexibility).
Week 1 (baseline) and Week 12 (discharge).
Community Cohesion - Mean Score on the Brief Cohesion Scale (RBDC-2D)
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Mean score of two items (each scored 0 to 10): perceived group belonging and trust in peers, derived from the Brief Community Dynamics Record (RBDC-2D). Range: 0 to 10. Higher scores indicate greater cohesion.
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Perceived Social Support - Single-Item Score
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Single-item score (0 to 10): perceived support from peers or staff. Higher scores indicate greater perceived support.
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Prosocial Behavior - Participation and Cooperation Index (RBDC-2D)
Zeitfenster: Every 48 hours from Day 1 through Week 12 (up to 12 weeks).
Composite index calculated as the sum of three items (each scored 0 to 3): participation in activities, cooperation with peers, and mutual help. Total range: 0 to 9. Higher scores indicate greater prosocial behavior.
Every 48 hours from Day 1 through Week 12 (up to 12 weeks).
Perceived Institutional Punitiveness - Single Item from RBDC-2D
Zeitfenster: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Single-item score (0 to 10): perceived harshness or unfairness of rules or sanctions. Higher scores indicate greater perceived punitiveness.
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
Global Network Strength derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Time Series
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Global strength (sum of absolute edge weights) estimated using graphical vector autoregression (gVAR). Unit: standardized Z-score. Higher values indicate greater overall connectivity among behavioral variables.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Node Centrality of Craving derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Standardized Z-score representing node centrality (expected influence) of craving within the temporal network. Higher values indicate greater influence on other variables.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Node Centrality of Contextual Rumination derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Standardized Z-score representing node centrality (expected influence) of contextual rumination (EBRC-10) within the temporal network.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Standardized Z-score representing node centrality (expected influence) of impulse/urgency within the temporal network
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Standardized Z-score representing node centrality (expected influence) of disengagement within the temporal network.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Node Centrality of Perceived Institutional Punitiveness - Temporal Network Analysis (gVAR Model)
Zeitfenster: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Standardized Z-score representing node centrality (expected influence) of perceived institutional punitiveness within the temporal network.
Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
Perceived Social Support - Total Score on Multidimensional Scale of Perceived Social Support (MSPSS)
Zeitfenster: Week 1 (baseline), Week 4, Week 8, and Week 12
Total score on the Multidimensional Scale of Perceived Social Support (MSPSS). Range: 12 to 84. Higher scores indicate greater perceived social support.
Week 1 (baseline), Week 4, Week 8, and Week 12

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Under The Tree Therapeutic Community

Ermittler

  • Hauptermittler: Lauro Gutiérrez Castro, Mtro., Under The Tree Miller A.C.
  • Hauptermittler: Oswaldo Barrera Torres, Amanecer entre nubes
  • Hauptermittler: Erick Rodolfo Guerrero Manjarrez, Universidad Autónoma Indígena de México
  • Hauptermittler: Denisse Lizeth Mares Ramírez, Centro de Estudios e Investigaciones en Comportamiento (CEIC)

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

15. Mai 2026

Primärer Abschluss (Geschätzt)

26. September 2026

Studienabschluss (Geschätzt)

2. Oktober 2026

Studienanmeldedaten

Zuerst eingereicht

20. April 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

8. Mai 2026

Zuerst gepostet (Tatsächlich)

14. Mai 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

14. Mai 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

8. Mai 2026

Zuletzt verifiziert

1. Mai 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • DICO-CT-MX-01

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

De-identified individual participant data (IPD) underlying the results reported in this study will be available, including ecological momentary assessment (EMA) data, psychometric measures, and behavioral records.

Data will be provided in a secure, encrypted format along with associated metadata, codebooks, and documentation necessary to reproduce the dynamic and network-based analyses.

IPD-Sharing-Zeitrahmen

De-identified individual participant data and supporting materials will be available beginning 6 months after study completion and will remain accessible for 5 years following publication of the primary results.

IPD-Sharing-Zugriffskriterien

Access to de-identified individual participant data (IPD) and supporting materials will be granted to qualified researchers affiliated with academic or clinical institutions. Requests must include a brief research proposal outlining objectives, methodology, and intended use of the data. Proposals will be reviewed by an independent committee to ensure scientific merit and ethical compliance. Approved users will have access to de-identified datasets, metadata, codebooks, and analytic code necessary for reproducibility. Data will be provided via secure, encrypted transfer after execution of a Data Sharing Agreement (DSA) prohibiting re-identification and unauthorized redistribution.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF
  • ANALYTIC_CODE

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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