Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model) (DICO)
2026년 5월 8일 업데이트: 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.
연구 개요
상세 설명
The study integrates three analytical levels:
- Individual behavioral processes (e.g., craving, psychological flexibility)
- Community-level dynamics (e.g., cohesion, reinforcement contingencies)
- 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.
연구 유형
관찰
등록 (추정된)
60
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Lauro Gutiérrez Castro, Mtro.
- 전화번호: +523314696107
- 이메일: saraqael_sefer@hotmail.com
연구 연락처 백업
- 이름: Ricardo Fernandez
- 전화번호: +52 1 33 1544 5474
연구 장소
-
-
Jalisco
-
Ajijic, Jalisco, 멕시코, 45920
- Comunidad Terapéutica Under The Tree
-
연락하다:
- Ricardo Fernandez
- 전화번호: +52 1 33 1544 5474
- 이메일: saraqael_sefer@hotmail.com
-
-
참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
아니
샘플링 방법
비확률 샘플
연구 인구
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.
설명
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
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
코호트 및 개입
그룹/코호트 |
개입 / 치료 |
|---|---|
|
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.
|
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.
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Treatment Adherence - Length of Stay
기간: 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
기간: 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
기간: 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)
기간: 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
기간: 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)
기간: 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
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)
기간: 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)
기간: 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
기간: 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)
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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)
기간: 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)
기간: 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)
기간: 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)
기간: 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
|
공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Lauro Gutiérrez Castro, Mtro., Under The Tree Miller A.C.
- 수석 연구원: Oswaldo Barrera Torres, Amanecer entre nubes
- 수석 연구원: Erick Rodolfo Guerrero Manjarrez, Universidad Autónoma Indígena de México
- 수석 연구원: Denisse Lizeth Mares Ramírez, Centro de Estudios e Investigaciones en Comportamiento (CEIC)
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. doi: 10.1146/annurev.clinpsy.3.022806.091415.
- Borsboom D, Cramer AO. Network analysis: an integrative approach to the structure of psychopathology. Annu Rev Clin Psychol. 2013;9:91-121. doi: 10.1146/annurev-clinpsy-050212-185608.
- Scheffer M, Bascompte J, Brock WA, Brovkin V, Carpenter SR, Dakos V, Held H, van Nes EH, Rietkerk M, Sugihara G. Early-warning signals for critical transitions. Nature. 2009 Sep 3;461(7260):53-9. doi: 10.1038/nature08227.
- Hofmann SG, Hayes SC. The Future of Intervention Science: Process-Based Therapy. Clin Psychol Sci. 2019 Jan;7(1):37-50. doi: 10.1177/2167702618772296. Epub 2018 May 29.
- Korecki JR, Schwebel FJ, Votaw VR, Witkiewitz K. Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Subst Abuse Treat Prev Policy. 2020 Jul 29;15(1):51. doi: 10.1186/s13011-020-00293-3.
- Society for Community Research and Action-Community Psychology, Division 27 of the American Psychological Association. The role of recovery residences in promoting long-term addiction recovery. Am J Community Psychol. 2013 Dec;52(3-4):406-11. doi: 10.1007/s10464-013-9602-6. No abstract available.
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (추정된)
2026년 5월 15일
기본 완료 (추정된)
2026년 9월 26일
연구 완료 (추정된)
2026년 10월 2일
연구 등록 날짜
최초 제출
2026년 4월 20일
QC 기준을 충족하는 최초 제출
2026년 5월 8일
처음 게시됨 (실제)
2026년 5월 14일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 5월 14일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 5월 8일
마지막으로 확인됨
2026년 5월 1일
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- DICO-CT-MX-01
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
예
IPD 계획 설명
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 공유 기간
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 공유 액세스 기준
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.
IPD 공유 지원 정보 유형
- 연구_프로토콜
- 수액
- ICF
- ANALYTIC_CODE
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
아니
미국 FDA 규제 기기 제품 연구
아니
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .