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

8 mei 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Geschat)

60

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

  • Naam: Ricardo Fernandez
  • Telefoonnummer: +52 1 33 1544 5474

Studie Locaties

  • Mexico
    • Jalisco
      • Ajijic, Jalisco, Mexico, 45920
        • Comunidad Terapéutica Under The Tree
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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.

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
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.
Ander: 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Treatment Adherence - Length of Stay
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Under The Tree Therapeutic Community

Onderzoekers

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

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

15 mei 2026

Primaire voltooiing (Geschat)

26 september 2026

Studie voltooiing (Geschat)

2 oktober 2026

Studieregistratiedata

Eerst ingediend

20 april 2026

Eerst ingediend dat voldeed aan de QC-criteria

8 mei 2026

Eerst geplaatst (Werkelijk)

14 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

14 mei 2026

Laatste update ingediend die voldeed aan QC-criteria

8 mei 2026

Laatst geverifieerd

1 mei 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • DICO-CT-MX-01

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

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-tijdsbestek voor delen

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-toegangscriteria voor delen

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 delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • SAP
  • ICF
  • ANALYTIC_CODE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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