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Behavioral Rigidity in Residential Treatment for Substance Use Disorder (RIG-TD) (RIG-TD)

14 mei 2026 bijgewerkt door: Lauro Gutiérrez Castro

Behavioral Rigidity as a Transdiagnostic Dynamic Process in Patients With Substance Use Disorders: A Longitudinal Observational Study

Behavioral rigidity, the tendency to maintain inflexible patterns of thinking and acting despite changing circumstances, is a common feature in substance use disorders, depression, and anxiety. This observational study aims to measure behavioral rigidity as a dynamic, transdiagnostic process in patients undergoing residential treatment for substance use. Using a longitudinal intensive repeated-measures design, participants complete weekly assessments of cognitive reactivity (Automatic Thoughts Questionnaire-8 item version, ATQ-8), behavioral activation (Behavioral Activation for Depression Scale, BADS), and experiential avoidance. A Behavioral Rigidity Index (BRI) is derived from these measures. Additionally, natural language processing (NLP) is applied to therapy session transcripts to quantify linguistic absolutism (e.g., use of words like "always," "never") and affective polarity. Bayesian multilevel models examine whether rigidity predicts current and next-week clinical status. The study also explores whether linguistic markers add unique predictive value beyond self-reports. Results may inform personalized monitoring and interventions targeting psychological inflexibility in addiction treatment.

Studie Overzicht

Toestand

Aanmelden op uitnodiging

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This is an observational, longitudinal intensive study with repeated measures (weekly assessments) conducted in a residential therapeutic community in Mexico. Participants are adults (N=34, age 18-60) with substance use disorder and co-occurring emotional dysregulation or behavioral maladaptation, receiving standard psychosocial treatment (not assigned by the research protocol). Inclusion requires a minimum stay of four weeks, at least three complete measurement time points, and ability to complete self-reports. Exclusion criteria: severe neurocognitive impairment, acute psychotic symptoms, or incomplete longitudinal records.

Measures are collected at the beginning of each weekly therapy session:

Automatic Thoughts Questionnaire-8 (ATQ-8): frequency of negative automatic thoughts (higher scores indicate more frequent negative automatic thoughts).

Behavioral Activation for Depression Scale (BADS): subscales of Activation (goal-directed activity) and Avoidance/Rumination (experiential avoidance).

From these, a Behavioral Rigidity Index (BRI) is computed in two versions:

BRI-Simple (BRI-S): sum of standardized intraindividual scores of ATQ-8 + BADS-Avoidance - BADS-Activation.

BRI-Pondered (BRI-P): weighted combination derived from principal component analysis of the three standardized scores. The first principal component explained the majority of the common variance, supporting unidimensionality of the construct.

Additionally, natural language processing (NLP) pipelines are applied to transcribed therapy sessions and self-registries. Text is tokenized, lemmatized, and normalized by document length. Four linguistic domains are extracted:

Affective polarity: density of negative/positive terms.

Linguistic absolutism: frequency of extreme quantifiers (e.g., "always", "never", "everything", "nothing").

Grammatical agency: proportion of active vs. passive voice sentences.

Lexical complexity: type-token ratio and entropy.

A Linguistic Rigidity Index (LRI) is created by standardizing and averaging absolutism scores and inverted negative polarity (higher LRI = greater linguistic rigidity).

Statistical analysis uses Bayesian multilevel models with random intercepts by participant. The outcome variable is intraindividual standardized ATQ-8 (ATQ8_total_z). Predictors include time in treatment, BRI (contemporary and lagged by one week), and LRI. Model comparison will be performed using information criteria appropriate for multilevel models. Secondary analyses explore dynamic systems metrics derived from the state space defined by ATQ-8 and BRI-P, such as deviation from typical states and return speed after disturbances.

All procedures comply with the Declaration of Helsinki. The protocol was approved by the institutional ethics committee (Comité de Ética en Investigación de la Comunidad Terapéutica Under The Tree). Participants gave informed consent for anonymized use of their clinical data for research purposes.

Studietype

Observationeel

Inschrijving (Geschat)

35

Contacten en locaties

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

Studie Locaties

  • Mexico
    • Jalisco
      • Potrerillos, Jalisco, Mexico, 45815
        • Under The Tree Potrerillos

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

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

Adult patients (age 18-60) with substance use disorder and co-occurring emotional dysregulation or behavioral maladaptation, admitted to a residential therapeutic community in Mexico. The sample includes both sexes, with an expected predominance of males (approximately 85%). Participants are receiving standard psychosocial treatment, including individual and group therapy, 12-step facilitation, and occupational activities. No healthy volunteers are included.

Beschrijving

Inclusion Criteria:

  • Minimum stay of four weeks in the residential treatment program
  • At least three complete longitudinal measurement time points
  • Ability to read, understand, and respond to self-report instruments in Spanish
  • Capacity to participate in structured clinical sessions
  • Diagnosis of substance use disorder (clinical assessment)

Exclusion Criteria:

  • Severe neurocognitive impairment
  • Acute psychotic symptoms
  • Incomplete longitudinal records (less than three time points)
  • Inability to complete self-report measures due to cognitive or language barriers

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
Participants with Substance Use Disorder
Adult patients (n=34) receiving standard residential treatment for substance use disorder in a therapeutic community. All participants undergo weekly assessments of cognitive reactivity (Automatic Thoughts Questionnaire-8 item version, ATQ-8), behavioral activation (Behavioral Activation for Depression Scale, BADS), and natural language processing (NLP) of therapy session transcripts.
Ander: No intervention
This is an observational study; no experimental intervention is administered. Participants continue their standard residential treatment as usual, which includes psychosocial therapy, 12-step facilitation, and occupational activities.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in negative automatic thoughts measured by the Automatic Thoughts Questionnaire 8-item version
Tijdsspanne: Weekly from baseline until discharge from treatment (up to 12 weeks)
The Automatic Thoughts Questionnaire 8-item version is a self-report measure assessing the frequency of negative automatic thoughts. Total scores range from 8 to 40, with higher scores indicating more frequent negative automatic thoughts. Longitudinal change in total score across treatment is evaluated as the primary outcome.
Weekly from baseline until discharge from treatment (up to 12 weeks)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Behavioral Rigidity Index - Pondered (study-derived composite index)
Tijdsspanne: Weekly from baseline until discharge (up to 12 weeks)
Study-derived composite index calculated from standardized longitudinal measures of negative automatic thoughts, behavioral activation, and avoidance/rumination. Higher scores indicate greater behavioral and cognitive rigidity across time.
Weekly from baseline until discharge (up to 12 weeks)
Behavioral activation measured by the Behavioral Activation for Depression Scale Activation subscale
Tijdsspanne: Weekly from baseline until discharge (up to 12 weeks)
The Activation subscale of the Behavioral Activation for Depression Scale assesses engagement in goal-directed activity and environmental reinforcement. Higher scores indicate greater behavioral activation.
Weekly from baseline until discharge (up to 12 weeks)
Avoidance and rumination measured by the Behavioral Activation for Depression Scale Avoidance/Rumination subscale
Tijdsspanne: Weekly from baseline until discharge (up to 12 weeks)
The Avoidance/Rumination subscale of the Behavioral Activation for Depression Scale assesses experiential avoidance and rumination-related behaviors. Higher scores indicate greater avoidance and rumination.
Weekly from baseline until discharge (up to 12 weeks)
Linguistic Rigidity Index derived from therapy session transcripts
Tijdsspanne: Weekly from baseline until discharge (up to 12 weeks)
Study-derived linguistic index calculated from automated natural language processing of therapy session transcripts, including frequencies of absolutist language and negative affective polarity. Higher scores indicate greater linguistic rigidity.
Weekly from baseline until discharge (up to 12 weeks)
Change in anxiety symptoms measured by the Generalized Anxiety Disorder 7-item scale
Tijdsspanne: Weekly from baseline until discharge (up to 12 weeks)
The Generalized Anxiety Disorder 7-item scale assesses severity of anxiety symptoms. Total scores range from 0 to 21, with higher scores indicating greater anxiety severity.
Weekly from baseline until discharge (up to 12 weeks)

Medewerkers en onderzoekers

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

Sponsor

Lauro Gutiérrez Castro

Onderzoekers

  • Hoofdonderzoeker: Lauro Gutiérrez Castro, Under The Tree Therapeutic Community

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 (Werkelijk)

25 mei 2025

Primaire voltooiing (Werkelijk)

15 april 2026

Studie voltooiing (Geschat)

1 juli 2026

Studieregistratiedata

Eerst ingediend

9 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

9 mei 2026

Eerst geplaatst (Werkelijk)

15 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

18 mei 2026

Laatste update ingediend die voldeed aan QC-criteria

14 mei 2026

Laatst geverifieerd

1 mei 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • IRC-P-CTUT-001

Plan Individuele Deelnemersgegevens (IPD)

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

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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