Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model) (DICO)
8 de maio de 2026 atualizado por: 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.
Visão geral do estudo
Status
Ainda não está recrutando
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Observacional
Inscrição (Estimado)
60
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Contato de estudo
- Nome: Lauro Gutiérrez Castro, Mtro.
- Número de telefone: +523314696107
- E-mail: saraqael_sefer@hotmail.com
Estude backup de contato
- Nome: Ricardo Fernandez
- Número de telefone: +52 1 33 1544 5474
Locais de estudo
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Jalisco
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Ajijic, Jalisco, México, 45920
- Comunidad Terapéutica Under The Tree
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Contato:
- Ricardo Fernandez
- Número de telefone: +52 1 33 1544 5474
- E-mail: saraqael_sefer@hotmail.com
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Não
Método de amostragem
Amostra Não Probabilística
População do estudo
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.
Descrição
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
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
|---|---|
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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.
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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.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Treatment Adherence - Length of Stay
Prazo: From admission to discharge (up to 12 weeks)
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Length of stay in treatment (number of days from admission to discharge), obtained from clinical records.
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From admission to discharge (up to 12 weeks)
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Disengagement - Total Score on Brief Disengagement Scale
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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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.
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Craving Intensity - Single-Item Scale
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Self-reported craving intensity using a single-item scale (0 to 10; 0 = no craving, 10 = extreme craving).
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Contextual Rumination - Total Score on the Brief Contextual Rumination Scale (BCRS-10)
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Total score on the Brief Contextual Rumination Scale (EBRC-10).
Range: 0 to 40.
Higher scores indicate greater rumination associated with substance use.
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
|
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Temporal Variability of Craving
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Within-participant temporal variance of craving scores derived from repeated measurements.
Higher values indicate greater instability.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Autocorrelation of Craving (Lag-1)
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Lag-1 autocorrelation coefficient of craving time series.
Higher values indicate greater temporal persistence of craving states.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)
Prazo: Week 1 (baseline) and Week 12 (discharge).
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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).
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Week 1 (baseline) and Week 12 (discharge).
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Community Cohesion - Mean Score on the Brief Cohesion Scale (RBDC-2D)
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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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.
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
|
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Perceived Social Support - Single-Item Score
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Single-item score (0 to 10): perceived support from peers or staff.
Higher scores indicate greater perceived support.
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
|
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Prosocial Behavior - Participation and Cooperation Index (RBDC-2D)
Prazo: Every 48 hours from Day 1 through Week 12 (up to 12 weeks).
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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.
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Every 48 hours from Day 1 through Week 12 (up to 12 weeks).
|
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Perceived Institutional Punitiveness - Single Item from RBDC-2D
Prazo: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
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Single-item score (0 to 10): perceived harshness or unfairness of rules or sanctions.
Higher scores indicate greater perceived punitiveness.
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Every 48 hours from Week 1 through Week 12 (up to 12 weeks)
|
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Global Network Strength derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Time Series
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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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.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Node Centrality of Craving derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Standardized Z-score representing node centrality (expected influence) of craving within the temporal network.
Higher values indicate greater influence on other variables.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Node Centrality of Contextual Rumination derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Standardized Z-score representing node centrality (expected influence) of contextual rumination (EBRC-10) within the temporal network.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Standardized Z-score representing node centrality (expected influence) of impulse/urgency within the temporal network
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
|
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Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)
Prazo: 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
|
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Node Centrality of Perceived Institutional Punitiveness - Temporal Network Analysis (gVAR Model)
Prazo: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Standardized Z-score representing node centrality (expected influence) of perceived institutional punitiveness within the temporal network.
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Derived from repeated measurements collected every 48 hours from Week 1 through Week 12
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Perceived Social Support - Total Score on Multidimensional Scale of Perceived Social Support (MSPSS)
Prazo: Week 1 (baseline), Week 4, Week 8, and Week 12
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Total score on the Multidimensional Scale of Perceived Social Support (MSPSS).
Range: 12 to 84.
Higher scores indicate greater perceived social support.
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Week 1 (baseline), Week 4, Week 8, and Week 12
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Investigador principal: Lauro Gutiérrez Castro, Mtro., Under The Tree Miller A.C.
- Investigador principal: Oswaldo Barrera Torres, Amanecer entre nubes
- Investigador principal: Erick Rodolfo Guerrero Manjarrez, Universidad Autónoma Indígena de México
- Investigador principal: Denisse Lizeth Mares Ramírez, Centro de Estudios e Investigaciones en Comportamiento (CEIC)
Publicações e links úteis
A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.
Publicações Gerais
- 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.
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Estimado)
15 de maio de 2026
Conclusão Primária (Estimado)
26 de setembro de 2026
Conclusão do estudo (Estimado)
2 de outubro de 2026
Datas de inscrição no estudo
Enviado pela primeira vez
20 de abril de 2026
Enviado pela primeira vez que atendeu aos critérios de CQ
8 de maio de 2026
Primeira postagem (Real)
14 de maio de 2026
Atualizações de registro de estudo
Última Atualização Postada (Real)
14 de maio de 2026
Última atualização enviada que atendeu aos critérios de controle de qualidade
8 de maio de 2026
Última verificação
1 de maio de 2026
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- DICO-CT-MX-01
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
SIM
Descrição do plano IPD
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.
Prazo de Compartilhamento de IPD
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.
Critérios de acesso de compartilhamento IPD
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.
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
- CIF
- ANALYTIC_CODE
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .