Psychosocial predictors of substance use cravings in a rural population: An ecological momentary analysis

Abstract

The relationship between psychological factors and substance use among rural populations has not been heavily researched, despite higher risks for this population. Utilizing an ecological momentary analysis (EMA) approach, this study aims to identify the psychological correlates behind the craving cycles experienced by residents in rural Georgia who are in treatment for substance use. For this purpose, contextual and psychosocial factors of over 50 participants in recovery were recorded over a period of a month at randomized intervals with the aim of identifying factors that influence the onset of cravings. Using mixed nonlinear regression analysis, we analyzed and identified factors that were connected to the onset of cravings experienced by participants. First, it was determined that the self-reported levels of cravings of participants fluctuated over periods of two days in a cyclical manner. It was also determined that previous history with opiate use as well as episodes of recent cravings strongly influenced future occurrences of cravings. Lastly, whereas factors such as dispositional factors were not significantly related to the onset of cravings, one's degree of spirituality was correlated with a reduction in overall craving levels. Although the sample was not large, this study indicated that the utilization of an EMA alongside various statistical tools and procedures can aid in the identification of the correlates of substance abuse in rural populations. With further research the psychological and environmental factors that influence the rates of substance use can be further understood.

Keywords

Substance use, cravings, Ecological Momentary Analysis (EMA), rural populations

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Psychosocial predictors of substance use cravings in a rural population: An ecological momentary analysis

The relationship between psychological factors and substance use among rural populations has not been heavily researched, despite higher risks for this population. Utilizing an ecological momentary analysis (EMA) approach, this study aims to identify the psychological correlates behind the craving cycles experienced by residents in rural Georgia who are in treatment for substance use. For this purpose, contextual and psychosocial factors of over 50 participants in recovery were recorded over a period of a month at randomized intervals with the aim of identifying factors that influence the onset of cravings. Using mixed nonlinear regression analysis, we analyzed and identified factors that were connected to the onset of cravings experienced by participants. First, it was determined that the self-reported levels of cravings of participants fluctuated over periods of two days in a cyclical manner. It was also determined that previous history with opiate use as well as episodes of recent cravings strongly influenced future occurrences of cravings. Lastly, whereas factors such as dispositional factors were not significantly related to the onset of cravings, one's degree of spirituality was correlated with a reduction in overall craving levels. Although the sample was not large, this study indicated that the utilization of an EMA alongside various statistical tools and procedures can aid in the identification of the correlates of substance abuse in rural populations. With further research the psychological and environmental factors that influence the rates of substance use can be further understood.