{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:15:58Z","timestamp":1781702158575,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T00:00:00Z","timestamp":1518998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001868","name":"National Science Council, Taiwan (ROC)","doi-asserted-by":"crossref","award":["NSC101-2314-B-037-057-MY3"],"award-info":[{"award-number":["NSC101-2314-B-037-057-MY3"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Heroin use is a severe problem worldwide. To develop more effective treatments for heroin abusers, a comprehensive psychosocial model of heroin use should be established and examined. We created and assessed a neuroticism, depression, attitudes, and heroin addiction (NDA) model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional study, 234 patients undergoing methadone replacement treatment were recruited from psychiatric clinics. We used Structural Equation Modeling (SEM) to assess all for neuroticism, depression, and a positive outcome expectancy (POE) (attitudes).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The full model had acceptable goodness\u2010of\u2010fit indices, but neuroticism was not significantly associated with a POE or heroin use. A reduced model that deleted insignificant paths had better goodness\u2010of\u2010fit indices, and neuroticism had indirect effects on heroin use via depression and a POE<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings provide evidence that depression, neuroticism, and POE affect heroin use. We also found that POE mediates between depression and heroin use. Despite the emotional regulation strategies recommended to help heroin abusers with depression to reduce the likelihood of their heroin use, teaching them with negative attitudes using heroin should also be considered when developing treatments for heroin abusers with depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>Our findings provide a comprehensive mechanism of addiction that is integrated with emotion, cognition, and personality. Drug\u2010related beliefs and emotional regulation can be targeted to reduce the likelihood of relapse in abusers with higher levels of neuroticism. 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