Hallford H Gene, Tivis Rick D, Nixon Sara Jo
Oklahoma Center for Alcohol and Drug-related Studies, University of Oklahoma Health Sciences Center, 800 NE 15th Street, Suite 410, Oklahoma City, OK 73104, USA.
Psychiatry Res. 2003 Dec 1;121(2):197-205. doi: 10.1016/s0165-1781(03)00221-x.
Substance abuse treatment programs have long contended that any post-treatment alcohol use is indicative of relapse. Recent studies, however, suggest more inclusive definitions. Zweben and Cisler (1996, 1999) consider both the drinking quantity and negative drinking consequences. Their proposed cutoffs integrate the 1995 NIAAA guidelines for sensible and high risk drinking levels with the objective assessment of drinking-related consequences into the definition of relapse. Our study applied this model to a group of detoxified alcoholics in a post-treatment followup project. We asked if: (1) Zweben and Cisler's drinking categories could be found in our sample; (2) whether subgroups defined by post-treatment drinking patterns differed with respect to their pre-treatment alcohol consumption levels, years of alcoholic drinking and drinking related problems; and (3) whether post-treatment drinking patterns were associated with differential psychosocial functioning at followup. Thirteen percent of the total sample (N=61) was found to meet Zweben and Cisler's moderate drinking category; 34% were abstinent, 27% heavy drinkers and 13 participants (26%) were unclassifiable. At treatment completion (T1), those who became moderate drinkers reported higher levels of self-confidence, but were otherwise similar to both abstainers and heavy drinkers. At followup (T2), approximately 1 year after initial testing (T1), groups differed on measures of emotional discharge, avoidance and logical coping skills and information seeking, suggesting a possible association between post-treatment drinking patterns and psychosocial functioning.
长期以来，药物滥用治疗项目一直认为，治疗后任何饮酒行为都表明复发。然而，最近的研究提出了更具包容性的定义。兹韦本和西斯勒（1996年、1999年）考虑了饮酒量和饮酒的负面后果。他们提议的临界值将1995年美国国家酒精滥用与酒精中毒研究所关于适度饮酒和高风险饮酒水平的指导方针与对饮酒相关后果的客观评估纳入复发的定义中。我们的研究将该模型应用于一个治疗后随访项目中的一组戒酒者。我们询问：（1）在我们的样本中是否能找到兹韦本和西斯勒的饮酒类别；（2）由治疗后饮酒模式定义的亚组在治疗前的酒精消费水平、饮酒年限和饮酒相关问题方面是否存在差异；（3）治疗后饮酒模式在随访时是否与不同的心理社会功能相关。在总样本（N = 61）中，13%的人符合兹韦本和西斯勒的适度饮酒类别；34%的人戒酒，27%的人大量饮酒，13名参与者（26%）无法分类。在治疗结束时（T1），那些成为适度饮酒者的人报告了更高的自信心，但在其他方面与戒酒者和大量饮酒者相似。在随访时（T2），即初始测试（T1）大约1年后，各组在情绪宣泄、回避、逻辑应对技能和信息寻求等测量指标上存在差异，这表明治疗后饮酒模式与心理社会功能之间可能存在关联。
