McAweeney Mary J, Zucker Robert A, Fitzgerald Hiram E, Puttler Leon I, Wong Maria M
Department of Psychiatry and Addiction Research Center, University of Michigan, Ann Arbor, Michigan, USA.
J Stud Alcohol. 2005 Mar;66(2):220-8. doi: 10.15288/jsa.2005.66.220.
Numerous studies have focused on the predictors of recovery in persons with alcohol use disorder (AUD). Most have been retrospective and have measured only predictors of short-term recovery after the completion of treatment. This prospective study evaluates the role of psychological and social factors in a community sample of both alcoholics and their partners in predicting recovery over a 9-year interval.
Alcoholic diagnostic status and life functioning of 134 community-recruited, initially coupled men meeting criteria for a 3-year Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AUD diagnosis at baseline were assessed over the 9-year period. Their partners also were assessed. Prediction involved comparing those who still had an AUD diagnosis at 9-year follow-up against those who no longer met AUD criteria.
Predictors of recovery included number of experiences with treatment, education, number of years of intervening recovery over the follow-up period, partner baseline AUD status and partner's social support network. Alcoholics' initial severity of drinking did not predict long-term outcome. Furthermore, recovered men's partners decreased their AUD in the interim, whereas nonremitters' partners increased their AUD. The findings highlight the transitions in and out of AUD, with 62% of the men having stable drinking patterns of either remission or unremitting AUD diagnosis over the entire follow-up period.
This study demonstrated the importance of interpersonal factors in maintaining AUD or promoting recovery. Consideration of partner characteristics and the marital context as factors in the recovery process is essential. Future research should examine the predictors of recovery in women, in adolescents and in racial groups other than white.
众多研究聚焦于酒精使用障碍(AUD)患者康复的预测因素。大多数研究为回顾性研究,且仅测量了治疗结束后短期康复的预测因素。这项前瞻性研究评估了心理和社会因素在一个由酗酒者及其伴侣组成的社区样本中对9年期间康复情况的预测作用。
对134名从社区招募的、最初为已婚的男性进行了为期9年的评估,这些男性在基线时符合《精神障碍诊断与统计手册》第四版中3年AUD诊断标准,评估内容包括酒精诊断状况和生活功能。他们的伴侣也接受了评估。预测涉及将9年随访时仍有AUD诊断的人与不再符合AUD标准的人进行比较。
康复的预测因素包括治疗经历次数、教育程度、随访期间干预康复的年数、伴侣基线AUD状况以及伴侣的社会支持网络。酗酒者最初的饮酒严重程度并不能预测长期结果。此外,康复男性的伴侣在这期间AUD有所减轻,而未康复者的伴侣AUD有所增加。研究结果突出了AUD的进进出出,62%的男性在整个随访期间饮酒模式稳定,要么处于缓解状态,要么持续有AUD诊断。
本研究证明了人际因素在维持AUD或促进康复方面的重要性。在康复过程中考虑伴侣特征和婚姻背景作为因素至关重要。未来的研究应考察女性、青少年以及非白人种族群体康复的预测因素。