Epstein Elizabeth E, Drapkin Michelle L, Yusko David A, Cook Sharon M, McCrady Barbara S, Jensen Noelle K
Center of Alcohol Studies, Rutgers-The State University of New Jersey, 607 Allison Road, Piscataway, New Jersey 08854-8001, USA.
J Stud Alcohol. 2005 May;66(3):369-78. doi: 10.15288/jsa.2005.66.369.
Participants in alcohol treatment outcome studies typically undergo extensive assessment protocols to determine eligibility and provide descriptive and predictive data before beginning therapy. Changes in alcohol consumption as a result of reactivity to assessment have generally not been studied; most researchers collapse data across the pretreatment period and compare them with within-treatment and posttreatment periods. Previously we found a reduction in drinking days from 90 days prebaseline to 3 months postbaseline, with no significant additional reduction during the second 3 months of treatment, in a clinical trial of cognitive-behavioral therapy (CBT) for alcohol-dependent women. The current study examined the points at which these participants stopped or reduced their drinking during the pretreatment assessment period.
As part of a randomized clinical trial of 6 months of individual or couples CBT for 102 alcoholic women, study participants were assessed briefly via a telephone screen, a 90-minute clinical intake session with their spouses, and then a 3- to 4-hour baseline research interview.
Changes in drinking frequency occurred at all four points in the pretreatment assessment process, resulting in 44% of the participants becoming abstinent before the first session of treatment. A decrease in drinking quantity across the assessment period also was found. Participants who significantly reduced drinking prior to Session 1 demonstrated better drinking outcomes during and 12 months after treatment.
Changes in alcohol consumption during the assessment process in treatment outcome studies should be examined in future studies, as implications abound for interpretation of results from clinical trials. Also, implications regarding the active ingredients in brief interventions and mechanisms of the therapeutic impact of alcohol assessment should be further addressed.
酒精治疗效果研究的参与者通常要接受广泛的评估方案，以确定其是否符合条件，并在开始治疗前提供描述性和预测性数据。因对评估产生反应而导致的酒精摄入量变化一般未被研究过；大多数研究人员将治疗前阶段的数据合并起来，并与治疗期间和治疗后阶段的数据进行比较。此前，在一项针对酒精依赖女性的认知行为疗法（CBT）临床试验中，我们发现从基线前90天到基线后3个月饮酒天数有所减少，在治疗的第二个3个月期间没有显著的额外减少。本研究调查了这些参与者在治疗前评估期间停止或减少饮酒的时间点。
作为一项针对102名酒精成瘾女性进行的为期6个月的个体或夫妻CBT随机临床试验的一部分，研究参与者通过电话筛选、与配偶进行90分钟的临床接诊，然后进行3至4小时的基线研究访谈进行简要评估。
在治疗前评估过程的所有四个时间点都出现了饮酒频率的变化，导致44%的参与者在第一次治疗 session 前戒酒。在整个评估期间还发现饮酒量有所减少。在第1次 session 前显著减少饮酒的参与者在治疗期间和治疗后12个月表现出更好的饮酒效果。
未来的研究应考察治疗效果研究中评估过程中酒精摄入量的变化，因为这对临床试验结果的解释有诸多影响。此外，关于简短干预中的活性成分以及酒精评估的治疗影响机制的问题也应进一步探讨。
