Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA.
J Stud Alcohol Drugs. 2010 Nov;71(6):930-7. doi: 10.15288/jsad.2010.71.930.
This study tested an integrated relapse model drawing hypotheses from both interpersonal and intra-individual relapse models. It was hypothesized that the relationships between alcohol-specific social support (support for drinking and support for not drinking) and drinking outcomes would be partially mediated by motivation.
Participants were 158 women with alcohol use disorders participating in two linked randomized controlled trials. One trial compared standard individual cognitive behavioral therapy (CBT) for alcohol use disorders with female-specific CBT for alcohol use disorders; the other compared alcohol behavioral couple therapy with blended individual CBT and alcohol behavioral couple therapy. Measures included the Important People Interview to measure social-support variables, the Timeline Followback to measure drinking variables, and the Stages of Change Readiness and Treatment Eagerness Scale to measure motivation.
Results of structural equation modeling suggested a mediational role of motivation in the relationship between support for drinking and drinking frequency. Individuals with more network support for drinking at baseline had less motivation for abstinence at the end of treatment, which predicted drinking frequency over the 6 months after treatment. The indirect effect of baseline support for drinking on 6-month follow-up drinking frequency was statistically significant. A similar, although only marginally significant, pattern was found for the relationship between support for not drinking and drinking frequency. Individuals with more social network for not drinking at baseline had more motivation at the end of treatment at the trend level, which in turn predicted 6-month follow-up drinking frequency. The indirect effect of baseline support for not drinking on 6-month follow-up drinking frequency trended toward significance.
This study offers preliminary evidence that motivation is one mechanism by which abstinence-specific social support affects treatment outcome.
本研究通过整合人际间和个体内复发模型来检验一个复发模型。研究假设，特定于酒精的社会支持（支持饮酒和支持不饮酒）与饮酒结果之间的关系将部分通过动机来介导。
参与者是 158 名患有酒精使用障碍的女性，她们参加了两项相互关联的随机对照试验。一项试验比较了标准的个体认知行为疗法（CBT）治疗酒精使用障碍与女性特异性 CBT 治疗酒精使用障碍；另一项试验比较了酒精行为夫妻治疗与混合个体 CBT 和酒精行为夫妻治疗。测量包括重要人物访谈来测量社会支持变量，时间线回溯来测量饮酒变量，以及阶段变化准备和治疗渴望量表来测量动机。
结构方程模型的结果表明，动机在支持饮酒与饮酒频率之间的关系中起着中介作用。基线时网络中支持饮酒的人越多，治疗结束时戒酒的动机越低，这预示着治疗结束后 6 个月内的饮酒频率。基线时支持饮酒对 6 个月随访饮酒频率的间接影响具有统计学意义。虽然只是略有显著，但支持不饮酒与饮酒频率之间的关系也呈现出类似的模式。基线时社会网络中支持不饮酒的人越多，治疗结束时的动机越强，这反过来又预示着 6 个月随访时的饮酒频率。基线时支持不饮酒对 6 个月随访饮酒频率的间接影响有显著趋势。
本研究提供了初步证据，表明动机是戒酒特异性社会支持影响治疗结果的机制之一。
