Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, USA.
Alcohol Alcohol. 2021 Jan 4;56(1):57-63. doi: 10.1093/alcalc/agaa098.
Natural processes of change have been documented in treatment-seekers who begin to reduce their drinking in anticipation of treatment. The study examined whether non-treatment-seeking problem drinkers would engage in drinking reduction in anticipation of participating in a research study.
Non-treatment-seeking problem drinkers (n = 935) were culled from five behavioral pharmacology studies. Participants reported on their alcohol use during the past 30 days using the Timeline Followback. Cluster analysis identified distinct groups/clusters based on drinking patterns over the 30-day pre-visit period. The identified clusters were compared on demographic and clinical measures.
Three distinct clusters were identified (a) heavy-decreasing drinking group (n = 255, 27.27%); (b) a moderate-stable drinking group (n = 353, 37.75%) and (c) low-stable drinking group (n = 327, 34.97%). The three clusters differed significantly on a host of measures including pre-visit drinking (age at first drink, drinking days, drinks per week, drinks per drinking day), alcohol use severity, alcohol craving, readiness for change, depression and anxiety levels. These differences were alcohol dose-dependent such that the heavier drinking group reported the highest levels on all constructs, followed by the moderate group, and the low drinking group last.
Baseline drinking patterns of non-treatment-seekers were generally stable and pre-visit reductions were only observed among the heavy drinking group. This generally stable pattern stands in contrast to previous reports for treatment-seeking samples. Nevertheless, the heavier drinking group, which is most similar to treatment-seekers, displayed pre-study drinking reduction. Overall, naturalistic processes of change may pose less of a threat to randomization and testing in this population.
已有研究记录了治疗前开始减少饮酒以期接受治疗的治疗寻求者的自然变化过程。本研究旨在检验非治疗寻求的问题饮酒者是否会在参与研究前减少饮酒。
从五项行为药理学研究中筛选出非治疗寻求的问题饮酒者（n=935）。参与者使用 Timeline Followback 在过去 30 天内报告他们的饮酒情况。聚类分析根据 30 天访前期间的饮酒模式确定不同的组/聚类。对确定的聚类进行比较，比较的指标包括人口统计学和临床指标。
确定了三个不同的聚类：（a）大量减少饮酒组（n=255，27.27%）；（b）中度稳定饮酒组（n=353，37.75%）和（c）低度稳定饮酒组（n=327，34.97%）。三个聚类在大量指标上存在显著差异，包括访前饮酒（首次饮酒年龄、饮酒天数、每周饮酒量、每次饮酒日饮酒量）、酒精使用严重程度、酒精渴求、改变的意愿、抑郁和焦虑水平。这些差异与酒精剂量有关，即饮酒量越高的组报告的所有结构水平越高，其次是中度饮酒组，最后是低度饮酒组。
非治疗寻求者的基线饮酒模式通常是稳定的，仅在大量饮酒组中观察到访前减少。这种普遍稳定的模式与以前针对治疗寻求者样本的报告形成鲜明对比。然而，与治疗寻求者最相似的大量饮酒组表现出研究前饮酒减少。总体而言，自然变化过程对该人群的随机化和测试的威胁可能较小。
