Silberman School of Social Work, Hunter College, City University of New York, New York, New York, USA.
Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.
Alcohol Clin Exp Res (Hoboken). 2023 Mar;47(3):527-539. doi: 10.1111/acer.15015. Epub 2023 Mar 5.
Motivational interviewing (MI) is a widely used intervention applied to a host of health behaviors, including alcohol consumption among individuals with alcohol use disorder (AUD). Age is an underexplored moderator of MI for treating AUD, with the impact of comparing older individuals with their younger counterparts virtually unexplored. Also unexplored is whether age is associated with distinct mechanisms of change (e.g., motivation and self-efficacy) within treatment.
This secondary data analysis utilizes combined data from two previous studies (total N = 228) that both aimed to test MI's mechanisms of action in the context of a goal for moderated drinking. Both studies had three conditions: MI, nondirective listening (NDL), and a self-change condition (SC). In the current analyses, the moderating impact of continuous age and age group, <51 (younger adults, YA) versus ≥51 (older adults, OA), on the impact of MI on alcohol use compared to NDL and SC were tested using generalized linear models. Age differences in confidence and commitment to reduce heavy drinking during treatment were also explored.
Age group by condition differences emerged, where NDL significantly reduced drinking among YA but not OA (mean -12 vs. -3 standard drinks, respectively). Among OA, MI outperformed NDL but not SC, though the effect was weak. Confidence and commitment during treatment were not significantly different across age-by-condition groups.
Findings underscore the importance of understanding the impact of age on treatment effectiveness, as providing a nondirective intervention for OA with AUD could provide suboptimal treatment. Further research is needed to explore these differential effects.
动机性访谈（MI）是一种广泛应用于各种健康行为的干预措施，包括治疗酗酒者的饮酒行为。年龄是治疗酗酒的 MI 的一个未充分探讨的调节因素，几乎没有探索比较老年人和年轻人的影响。同样未探索的是，年龄是否与治疗过程中的不同变化机制（例如动机和自我效能）相关。
本二次数据分析利用了两项先前研究的综合数据（总 N=228），这两项研究均旨在测试 MI 在适度饮酒目标背景下的作用机制。这两项研究都有三个条件：MI、非指导性倾听（NDL）和自我改变条件（SC）。在当前的分析中，使用广义线性模型检验了连续年龄和年龄组（<51 岁（年轻人，YA）和≥51 岁（老年人，OA））对 MI 对酒精使用的影响与 NDL 和 SC 的调节作用。还探讨了治疗期间减少重度饮酒的信心和承诺在年龄上的差异。
出现了年龄组与条件的差异，NDL 显著减少了 YA 的饮酒量，但对 OA 没有影响（分别为-12 与-3 个标准饮品）。对于 OA，MI 优于 NDL，但不如 SC，尽管效果较弱。在治疗期间，信心和承诺在不同的年龄-条件组之间没有显著差异。
这些发现强调了了解年龄对治疗效果的影响的重要性，因为为患有 AUD 的 OA 提供非指导性干预可能提供次优的治疗。需要进一步研究来探索这些差异的影响。
