Beattie M C, Longabaugh R, Elliott G, Stout R L, Fava J, Noel N E
Center for Health Care Evaluation, Department of Veterans Affairs Medical Center, Palo Alto, Calif.
J Stud Alcohol. 1993 May;54(3):283-96. doi: 10.15288/jsa.1993.54.283.
This article describes a conceptual model developed to explain abusive use of alcohol and reports results of an initial test of that conceptualization. General social support is hypothesized to affect the level of subjective well-being, while alcohol-relevant social support affects the degree of alcohol involvement. A cross-sectional test of two models derived from this formulation was made using data from 148 alcoholic clients entering treatment at a private non-profit psychiatric facility. Results indicate that a model in which no direct relationship between alcohol involvement and subjective well-being is specified provides a more parsimonious explanation of interrelationships at the time of treatment entry. Alcohol involvement is explained by alcohol-relevant affiliative and instrumental support (albeit weakly), and subjective well-being is explained by general affiliative and instrumental social support. There is virtually no interrelationship between alcohol involvement and subjective well-being once the support variables are taken into account. The findings indicate that treatment should more often incorporate others from a client's social network, using significant others first to provide general social support and later alcohol-relevant support as well. Further analyses involving samples with more heterogeneity in levels of social investment and exploring the utility of these variables for treatment matching categorization decisions are warranted.
本文描述了一个为解释酒精滥用而开发的概念模型，并报告了该概念化的初步测试结果。假设一般社会支持会影响主观幸福感水平，而与酒精相关的社会支持会影响酒精参与程度。使用来自一家私立非营利性精神病院接受治疗的148名酗酒患者的数据，对由此公式得出的两个模型进行了横断面测试。结果表明，一个未明确规定酒精参与与主观幸福感之间直接关系的模型，能更简洁地解释治疗开始时的相互关系。酒精参与程度由与酒精相关的亲和性和工具性支持来解释（尽管很微弱），主观幸福感由一般亲和性和工具性社会支持来解释。一旦考虑到支持变量，酒精参与和主观幸福感之间几乎没有相互关系。研究结果表明，治疗应更频繁地纳入患者社交网络中的其他人，首先利用重要他人提供一般社会支持，随后也提供与酒精相关的支持。有必要进行进一步分析，涉及社会投资水平更具异质性的样本，并探索这些变量在治疗匹配分类决策中的效用。
