Sobell L C, Sobell M B, Toneatto T, Leo G I
Addiction Research Foundation, Toronto, Ontario, Canada.
Alcohol Clin Exp Res. 1993 Apr;17(2):217-24. doi: 10.1111/j.1530-0277.1993.tb00752.x.
This study investigated natural recoveries (self-change) from alcohol problems, and overcame several methodological problems that affected the few previous studies of this phenomenon. Three groups of individuals who had resolved an alcohol problem without treatment were interviewed about their drinking history, life events that occurred during the year prior to their resolution, and factors that helped maintain their resolution. As a control for prevalence of life events, a control group of nonresolved, nontreated alcohol abusers were interviewed about events in a randomly selected year. Collaterals were interviewed for all subjects. No life event or constellation of events was differentially associated with the resolutions across the three resolved groups or differentiated the resolved and nonresolved groups. Interviews with resolved subjects were qualitatively analyzed-the majority (57%) of recoveries were characterized as involving a "cognitive evaluation" or appraisal of the pros and cons of drinking. Spousal support was reported by the greatest number of resolved subjects as having helped them maintain their resolution. Findings from this study may provide direction for developing new treatment strategies and for accelerating self-change among problem drinkers in the community. The study also demonstrates the importance of using a control group, without which very different conclusions might have been drawn.
本研究调查了酒精问题的自然康复情况(自我改变),并克服了影响此前该现象少数研究的几个方法学问题。对三组未经治疗就解决了酒精问题的个体进行了访谈,了解他们的饮酒史、解决问题前一年发生的生活事件以及有助于维持戒酒状态的因素。作为生活事件发生率的对照,对一组未解决问题、未接受治疗的酗酒者在随机选择的一年中的事件进行了访谈。对所有受试者的旁证进行了访谈。在三个已解决问题的组中,没有任何生活事件或一系列事件与戒酒情况存在差异关联,也没有区分已解决问题和未解决问题的组。对已解决问题的受试者的访谈进行了定性分析——大多数(57%)康复情况的特点是涉及对饮酒利弊的“认知评估”或评价。报告称,配偶的支持对最多已解决问题的受试者维持戒酒状态起到了帮助。本研究的结果可能为制定新的治疗策略以及加速社区中问题饮酒者的自我改变提供指导。该研究还证明了使用对照组的重要性,没有对照组可能会得出非常不同的结论。