With the growing recognition that, for some, significant changes in drinking occur before the fi rst treatment session (i.e., pretreatment change), researchers have called for the careful assessment of when change occurs and its potential impact on mechanism of behavior change (MOBC) research. Using a commonly hypothesized MOBC variable, alcohol abstinence self-efficacy, the primary aim of this study was to examine the effect of pretreatment change on the study of MOBCs. Method: Sixty-three individuals diagnosed with alcohol dependence were recruited to participate in a 12-week cognitive-behavioral treatment. Participants completed weekly assessments of self-efficacy and drinking behaviors. Results: Multilevel time-lagged regression models indicated that pretreatment change significantly moderated the effect of self-efficacy on the number of drinking days, such that among those higher on pretreatment change, higher self-efficacy ratings predicted lower rates of drinking days in the week until the next treatment session. In contrast, pretreatment change did not moderate the effect of self-efficacy on the rate of heavy drinking days. Conclusions: Results from the current study add to a small but growing body of research highlighting the importance of pretreatment change when studying MOBCs. Further, these results provide important insights into the conditions in which self-efficacy may play an important role in treatment outcomes.

Results are consistent with previous studies demonstrating the high prevalence of medical comorbidities following traumatic brain injury and extend these findings to veterans and service members. This study suggests that medical comorbidities may have a cumulative impact on poor psychological health after traumatic brain injury. Rehabilitation professionals and other treatment providers should screen for and treat medical conditions as part of a synergistic approach to post-TBI care.

No abstract

No abstract

Background:The Approach and Avoidance of Alcohol questionnaire (AAAQ) was developed as a measure of craving to assess both desires to consume and desires to avoid consuming alcohol. Although the measure has been used in a variety of populations to predict future alcohol use behavior, the factor structures observed varies based on sample type (e.g., clinical versus college samples) and may be overly long for use in repeated measure designs. The current article describes the development of a brief version of the AAAQ for use in clinical populations.Methods: Using existing data sets of individuals in treatment for alcohol use disorder, exploratory analyses (e.g. exploratory factor analysis and item response theory) were conducted using an inpatient sample (N=298) at a substance abuse treatment facility. Confirmatory analyses (e.g., confirmatory factor analysis and multiple regression) were conducted using an inpatient detoxification sample (N=175) and a longitudinal outpatient treatment sample (N=53). Results:The brief AAAQ had comparable internal consistency, explained a similar amount of variance in alcohol consumption and related problems, and exhibited superior model fit as compared to the original measure.