BackgroundOvercoming Addictions (OA) is an abstinence-oriented, cognitive behavioral, Web application based on the program of SMART Recovery. SMART Recovery is an organization that has adapted empirically supported treatment strategies for use in a mutual help framework with in-person meetings, online meetings, a forum, and other resources.ObjectiveTo evaluate the effectiveness of OA and SMART Recovery (SR) with problem drinkers who were new to SMART Recovery. Our experimental hypotheses were: (1) all groups will reduce their drinking and alcohol/drug-related consequences at follow-up compared to their baseline levels, (2) the OA condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR), and (3) the OA+SR condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR only).MethodsWe recruited 189 heavy problem drinkers primarily through SMART Recovery’s website and in-person meetings throughout the United States. We randomly assigned participants to (1) OA alone, (2) OA+attend SMART Recovery (SR) meetings (OA+SR), or (3) attend SR only. Baseline and follow-ups were conducted via GoToMeeting sessions with a Research Assistant (RA) and the study participant. We interviewed significant others to corroborate the participant’s self-report. Primary outcome measures included percent days abstinent (PDA), mean drinks per drinking day (DDD), and alcohol/drug-related consequences.ResultsThe intent-to-treat analysis of the 3-month outcomes supported the first hypothesis but not the others. Participants in all groups significantly increased their percent days abstinent from 44% to 72% (P<.001), decreased their mean drinks per drinking day from 8.0 to 4.6 (P<.001), and decreased their alcohol/drug-related problems (P<.001). Actual use relationships were found for the OA groups, between SR online meetings and improvement in PDA (r=.261, P=.033). In addition in the OA groups, the number of total sessions of support (including SR & other meetings, counselor visits) was significantly related to PDA (r=.306, P=012) and amount of improvement in alcohol-related problems (r=.305, P=.012). In the SR only group, the number of face-to-face meetings was significantly related to all three dependent variables, and predicted increased PDA (r=.358, P=.003), fewer mean DDD (r=-.250, P=.039), and fewer alcohol-related problems (r=-.244, P=.045), as well as to the amount of improvement in all three of these variables. Six-month follow-ups have been completed, and the results are currently being analyzed.ConclusionsThese results support our first experimental hypothesis but not the second or third. All groups significantly increased their PDA and decreased both their mean DDD and their alcohol-related problems, which indicates that both interventions being investigated were equally effective in helping people recover from their problem drinking.Trial RegistrationClinicaltrials.gov NCT01389297; http://clinicaltrials.gov/ct2/show/NCT01389297 (Archived by ...
Objective To evaluate the effectiveness of a computer-delivered intervention (CDI) to reduce heavy drinking and alcohol-related problems in college students in two randomized clinical trials. Method In Experiment 1, we randomized 144 students to either the CDI or an assessment-only control group with follow-ups at 1 and 12 months. In Experiment 2, we randomized 82 students to either the CDI or a delayed-assessment control group with follow-up at 1 month. Results Experiment 1. Participants in both groups significantly reduced their drinking at both follow-ups. Compared to the control group, the CDI group reduced their drinking significantly more at 1 and 12 months on three drinking measures at α < .05. Using a more conservative, Bonferroni-adjusted criterion yielded one significant difference in a measure of heavier drinking at the 1 month follow-up. The mean between-group effect sizes were d = .34 and .36 at 1 and 12 months, respectively. Experiment 2. Compared to the delayed assessment control group, the CDI group significantly reduced (by the Bonferroni-adjusted criterion) their drinking on all consumption measures. Conclusion These results support the effectiveness of the CDI with heavy drinking college students when used in a clinical setting. In addition, the significant reductions in typical drinking in the control group in Experiment 1 and not in Experiment 2 combined with comparable baseline characteristics suggests that the control group in Experiment 1 demonstrated assessment reactivity.
A structured psychiatric interview designed for both clinical assessment and data collection was given to 50 pairs of well-matched pediatric and psychiatric clinic children and their mothers. The two groups were shown to be clearly distinguished on the basis of numbers of symptoms. Behavior and school symptoms gave the sharpest distinction between the two groups. Neurotic and somatic symptoms were the poorest discriminators. The psychiatric children showed significantly more antisocial symptoms than their matched pediatric peers. Age differences showed the expected trends with the widest divergence in the number of symptoms being in the oldest age group.
Eighty four heavy drinkers who responded to a newspaper recruitment ad were randomly assigned to receive either: a) training in a moderate drinking protocol via an Internet-based program (www.moderatedrinking.com) and use of the online resources of Moderation Management (MM) (www.moderation.org) or b) use of the online resources of MM alone. Follow-ups are being conducted at 3, 6, and 12 months. Results of the recently completed 3 month follow-up (86% follow-up) indicated both groups significantly reduced their drinking based on these variables: standard drinks per week; percent days abstinent; and mean BAC per drinking day. Both groups also significantly reduced their alcohol-related problems. Relative to the control group the experimental group had better outcomes on percent days abstinent and log Drinks per Drinking Day. These short-term outcome data provide evidence for the effectiveness of both the moderate drinking web application and of the resources available online at MM in helping heavy drinkers reduce their drinking and alcohol-related problems.
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