Ascertaining the relationships between the trajectories of specific categories of alcohol-related negative consequences and subsequent drinking behavior.

Abstract

The overwhelming majority of people who drink alcohol do so nonproblematically. Nevertheless, approximately 17.6 million Americans have been diagnosed with an alcohol use disorder (AUD), which can be severely debilitating and contribute to both increased morbidity and premature mortality. Irrespective of treatment approach, drinking behavior modifications are often short-lived and relapse is common.The first year following AUD treatment has been identified as a period of high risk for relapse, and thus an important timeframe for enquiry regarding alcohol-related behavior change and its maintenance. In addition, at least among individuals with a diagnosed AUD, alcohol use and negative consequences have been shown to be related reciprocally.A commonly used measure of alcohol-related negative consequences is the Drinker Inventory of Consequences (DrInC) which has been supported empirically in several studies, although investigations of specific categories of alcohol-related negative consequences and their trajectories have been lacking. Given this background, the purpose of this dissertation was to conduct secondary data analyses to: (1) confirm the previously reported factor structure of the DrInC; (2) follow the course of the five DrInC categories of alcohol-related negative consequences across the first year post AUD iii treatment initiation; (3) investigate whether these trajectories vary by participant gender, age or assigned treatment condition; and (4) examine the relationships between these trajectories and subsequent drinking behavior. Data from the outpatient arm of Project MATCH (n = 952), to date the largest psychosocial alcohol treatment randomized clinical trial, were analyzed for this dissertation.Study results confirmed the DrInC factor structure and the trajectory of each DrInC category was indicative of improved alcohol-related problems across the first year post-treatment initiation period. Specific DrInC categories varied as a function of participant gender, age, and assigned treatment condition and these trajectories were predictive of subsequent drinking behavior. Specifically, higher intercepts during the three-month treatment period were associated with poorer drinking behavior one year later. Alternatively, steeper slopes were associated with improved drinking behavior and some of these relationships were modified by gender, age, and treatment condition. It was concluded that assessing alcohol-related negative consequences during the first year post-treatment initiation can have clinical utility. iv ACKNOWLEDGEMENT and DEDICATION

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