Profiles of confidence and commitment to change as predictors of moderated drinking: A person-centered approach.

Abstract

Identifying who among problem drinkers is best suited for moderation and has the greatest likelihood to control drinking has important public health implications. The current study aimed to identify profiles of problem drinkers who may be more or less successful in moderating drinking within the context of a randomized clinical trial of a brief treatment for alcohol use disorder. A person-centered approach was implemented, utilizing composite, baseline daily diary values of confidence and commitment to reduce drinking. Problem drinkers (N=89) were assessed, provided feedback about their drinking, and randomly assigned to one of three conditions: two brief AUD treatments or a third group asked to change on their own. Global self-report assessments were administered at baseline and week 8 (end of treatment). Daily diary composites were created from data collected via an Interactive Voice Recording system during the week prior to baseline. A K-means cluster analysis identified three groups: High, Moderate, and Low confidence and commitment to change drinking. Group differences were explored, and then group membership was entered into generalized estimating equations (GEE) to predict drinking trajectories over time. Findings revealed that the groups differentially reduced their drinking, such that the High group had greater reduction in drinking and a faster rate of reduction than the other two groups, and the Moderate group had greater reduction than the Low group. Findings suggest that baseline motivation and self-efficacy are important to predicting prognoses related to successful moderated drinking. Limitations and arenas for future research are discussed.

Exploration of treatment matching of problem drinker characteristics to motivational interviewing and non-directive client-centered psychotherapy

“…To further probe the conditional effect of depression on condition, we examined whether these effects might be mediated by daily commitment or confidence to resist heavy drinking in an exploratory analysis. We hypothesized that commitment or confidence, which are found to predict drinking (Kuerbis, Armeli, Muench, & Morgenstern, 2013, 2014; Morgenstern et al, 2016), might be impacted by depression. For example, it might be for those with higher levels of depressive symptoms, receiving therapy differentially increases commitment not to drink heavily compared to the non-therapy condition, whereas at low levels of depression, there is no differential effect of receipt of therapy on commitment.…”

Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later

“…Rather than using methods that attempt to generalize across individuals, maybe we should develop models that describe how an individual changes over time, and then attempt to aggregate such models across sub-sets of individuals? Morgenstern and colleagues (e.g., Kuerbis et al, 2014) have provided proof of concept for this type of person-centered approach.…”

Implicit Alcohol Approach and Avoidance Tendencies Predict Future Drinking in Problem Drinkers

“…We ran a separate model for each measure of drinking behavior from the TLFB—SSD, NDD, and DDD. Consistent with our prior work (Kuerbis et al, 2014), we included these three indices of drinking outcomes to more fully assess the relationships between change processes and drinking outcomes among problem drinkers. In the analyses predicting outcome drinking, we controlled for baseline drinking.…”