The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment

Abstract

BackgroundCognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA). The Drinking-Related Cognitions Scale (DRCS) is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS.MethodsParticipants in this study were 175 middle-aged and elderly Japanese male patients who met the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge.ResultsOf the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low positive alcohol expectancies, high abstinence self-efficacy, high perception level of impaired control over drinking, and high perception level of drinking problems measured by DRCS.ConclusionsThe DRCS was considered to have satisfactory predictive validity, which further supports our previous findings. It was suggested that DRCS is a promising rating scale for evaluating multidimensional cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment.

GRIK1 Genotype moderates topiramate's effects on daily drinking level, expectations of alcohol's positive effects and desire to drink

“…Much of this literature focuses on college students, in whom expectations of positive effects of alcohol predicted changes in hazardous or problem drinking in both sexes (Werner et al 1995, Zamboanga et al 2006). Other studies provide similar evidence of the predictive effects of positive alcohol expectancies on drinking behavior in adults of a variety of ethnic groups (Grotmol et al 2010, Nicolai et al 2012, Sawayama et al 2012). Although topiramate has prominent cognitive adverse effects (Sommer et al 2013), there is no evidence as to whether its use in alcohol treatment is associated with effects on cognitions such as expectancies.…”

Intención de cambio y búsqueda de ayuda en bebedores problemáticos

“…Esto es coherente con los resultados de otros estudios donde la negación de un consumo problemático o la no intención de realizar cambios en el patrón de consumo se menciona como una característica propia de aquellas personas a los que se le detecta un consumo problemático o dependencia de alcohol, actuando como barreras para la búsqueda de tratamiento o inicio de cambios (Aira, Kauhanen, Larivaara, & Rautio, 2003;Arborelius & Damström Thakker, 1995;Beich, Gannik, & Malterud, 2002;Grant, 1997;Morse & Flavin, 1992;Wells et al, 2007). En este sentido, la negación es un factor cognitivo en los pacientes con dependencia teniendo un papel defensivo para éstos, tal y como referencian Sawayama et al (2012), pudiendo ser a su vez un indicador de falta de motivación para el cambio (Miller, 1983). Por lo tanto, es necesario continuar con el estudio de las barreras para la búsqueda de ayuda, así como, el desarrollo de estrategias que aumenten la motivación para el cambio en la población de consumidores de alcohol.…”

Daily associations between PTSD, drinking, and self-appraised alcohol-related problems.

“…According to prevailing theoretical orientations to AUD treatment, behavior change is made possible in part through awareness and accurate assessment of alcohol-related problems (Donovan, 2003; Prochaska & Vellicer, 1997). For individuals entering alcohol treatment, the more accurate they are in their self-appraisal of their pre-treatment alcohol-related problems, the more positive their treatment outcome (Sawayama et al, 2012). Given that those with unremitting PTSD fare worse in AUD treatment outcome (Read, Brown & Kahler, 2004), it is possible that PTSD contributes to this disparity by either exacerbating alcohol-related problems or disrupting accurate self-rating of alcohol-related problems.…”