Psychometric properties of the California Psychological Inventory Socialization scale in treatment-seeking alcoholics.

Sociopathy has been identified as a prominent factor affecting the development and treatment of alcoholism. The present report examines the psychometric properties of a scale used to assess sociopathy, the California Psychological Inventory Socialization scale (CPI-So). The participants were 1,627 alcoholic adults taking part in a national trial of patient-treatment matching. The distribution of CPI-So scores was consistent with that of other studies of alcoholics, and the findings support the reliability and validity of the scale with this population. A principal-components analysis was generally consistent with similar analyses of nonalcoholic samples and identified 2 subscales that appear to tap previously described "personality" and "behavioral" dimensions of sociopathy. These subscales may be useful in further studies as potential bases for making patient-treatment matching decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing network support for drinking: Network Support Project 2-year follow-up.

The Network Support Project was designed to determine whether a treatment could lead patients to change their social network from one that supports drinking to one that supports sobriety. This study reports 2-year posttreatment outcomes. Alcohol-dependent men and women (N = 210) were randomly assigned to 1 of 3 outpatient treatment conditions: network support (NS), network support + contingency management (NS + CM), or case management (CaseM, a control condition). Analysis of drinking rates indicated that the NS condition yielded up to 20% more days abstinent than the other conditions at 2 years posttreatment. NS treatment also resulted in greater increases at 15 months in social network support for abstinence, as well as in AA attendance and AA involvement than did the other conditions. Latent growth modeling suggested that social network changes were accompanied by increases in self-efficacy and coping that were strongly predictive of long-term drinking outcomes. The findings indicate that a network support treatment can effect long-term adaptive changes in drinkers' social networks and that these changes contribute to improved drinking outcomes in the long term. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Matching alcoholics to coping skills or interactional therapies: Posttreatment results.

This study tested the hypothesis that patients could be matched to effective treatments on the basis of certain pretreatment characteristics. Specifically, it was hypothesized that those Ss who showed more sociopathy, more psychopathology, and greater neuropsychological impairment would have better outcomes when treated with coping skills training and, conversely, that those with less impairment in these areas would have better outcomes with interactional treatment. Ninety-six male and female Ss were recruited from an inpatient alcoholism treatment program and randomly assigned to 1 of these 2 types of aftercare group treatment. Linear and logistic regression analyses partially confirmed the hypotheses. Coping skills training was more effective for Ss higher in sociopathy or psychopathology, and interactional therapy was more effective for Ss lower in sociopathy. Generally, both treatments appeared equally effective for Ss lower in psychopathology. Contrary to expectations, those more neuropsychologically impaired appeared to have better outcomes after interactional therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy for pathological gamblers.

Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Alcoholism: A bio-psycho-social approach.

Reviews the book, Alcoholism: A bio-psycho-social approach by Jerome David Levin (1990). This small volume sets its task as providing counseling students with a comprehensive knowledge base "summarizing biochemical, pharmacological, physiological, anthropological, sociological, epidemiological, historical, and psychological findings on alcohol and its use and abuse" (Preface, p. xi). It treats each of these, in varying degrees of depth, in seven chapters. Perhaps the greatest strength of the book is its thorough presentation of the medical consequences of alcoholism, the mechanisms involved, and the interplay between biological and psychological factors. Unfortunately, this volume does not provide sufficient coverage of treatment-related issues. It may serve as an introductory overview of the alcoholism field for undergraduate or graduate students, or professionals from other fields. It is too advanced, however, in its use of concepts and language, for paraprofessional students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping skills and treatment outcomes in cognitive-behavioral and interactional group therapy for alcoholism.

In the present study 128 alcohol dependent men and women received 26 weeks of group treatment in one of two modalities: Cognitive-behavioral treatment (CBT) intended specifically to develop coping skills or interactional therapy intended to examine interpersonal relationships. Coping skills and drinking were assessed prior to and after treatment and up to 18 months after intake. Results indicated that both treatments yielded very good drinking outcomes throughout the follow-up period. Increased coping skills was a significant predictor of outcome. However, neither treatment effected greater increases in coping than the other. Specific coping-skills training was not essential for increasing the use of coping skills. The results raise questions about the efficacy of specific treatment elements of CBT in treatment of alcohol dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internal validity of Project MATCH treatments: discriminability and integrity

Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) is a multisite collaborative project designed to evaluate patient-treatment interactions in alcoholism treatment. To evaluate whether major threats to the internal validity of the independent (treatment) variable in Project MATCH could be ruled out, we investigated several aspects of treatment integrity and discriminability. In this study, 1,726 alcohol-dependent participants at 10 sites were randomized to 3 treatments: cognitive-behavioral treatment (CBT), motivational enhancement therapy (MET), and 12-step facilitation (TSF). Participants received treatment either as outpatients or as aftercare following a more intensive inpatient or day hospital treatment. For both the outpatient and aftercare arms of the study, treatments were discriminable in that therapists implemented each of the treatments according to manual guidelines and rarely used techniques associated with comparison approaches. Participants received a high level of exposure to their study treatments, and the intended contrast in treatment dose between MET and the 2 more intensive treatments (CBT and TSF) was obtained. Alcoholics Anonymous involvement was significantly higher for participants assigned to TSF versus MET or CBT, whereas the treatments did not differ in utilization of other nonstudy treatments. Nonspecific aspects of treatment such as therapist skillfulness and level of the therapeutic alliance were comparable across treatment conditions.     

Cross system agreement for substance use disorders: DSM-III-R, DSM-IV and ICD-10

This report presents results of a field trial of Substance Use Disorders as defined by DSM-III-R, DSM-IV (proposed) and ICD-10. Diagnoses based on the three systems were derived from interviews using the Composite International Diagnostic Interview (CIDI) in a heterogeneous sample of 521 adults drawn from clinical and community settings. Two issues are addressed: (1) cross system agreement; and (2) syndrome coherence of proposed criterion sets for Substance Dependence in each of the three systems. Findings were as follows: (1) Cross system agreement for Dependence was generally high, especially between DSM-III-R and DSM-IV. (2) Cross system agreement was lower for DSM-III-R and DSM-IV Abuse and very low for DSM-IV Abuse and ICD-10 Harmful Use. (3) Agreement varied across drug categories with lowest DSM-III-R/DSM-IV agreement for alcohol abuse and DSM-IV/ICD-10 agreement for marijuana use disorders. (4) Overall prevalence differed for the three systems with DSM-IV yielding highest rates followed by DSM-III-R and ICD-10 in that order. (5) Factor analysis of Dependence criteria showed high loadings of all items on a single factor across the three diagnostic systems and for all categories of drugs. Implications for validity of the dependence syndrome construct and for revisions in DSM-IV are discussed.     

Coping and self-efficacy in marijuana treatment: Results from the Marijuana Treatment Project.

This study examined whether a coping-skills-based treatment for marijuana dependence operated by encouraging the use of coping skills or via other mechanisms. Participants were 450 men and women treated in the multisite Marijuana Treatment Project who were randomly assigned to motivational enhancement therapy plus cognitive-behavioral (MET-CB) treatment, motivational enhancement therapy (MET), or a delayed treatment control group. Marijuana use and coping skills were measured at baseline and at follow-ups through 15 months. Results showed that marijuana outcomes were predicted by treatment type and by coping skills use, but that the coping-skills-oriented MET-CB treatment did not result in greater use of coping skills than did the MET treatment. The results suggest that mechanisms of coping skills treatment may need to be reconceptualized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aversive schedules with independent probabilities of reinforcement for responding and not responding by rhesus monkeys: II. Without signal.

Manipulated independently the probabilities of aversive stimulus presentation given the occurrence or the nonocurrence of a leverpress response. 10 naive male rhesus monkeys (Macaca mulatta) were divided into 5 groups, each group receiving a different sequence of the 2 probabilities and thereby a different sequence of electric shock presentation schedules ranging between avoidance and punishment. The schedules provided systematic control both of the amount of response facilitation that occurred when response-produced shocks were first introduced following avoidance training and of the postfacilitation response rate decline. When the probability of shock presentation following a response was less than that for not responding, scalloped response patterns occurred; when the relative shock probabilities were reversed, bipeak response patterns were observed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)