Alcohol Abstinence Self-Efficacy Research Articles

Concurrent alcohol and tobacco treatment: Effect on daily process measures of alcohol relapse risk.

The aim of this study was to compare the effects of alcohol treatment along with concurrent smoking treatment or delayed smoking treatment on process measures related to alcohol relapse risk. Alcohol dependent smokers (N = 151) who were enrolled in an intensive outpatient alcohol treatment program and were interested in smoking cessation were randomized to a concurrent smoking cessation (CSC) intervention or to a waiting list for delayed smoking cessation (DSC) intervention scheduled to begin 3 months later. Daily assessments of relapse process measures were obtained using an Interactive Voice Response (IVR) system for 12 weeks after the onset of smoking treatment in the CSC condition, and before beginning smoking treatment in the DSC condition. Smoking outcomes were assessed at 2 and 13 weeks after starting treatment. Seven-day carbon monoxide (CO) verified smoking abstinence in the CSC condition was 50.5% at 2 weeks and 19.0% at 13 weeks compared with 2.2% abstinence at 2 weeks and 0% abstinence at 13 weeks for those in the DSC condition. Drinking outcomes were not significantly different for CSC versus DSC treatment conditions. On daily IVR assessments, CSC participants had significantly lower positive alcohol outcome expectancies relative to DSC participants. Multilevel modeling (MLM) analyses of within-person effects across the 12 weeks of daily monitoring showed that daily smoking abstinence was significantly associated with same day reports of lower alcohol consumption, lower urge to drink, lower negative affect, lower positive alcohol outcome expectancies, greater alcohol abstinence self-efficacy, greater alcohol abstinence readiness to change, and greater perceived self-control demands. Analyses of process measures provide support for recommending smoking intervention concurrent with intensive outpatient alcohol treatment. (PsycINFO Database Record

The indirect effect of the therapeutic alliance and alcohol abstinence self-efficacy on alcohol use and alcohol-related problems in Project MATCH.

Empirical literature indicates that the therapeutic alliance explains a modest but reliable proportion of variance in predicting alcohol-related outcomes among individuals in treatment for alcohol use disorders (AUDs). Hartzler and colleagues (2011) showed in the COMBINE data set that alcohol abstinence self-efficacy is a potentially important statistical mediator of the relationship between the alliance and client outcomes. The purpose of this study was to replicate this finding in the Project MATCH data set. We used total alliance ratings on the Working Alliance Inventory and tested both client and therapist ratings in mediation analyses. We found that posttreatment self-efficacy accounted for the effect of therapist and client ratings of alliance (measured at session 2) on posttreatment drinking outcomes (drinks per drinking day and alcohol-related problems). In addition, we found a moderation effect of treatment, such that the association between the client's rating of the alliance and self-efficacy changes was positive for individuals in the cognitive behavioral treatment group but negative for those receiving motivation enhancement or Twelve-Step Facilitation. This study reaffirms the importance of the therapeutic alliance and self-efficacy in predicting AUD outcomes. Future research should examine changes in the therapeutic alliance throughout treatment and how these changes are related to self-efficacy and AUD treatment outcomes over time.

How well do TTM measures work among a sample of individuals with unhealthy alcohol use that is characterized by low readiness to change?

Little is known about the applicability of the transtheoretical model of intentional behavior change (TTM) to individuals with unhealthy alcohol use that is primarily characterized by low readiness to change. This study examined the psychometric properties of short measures by assessing three core constructs of the TTM: the 20-item Processes of Change (POC-20) scale, and short versions of the Alcohol Decisional Balance Scale (ADBS) and the Alcohol Abstinence Self-Efficacy (AASE) scale. A sample of 427 individuals with unhealthy alcohol use (Mage = 30 years, 65% men), identified at job agencies in northeastern Germany, completed all three scales. Item difficulty (d), selectivity (rit), and Cronbach's alpha were calculated. Confirmatory factory analyses were used to test for construct validity and latent mean differences across the stages. The psychometric properties of the 8-item AASE were adequate (d range: 0.59-0.78; rit range: 0.59-0.68; α range: 0.74-0.81), except for one subscale. Most items of the POC-20 and the 10-item ADBS were difficult (dPOC range: 0.08-0.40; dADBS range: 0.21-0.58); selectivity (ritPOC range: 0.26-0.62; ritADBS range: 0.34-0.68) and internal consistency (αPOC range: 0.41-0.76; αADBS range: 0.64-0.78) were low to moderate. Construct validity was acceptable (Comparative Fit Index range: 0.95-0.99). The association between stages and TTM constructs partially followed expected patterns. Suggestions for modifications of TTM measures are discussed for better applicability among proactively recruited samples of individuals with unhealthy alcohol use and with primarily low readiness to change. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

알코올의존자의 회복에 영향을 미치는 요인

Purpose: This study was conducted to investigate influencing factors on recovery among alcoholics. Methods: The participants were 123 hospitalized patients with alcohol use disorder in two hospitals in Gyeonggi province. The data were collected from May 16 to June 4, 2012 using self-report questionnaires including Hanil Alcohol Insight Scale, Alcohol Abstinence Self-Efficacy Scale, and Recovery Scale. The data were analyzed using the SPSS/Win 18.0 program with descriptive statistics, Pearson's correlation coefficient and regression analysis. Results: Recovery is positively related to abstinence self-efficacy and duration of abstinence. Recovery differed by insight type, gender, and occupation. Insight, duration of abstinence, gender, and occupation accounted for 59.1% of the variance in recovery of the alcoholics. Conclusion: The influencing factors on recovery among alcoholics were insight, duration of abstinence, gender, and occupation. Programs focusing on insight, abstinence self-efficacy, and abstinence maintenance should be developed and provided. When developing the programs, the environmental context in which the alcoholics work should be considered.

Reward and relief craving tendencies in patients with alcohol use disorders: Results from the PREDICT study

BackgroundPrevious research suggests that patients' tendencies toward either reward or relief craving are distinct continuous factorial dimensions of craving for alcohol. According to these tendencies patients with alcohol use disorders (AUD) might also be allocated into distinct subgroups. In personalized treatment, patients of such different subgroups might respond differently to various psychotherapeutic and pharmacological interventions aimed at relapse prevention. ObjectivesTo establish that the items of the subscale Temptation to Drink of the Alcohol Abstinence Self-Efficacy Scale (AASE) capture two continuous dimensions of reward and relief craving, and that they allow the identification of respective discrete class factors and subgroups of patients with AUD. MethodsNonlinear confirmatory factor analysis (CFA) and latent class factor analysis (LCFA) were performed with data from 426 detoxified patients with AUD. The validity of continuous relief and reward dimensions, discrete class factors, and subtypes with different craving tendencies was established by including past drinking in positive and negative settings, gender, trait anxiety and perceived stress as covariates in the finally accepted CFA and LCFA measurement models. ResultsThe AASE temptation items formed two continuous relief and reward craving factors. They also associated themselves to two binary class factors, which defined four craving subgroups. Two of them (21% and 29% of patients) were characterized by high levels of either reward or relief craving tendencies. A third subgroup (31%) rated both tendencies in an equal high measure, while a fourth (18%) reported almost no craving tendencies at all. Past drinking in negative and positive settings was significantly associated with relief or reward craving tendencies. Male patients reported reward drinking more frequently than female patients. Trait anxiety was positively related only to the relief craving tendency. Unexpectedly, patients' level of perceived stress was associated with both craving tendencies. ConclusionsThe AASE temptation items are suited to identify relief and reward craving dimensions and to assign patients to according subtypes. Thus, they can be used to screen for corresponding patient subgroups, possibly allowing allocation to interventions that are specifically tailored to patient's particular craving tendencies. Hence: A relatively simple psychometric measure could help in improving treatment outcomes through a personalized approach to intervention.

The Effect of Alcohol Abstinence Self-efficacy and Mindfulness on Alcohol Problems among College Students

The Effect of Alcohol Abstinence Self-efficacy and Mindfulness on Alcohol Problems among College Students

Development of a Brief Abstinence Self-Efficacy Measure

This study compared the 40-item Alcohol Abstinence Self-Efficacy (AASE) scale with domains of confidence and temptation to a new 12-item version developed by the authors consisting of the same domains. There were 126 participants who completed the survey. Psychometric analysis demonstrated high reliability and validity consisting of high correlations between domains of confidence (α = .92) and temptation (α = .88) in the 40-item version of the scale compared to the briefer version. The 12-item version appears to provide a clinically reliable and valid measure of AASE domains of confidence and temptation, providing a more efficient tool for clinical practice.

Cognitions associated with recovery from alcohol dependence1

The present study examined the cognitive factors uniquely associated with the status of alcohol dependence recovery, assessing Korean patients who were recovered (n = 57), having been alcohol-abstinent for 4 months or more after treatment, and who were nonrecovered (n = 213), being still in treatment. Compared with the nonrecovered group, the recovered group reported lower levels of denial of drinking problems and rationalization of drinking (two dimensions of specific beliefs that facilitate alcohol use), dysfunctional attitudes, depressed mood, and emotion-focused coping. The recovered group also showed higher levels of alcohol abstinence self-efficacy and problem-focused coping. Both denial and alcohol abstinence self-efficacy were uniquely associated with alcohol dependence recovery, when we controlled for the other relevant predictors, whereas neither dysfunctional attitudes nor rationalization were so associated. These findings could be useful in refining psychological interventions facilitating the recovery of alcohol-dependent patients.

A Culturally Focused Wellness Intervention for American Indian Women of a Small Southwest Community: Associations with Alcohol Use, Abstinence Self-Efficacy, Symptoms of Depression, and Self-Esteem

This study examined the influence of a culturally focused wellness intervention on alcohol consumption, alcohol abstinence self-efficacy, depression, and self-esteem among women of a small American Indian community in the southwestern United States. Participation in two intervention approaches was compared: a curriculum-based health promotion–only approach and health promotion combined with cognitive-behavioral skills building (CBSB). The wellness intervention was tested in a prospective, randomized, two-group design with repeated measures. There was no control group. An American Indian community in the Southwest. American Indian women, ages 18 to 50 (N = 268). A 10-session culturally focused curriculum-based health promotion intervention, with a CBSB component, was developed using a community-based participatory research process. Comparisons were made between those who attended the health promotion plus CBSB intervention and those who attended the intervention without the CBSB component. Information regarding demographics, substance use, alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem was collected through a structured interview. Regression was used to evaluate the effect of the intervention on alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem in CBSB and non-CBSB groups. Although there were no significant differences between the CBSB and non-CBSB groups, the results indicate a significant decrease in alcohol consumption and symptoms of depression, and a significant increase in alcohol abstinence self-efficacy and self-esteem, from baseline to the 6-month follow-up for both groups. Evidence suggests that this culturally focused health promotion intervention has a positive impact on alcohol use, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem among American Indian women.

Spirituality during Alcoholism Treatment and Continuous Abstinence for One Year

The primary aim of this prospective study was to examine the role of several aspects of spirituality in maintaining abstinence from alcohol for one year in persons treated for alcohol dependence. The roles of alcohol abstinence self-efficacy and Alcoholics Anonymous affiliation were also examined. Seventy-four adults with alcohol dependence who had completed a three-week outpatient addiction program participated in this study. Instruments used included the Spiritual Well-Being Scale, Duke Religion Index, Brief Religious Coping Scale, Alcohol Abstinence Self-Efficacy Scale, and Alcoholics Anonymous Affiliation Scale. Abstinence data was collected from participants and collaterals three, six, and twelve months after treatment discharge. Demographics, discharge measures, and the change in scores from admission to discharge were compared between those with and without 12-month alcohol abstinence using logistic regression or Fisher's exact tests. Twenty-eight participants were categorized as continuously abstinent for one year. The strongest associations between 12 month abstinence and the variables of interest were discharge scores of abstinence self-efficacy and existential well-being, and increases during treatment in scores of private spiritual practices. Increased age demonstrated a significant association with positive outcome. The associations of private spiritual practices, existential well-being, and abstinence self-efficacy with one year of continuous abstinence following treatment discharge suggest the importance of addressing issues related to these variables during alcoholism treatment. More research is needed to understand the role of these variables in promoting and maintaining abstinence and to determine whether or not a related intervention would improve abstinence rates.

Der Zusammenhang zwischen Selbstwirksamkeit und Alkoholabstinenz bei ambulant und stationär behandelten Patienten: Ergebnisse einer 2-Jahres-Katamnese

This study examines the relationship between (alcohol specific) self-efficacy expectancies and abstinence from alcohol measured at 3 follow-ups (t1 = 6, t2 = 12 and t3 = 24 months after treatment) in 3 groups of patients with different severity levels of their alcohol dependency. N = 169 patients were included (n = 65 outpatient treatment, n = 51 inpatient short-term and n = 53 inpatient long-term treatment). Self-efficacy was measured using the Alcohol Abstinence Self-Efficacy Scale (AASE). Treatment outcome was defined as complete abstinence from alcohol at time of follow-ups. The AASE differentiates reliably between abstinent and non-abstinent patients in each treatment group at the 3 follow-ups. Abstinent patients had significant higher scores in both of the two subscales confidence and temptation. The strongest relationship between AASE and treatment outcome could be found for subjects in short-term inpatient treatment. The impact of the results for clinical practice is discussed.

The need for substance abuse after-care: Longitudinal analysis of Oxford House

Aims There is a need to explore the processes of social support and self-efficacy change over time among individuals in recovery homes, and to assess the extent to which residents remain abstinent, obtain and maintain employment, refrain from criminal activity, and utilize health care systems both while within the and after leaving such settings. Design Residents were recruited and interviewed at an initial baseline phase and then re-interviewed at three subsequent 4-month intervals. Setting Oxford Houses are recovery home residences for individuals with substance abuse and dependence problems who seek a supportive, democratic, mutual-help setting. Participants A national US sample of Oxford House residents ( n = 897: 604 men, 293 women). Measurements Information was gathered on abstinence, social support, self-efficacy, employment, criminal history, and medical care utilization. Findings Change in cumulative abstinence was predicted by support for alcohol use, abstinence self-efficacy, and length of residency in OH (i.e., less than versus ≥ 6 months), even after controlling for initial time spent in OH. Conclusions Results suggest that receiving abstinence support, guidance, and information from recovery home members committed to the goal of long-term sobriety may enhance residents' abstinence self-efficacy and enable persons recovering from alcohol and other drug addiction to reduce the probability of a relapse.

Examining the Effects of Alcoholism Typology and AA Attendance on Self-Efficacy as a Mechanism of Change

Existing research indicates that increased self-efficacy to sustain abstinence is a strong causal mechanism explaining later reduction of drinking. Little is known about how mechanisms of change may differ among distinct subgroups of alcoholics. The purpose of this study was to evaluate the mediational role of self-efficacy on changes in drinking associated with Alcoholics Anonymous (AA) attendance in Type-A and Type-B alcoholics. Analysis of covariance and structural equation modeling were used to model 6-, 9-, 12-, and 15-month data from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) participants who were classified as Type-A or Type-B alcoholics (N=1,284; 72% male). Measures of AA attendance and percent days abstinent were taken from the Form 90. Self- efficacy was assessed with the Alcohol Abstinence Self-Efficacy Scale. Alcoholism typology and AA attendance were independent predictors of later self-efficacy, but there was no interaction between typology and AA attendance. Abstinence self-efficacy mediated a modest proportion of the effect of posttreatment AA attendance on later abstinence in both Type-A and Type-B alcoholics. The strength of this mediation did not differ by typology. Self-efficacy for abstinence has a strong direct relationship to abstinence across treatment conditions and typologies. Increases in self-efficacy mediate some of the beneficial effects of AA for Type-A and Type-B alcoholics. Further work is necessary to determine whether self-efficacy plays a different role in the recovery of Type-A versus Type-B alcoholics.

Measuring self-efficacy among drug-involved probationers.

Self-efficacy has been shown to be related to outcomes from interventions for alcohol and tobacco abuse but relatively little attention has been focused on it in evaluations of treatment for illicit drug abuse. Almost no research has examined offenders involved with drugs. The current study, therefore, adapted the Alcohol Abstinence Self-efficacy Scale of DiClemente, Carbonari, Montgomery, and Hughes and administered it to 250 probationers mandated to 6 months of residential treatment. With some modifications, confirmatory factory models replicated four previously reported dimensions, e.g., Negative Affect, Social/Positive, Physical and Other Concerns, Cravings and Urges. Findings also indicated high construct validity for the Alcohol Abstinence Self-efficacy Scale as adapted here. Studies are needed to examine the use of self-efficacy as a prospective measure of treatment progress and to explore its association with outcomes from corrections-based treatment.

Psychiatric severity and behavior change in alcoholism: The relation of the transtheoretical model variables to psychiatric distress in dually diagnosed patients

Treatment programming for individuals diagnosed with a chronic mental illness and an alcohol use disorder could be enhanced by employing techniques that focus on those change process variables that are most strongly related to psychiatric distress. Prochaska and DiClemente’s transtheoretical model (TTM) provides a useful framework within which to study these relations. The associations between psychiatric severity and the TTM constructs of stages and processes of change, decisional balance, temptation, and self-efficacy were measured among 132 alcohol-dependent patients in a public mental health clinic’s outpatient dual diagnosis program. Participants’ scores on the Temptation subscale of the Alcohol Abstinence Self-Efficacy Questionnaire are strongly related to psychiatric severity: The more psychiatric distress a person is experiencing, the more he or she is tempted to drink, particularly in situations that trigger negative affect. Decisional balance considerations are also related to psychiatric severity: The higher participants scored on the Global Severity Index of the Brief Symptom Inventory, the more importance they placed on the negative aspects, or cons, of drinking. Subjects with more psychiatric distress also scored higher on the maintenance stage of change subscale, possibly indicating an increased fear of relapse and struggle to maintain sobriety.

The Alcohol Abstinence Self-Efficacy scale.

This study describes the development and the initial psychometric properties of a 20-item, self-report measure to assess Bandura's construct of self-efficacy applied to alcohol abstinence. Efficacy expectations are theorized to mediate behavior change and moderate effort and effective action. The sample was 174 male and 92 female subjects who came to an outpatient alcoholism treatment clinic. Abstinence efficacy was assessed with subject ratings on a 5-point Likert scale of confidence to abstain from alcohol across 20 different high-risk situations. A parallel set of items assessed subjects' temptation to drink in each situation. This Alcohol Abstinence Self-Efficacy scale (AASE) demonstrated a solid subscale structure and strong indices of reliability and validity. The four 5-item subscales measured types of relapse precipitants labeled negative affect, social positive, physical and other concerns, and withdrawal and urges. Both in structure and mean scores the AASE demonstrated no substantive gender differences. The AASE represents a brief, easily usable and psychometrically sound measure of an individual's self-efficacy to abstain from drinking.