Alcohol-dependent Persons Research Articles

Personality organisation and the tendency to rumination in a group of alcohol-dependent persons

Introduction and objective: Kernberg’s model of personality organisation allows to explain the sources of pathomechanisms underlying mental disorders, personality disorders in particular. Ruminations are automatic, constantly recurring thoughts that constitute a predisposition to a specific interpretation of the world and oneself. They are associated with two mechanisms – adaptive (reflection) and maladaptive (rumination). The aim of the study was to investigate the relationship between personality organisation and the general tendency to rumination, rumination on anger and sadness, and reflectivity among alcohol addicts. Materials and methods: 91 alcohol-dependent persons aged 20–77 years (mean, M = 43.57; standard deviation, SD = 12.92), including 26 women and 65 men, participated in the study. The Inventory of Personality Organization (IPO) by John F. Clarkin, Pamela A. Foelsch and Otto F. Kernberg (Polish adaptation by Agnieszka Izdebska and Beata Pastwa-Wojciechowska), The Rumination-Reflection Questionnaire (RRQ-short) by Janet A. Carter (Polish adaptation by Stanisław Radoń), Sadness and Anger Rumination Inventory (SARI) by Maya Peled and Marlene Moretti (Polish adaptation by Małgorzata Anna Basińska) and a sociodemographic questionnaire were used. Results: A significant positive correlation was found between the tendency to rumination and anger and sadness rumination and all dimensions of personality organisation. A higher level of identity diffusion predicted a higher tendency to rumination and sadness rumination. A higher level of identity diffusion and aggression predicted a higher tendency to anger rumination. Moreover, marital status, comorbid mental disorders and age at problematic alcohol use onset were significantly correlated with the analysed variables. Conclusions: A positive relationship between ruminations and all dimensions of personality organisation was confirmed. Greater identity diffusion was a predictor of the tendency to ruminate in its analysed ranges in the study group of alcohol-dependent individuals.

Relationship between the assessment of violent actions and the manifestations of personal characteristics in alcohol-dependent individuals

Objective. To determine the relationship between violent acts and personality characteristics in alcohol dependent individuals.Materials and methods. The study was conducted in the penitentiary system. It involved 295 men with alcohol dependence syndrome (F10.2) aged from 21 to 60 years, with an average age of 40.7 ± 8.9 years and an average alcohol intake of 13.5 years. During the study, patients with alcohol dependence syndrome were divided into three groups. The following psychodiagnostic methods were used: the technique “Types of aggressiveness” developed by L. G. Pochebut (2012), the questionnaire “Style of self-regulation of behavior” (SSP-98), the test-questionnaire “Study of volitional self-regulation”, the questionnaire for the study of stages of psychotherapy “URICA” and others. Statistical analysis was carried out using the program SPSS 19.0. Spearman’s R-criterion and Mann-Whitney U-criterion were used.Results. The revealed high level of the final HCR-20 score in all three groups under study indicates a significant risk of committing violent acts, low adaptive capabilities and reduced stress tolerance of alcohol-dependent persons. The revealed average level of tolerance showed that personality traits, attitudes and beliefs of alcohol-dependent persons to a great extent determine their ambivalent attitude to the surrounding world with a combination of both tolerant and intolerant traits.The existing dual causal relationship between alcohol intake and stress manifestation shows that excessive stress increases the risk of alcohol-related problems, alcohol abuse in turn causes significant alcohol distress.Conclusions. The risk of violent acts in persons with alcohol dependence syndrome depends on the severity of such personality characteristics as aggressiveness and emotional excitability, low stress resistance, intolerance, and decreased ability to volitional self-regulation.

Further Evidence of Relationship Between Thiamine Blood Level and Cognition in Chronic Alcohol-Dependent Adults: Prospective Pilot Study of an Inpatient Detoxification with Oral Supplementation Protocol.

The relationship between thiamine blood level (TBL) and cognition remains uncertain including amongst alcohol-dependent persons (ADP) AIM: To evaluate this relationship during protocol-driven inpatient alcohol detoxification treatment including thiamine supplementation (AD+Th) METHODS: Prospective 3-week study with 100 consecutively admitted detoxification-seeking ADP (47.7±11 years-old, 21% females) without superseding comorbidities requiring treatment. TBL and Montreal Cognitive Assessment (MoCA) were measured at admission (t1, pre-AD+Th) and discharge (t3, post-AD+Th). Frontal Assessment Battery (FAB) was performed at t1. AD+Th included abstinence, pharmacological alcohol withdrawal syndrome treatment and oral thiamine supplementation (200 mg/day for 14 days). Regression and mediation analyses assessed TBL-cognition relationships. We found no cases of Wernicke Encephalopathy (WE) and only one case of thiamine deficiency. Both MoCA and TBL significantly improved across AD+Th (with medium-to-large effect sizes). At t1, TBL significantly predicted MoCA and FAB sum scores (medium effect sizes; extreme and very strong evidence, respectively). The clear TBL-MoCA association disappeared at t3. In multivariate regression and mediation analyses exploring key influential factors of cognition (identified by LASSO regression), the TBL-MoCA interactions did not relevantly change at t1 and t3. Age, serum transaminases, vitamin D levels, drinking-years and depression score weakly modified the relationship. TBL was a robust predictor of pre-detoxification cognitive impairment, and both TBL and cognition improved significantly during AD+Th (including abstinence) in our ADP population, supporting routine thiamine supplementation for ADP, even those at low WE-risk. TBL-cognition relationship was minimally confounded by age, alcohol-toxicity proxies, mood, and vitamin D levels. https://osf.io/b54eh/.

Evaluation of abstinence motivation for people who have alcohol dependence

Problem. Alcohol addiction is an important problem for both society and healthcare. A lot of scientific research on the problems, conse-quences and treatment of alcohol consumption has been carried out in the world and in Lithuania, but there is a lack of deeper analysis of personal experiences related to the motivation of addicted persons, their opinion about treatment and needs.
 Aim of the study is to assess the motivation for sobriety of alcohol-dependent persons.
 Methods. A qualitative study was conducted using a semi-structured interview and analyzing the data using the qualitative content analysis method. The study participants are 6 alcohol-dependent persons who continue treatment in the psychosocial rehabilitation department during the study.
 Results and Conclusions. Based on the statements of the participants in the study, it was found out that it was not easy for the respondents to give up alcohol: they distanced themselves from friends who drank alcohol, they felt awkward and stupid when they had to explain why they did not drink, it was unpleasant to see drunken friends with sober eyes, it was difficult to figure out what to do, especially on weekends. The participants decided to pursue sobriety based on external and internal motivation. External motivating factors family members, relatives, colleagues, lost work and property; internal - deteriorated health, relationship problems in the family, stigmatizing society's attitude, self-loathing.

ВЗАИМОСВЯЗЬ ОЦЕНКИ САМОАКТИВАЦИИ С ВОЛЕВОЙ САМОРЕГУЛЯЦИЕЙ И ТИПОМ МЕЖЛИЧНОСТНЫХ ОТНОШЕНИЙ ЗАВИСИМЫХ ОТ АЛКОГОЛЯ ЛИЦ

Background. The process of psychotherapy of alcohol-addicted persons becomes effective through understanding the relationship between self-activation motives, the state of self-regulation and their social functioning. Purpose: To study the relationship between the assessment of self-activation, volitional self-regulation and the types of interpersonal relationships in alcohol-dependent persons in order to determine therapeutic «targets» for a targeted impact on dependent constructs in the process of psychotherapy. Material and methods. The study was conducted on the basis of the medical and labor dispensary (LTP) No.5 of the Ministry of Internal Affairs of the Republic of Belarus. A total of 250 men aged 24 to 60 years were examined. Group I included persons with alcohol dependence syndrome, who while in the LTP setting, underwent psychotherapy for persons with alcohol dependence syndrome (150). Group II consisted of persons with alcohol dependence syndrome, who while in the LTP setting, participated in the standard program of medical and social readaptation (100). The following psychodiagnostic methods were used: test questionnaire «Research of volitional self-regulation»; BIS/BAS questionnaire; the technique «Diagnostics of interpersonal relations». Results. The results of assessing the type of interpersonal relationships, volitional self-regulation and sensitivity to positive and negative stimuli did not reveal statistically significant differences between the groups (p>0.05). We identified weak positive relationships in people of group I between «Perseverance» on the BAS scale and the type of relationship «Selfish», «Aggressive», «Suspicious», «Dependent» (p<0.01); between «Pleasure seeking» on the BAS scale and «Authoritarian» (p<0.01), between «Pleasure seeking» on the BAS scale and «Aggressive», «Suspicious», «Dependent» (p<0.01); between BIS and «Suspicious», «Subordinate», «Dependent», «Friendly», «Altruistic» (p<0.05). Weak negative relationships were identified in people of groups I and II between the BIS scale and the scale of volitional self-regulation «Persistence», «General level of volitional self-regulation» (p<0.05). We also identified weak negative relationships in people of group I between the «Self-control» scale and BAS «Persistence», BAS «Pleasure seeking», BAS «Reactivity» (p<0.01); between BAS «Persistence» and BAS «Search for pleasure» and the scale «General level of volitional self-regulation» (p<0.01). Conclusion. The obtained data of relationships made it possible to take into account the dual nature of the selfactivation system and include an intermittent sequence in the process of psychotherapy: the importance of emotional support experience (BAS), leveling and reshaping of negative experience (BIS), reassessment of the subjective significance of one's own personality with the activation of awareness and constructive choice of effective sobriety tools (BAS), the development of a system to counter dependent stimuli and challenges (BIS), the integration of the value of sober thinking into the life system (BAS).

Evaluation of neuroendocrine dysfunction in the diagnosis of depressive and non-depressive alcohol-dependent persons

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Initial Study on COMT and DRD2 Gene Polymorphisms as Well as the Influence of Temperament and Character Trait on the Severity of Alcohol Craving in Alcohol-Dependent Patients.

The main aim of this work was to determine the impact of COMT and DRD2 gene polymorphisms together with temperament and character traits on alcohol craving severity alcohol-dependent persons. The sample comprised of 89 men and 16 women (aged ). For the sake of psychological assessment various analytic methods have been applied like the Short Alcohol Dependence Data Questionnaire (SADD), Penn Alcohol Craving Scale (PACS) or Temperament and Character Inventory (TCI) test. The SNP polymorphism of the analyzed genes was determined by Real Time PCR test. The results showed, that the COMT polymorphismmay have an indirected relationship with the intensity and changes in alcohol craving during abstinence. The DRD2 receptor gene polymorphisms are related with the intensity of alcohol craving. It seems that the character traits like “self-targeting”, including “self-acceptance”, are more closely related to the severity of alcohol craving and polymorphic changes in the DRD2 receptor than temperamental traits. Although this is a pilot study the obtained results appeared to be promising and clearly indicate the link betweengene polymorphisms alcohol craving and its severity.

Effects of an integrated intervention program for alcoholism (IIPA) on learning, memory and quality of life (QOL) in persons with alcohol dependence at the Centre for Addiction Medicine, Bengaluru, India

PurposeThis study aims to examine the effectiveness of an integrated intervention program for alcoholism (IIPA) for improving verbal encoding and memory, visuospatial construction, visual memory and quality of life (QoL) in persons with alcohol dependence.Design/methodology/approachThe sample comprised treatment-seeking alcohol-dependent persons (n = 50), allotted into two groups: (1) the treatment as usual (TAU) group (n = 25) and (2) the treatment group (n = 25)]. The groups were matched on age (±1 year) and education (±1 year). The TAU group received standard pharmacological treatment, psychotherapeutic sessions on relapse prevention and yoga for 18 days, while the treatment group received IIPA sessions in addition to the usual treatment. Auditory verbal learning test, complex figure test and QoL scale were administered at pre- and post-treatment along with screening measures.FindingsThe two groups were comparable on demographic variables, clinical characteristics and outcome measures at baseline. Pre- to post-treatment changes (gain scores) comparison between the treatment and TAU groups revealed a significant difference in verbal encoding, verbal and visual memory, verbal recognition, visuospatial construction and QoL.Research limitations/implicationsThis study suggests that IIPA is effective for improving learning and memory in both modality (verbal and visual) and QoL in persons with alcoholism. The IIPA may help in better treatment recovery.Practical implicationsThe IIPA may help in treatment for alcoholism and may enhance treatment efficacy.Originality/valueIIPA is effective for improving learning and memory in both modalities and QoL in persons with alcohol dependence. The IIPA may help in better treatment recovery.

The Effect of Baseline Patterns of Spiritual Coping, Forgiveness, and Gratitude on the Completion of an Alcohol Addiction Treatment Program

The purpose of this study was to identify distinct profiles of persons beginning alcohol addiction therapy with similar baseline configurations of spiritual coping, forgiveness, and gratitude. The associations between latent profile membership and the completion of therapy were also examined. The sample was composed of 358 alcohol-dependent persons receiving an outpatient treatment program. The Spiritual Coping Questionnaire, the Forgiveness Scale, and the Gratitude Questionnaire were used to assess the baseline levels of spirituality-related variables. Using latent profile analysis, five profiles were identified: (1) both moderately positive and negative dimensions of spirituality (33.2%), (2) moderately positive dimensions of spirituality (21.0%), (3) predominantly negative dimensions of spirituality (20.2%), (4) mixed dimensions of spirituality with the lowest positive religious coping (14.0%), and (5) highly positive dimensions of spirituality (11.6%). Notably, the latent profiles differed in terms of the treatment completion rates. The results suggest the need to carry out a multidimensional assessment of spiritual functioning of persons beginning alcohol addiction therapy to provide treatment that is adjusted to patients’ spiritual potential and deficits.

Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence.

Introduction:Motivational enhancement therapy is characterized as a directive, client-centered intervention which helps in modification of behavior by helping subjects in identifying and resolving the ambivalence toward a change in self. In order to free one from the vicious cycle of the alcohol trap one needs self-efficacy, which serves a protective role to prevent from relapses. The study aims to assess and compare the effectiveness of MET on the self-efficacy of individuals pre and posttest with control design were applied.Methods:A total of 40 subjects, alcohol-dependent persons fulfilling International classification of Diseases-10 criteria were selected through purposive sampling method from Outdoor and Indoor Service of Psychiatry Department IMS BHU, Varanasi, were randomly divided into two groups. 1st group 20 subjects were given motivational enhancement therapy session for 10 sessions along with treatment as usual (MET + TAU), whereas 2nd group control group were given treatment as usual (TAU) at the end of intervention post level of self-efficacy were measured through self-efficacy scale. Modified Kuppuswamy Socioeconomic Status Scale, Alcohol use disorder identification test, Self-Efficacy Scale as tools were used.Result:The result shows that the mean value of self-efficacy in (MET + TAU) group before intervention was 56.30 ± 2.99 and mean value of self-efficacy in (MET + TAU) after intervention was 60.75 ± 2.65 which shows significant difference is found in self-efficacy after intervention.Conclusion:Motivational enhancement therapy tries to decrease ambivalence so as to enhance the change in the subject's self-efficacy which assists the individuals in abstinence from alcohol.

Salivary Carbohydrate-Deficient Transferrin in Alcohol- and Nicotine-Dependent Males.

Serum carbohydrate-deficient transferrin (CDT), an 80 kDa glycoprotein, is one of the most commonly employed biomarkers to detect alcohol dependence. Some salivary glycoproteins such as α-amylase, clusterin, haptoglobin, light/heavy-chain immunoglobulin, and transferrin, which alter glycosylation in alcohol-dependent persons, have been suggested to be potential alcohol markers. However, their identification is based on indirect analysis of lectin glycosidic bonds and molecular weight. We investigated the CDT content in the saliva of alcohol- and nicotine-dependent men. The CDT concentration (ng/mL, ng/mg protein) was determined by an Enzyme-Linked Immunosorbent Assay (ELISA) commercial kit in 55 men: 20 healthy social drinkers (C), 10 chronic cigarette smokers (S), 10 alcohol-dependent non-smokers (A), and 15 alcohol-dependent smokers (AS). Surprisingly, there were no differences in the concentrations of CDT between the studied groups. Salivary pH was the lowest in the AS and the highest in the A group. Therefore, salivary CDT cannot be used as an alcohol dependence marker as measured by ELISA. We suggest that direct identification of glycoproteins is necessary to search for potential salivary alcohol biomarkers. Molecules smaller than 40 kDa, which easily translocate from blood to the saliva, might be preferred as salivary alcohol markers.

The Importance of Assessing Quality of Life in Patients with Alcohol Dependence

Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered as a valid measure in evaluating the success of the treatment of patients with alcohol dependence. The goal of the study was to investigate QoL and some sociodemographic characteristics of patients with alcohol dependence in comparison with healthy individuals. Cross-sectional study (which is part of larger study) included 312 patients with alcohol dependence and 329 healthy individuals of both sexes. Structured interview for sociodemographic and alcohol related data, the Croatian version of the 5.00 Mini International Neuropsychiatric Interview (MINI), and the short version of the World Health Organization Quality of Life (WHOQoLBREF) were used. The results have shown that alcohol dependent patients were significantly more frequently uneducated (p=0.006) and primary education (p<0.001), while healthy individuals were significantly more likely to have secondary (p=0.003) and tertiary education (p=0.013). Patients with alcohol dependence were significantly more likely to be single (p=0.005), divorced (p<0.001), and living as married (p=0.008) compared to healthy people, while healthy populations were more often married (p<0.001) in comparison to alcohol addicts. Alcohol dependent persons were more often unemployed (p<0.001) and retired (p=0.005). Patients with alcohol dependence were more likely to have a perceived a sense of illness (p<0.001) than healthy subjects. There were significant differences in all domains of QoL: general, physical, psychological, social, and environment between patients with dependence and healthy individuals (p<0.001). To conclude, alcohol dependence has been shown to be negatively correlated with overall QoL and domains of QoL: physical, psychological, social, and environmental. Education of patients with alcohol dependence was lower than in healthy people, who were more likely to live in marriage and were employed.

Changes in the Expression of DNA Methylation Related Genes in Leukocytes of Persons with Alcohol and Drug Dependence

Abstract Background and objectives. Though numerous studies have shown that the dysregulation of the epigenetic control is involved in disease manifestation, limited data is available on the transcriptional activity of DNA methylation related genes in alcohol and drug addiction. With regard to this, in this study we analyzed the expression levels of genes involved in DNA methylation, including DNMT1, DNMT3a, MeCP2, MBD1, MBD2, MBD3 and MBD4, in blood samples of alcohol and drug dependent persons in comparison to healthy abstainers. Methods. The study included 51 participants: 16 persons with alcohol dependence, 17 persons with drug dependence and 18 clinically healthy controls. To detect the relative mRNA expression levels of the studied genes, Quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis was applied. Results. Of the seven studied genes, four showed altered expression. MeCP2 and MBD1 were downregulated in the alcohol dependent group (FC = 0.805, p = 0.015 and FC = 0.846, p = 0.034, respectively), while DNMT1 and MBD4 were upregulated in the group with drug dependence (FC = 1.262, p = 0.001 and FC = 1.249, p = 0.005, respectively). No statistically significant changes in the relative mRNA expression were found for DNMT3a, MBD2 and MBD3 genes. Conclusions. Our results are indicative for a role of DNA methylation related genes in alcohol and drug addiction mediated through changes in their transcriptional activity. Studies in this direction will enable better understanding of the underlying mechanisms of addictions supporting the development of more effective therapeutic strategies.

Complicated Alcohol Withdrawal-An Unintended Consequence of COVID-19 Lockdown.

AimTo assess the impact of COVID-19-related lockdown in India on alcohol-dependent persons.MethodWe examined the change in the incidence of severe alcohol withdrawal syndrome presenting to hospitals in the city of Bangalore.ResultsA changepoint analysis of the time series data (between 01.01.20 to 11.04.20) showed an increase in the average number of cases from 4 to 8 per day (likelihood ratio test: χ2 = 72, df = 2, P < 0.001).ConclusionAn unintended consequence of the lockdown was serious illness in some patients with alcohol use disorders.

Perceived Stress as a Predictor of Depressive symptoms among Wives of Alcohol Dependent Persons

The present study observed the possible predictive effect of perceived stress on the depressive symptoms of wives of alcohol-dependent persons. Participants of the study involved 204 selected wives of alcohol-dependent persons from the 20 Kudumbasree groups (Women self-help group in Kerala, India) who completed the Perceived stress scale and Depressive Anxiety Stress Scale that measured perceived stress and depressive symptoms respectively. The results of the study showed a significantly positive relationship between perceived stress and depressive symptoms. Moreover, a regression analysis of the data showed that a significant variance of 60.3% of the depressive symptoms. The present study clearly gave the idea of perceived stress reduction can lessen the development of depressive symptoms among the participants. Thus, the present study recommends the need for a psychotherapeutic intervention program to be developed that can reduce perceived stress and depressive symptoms among wives of alcohol-dependent persons.

Aplikacje mobilne przeznaczone dla osób uzależnionych od alkoholu jako narzędzia wspierające proces zdrowienia

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Klingemann J, Wróblewski M, Wieczorek Ł. Mobile applications for alcohol dependent persons as tools supporting the recovery process. Alcoholism and Drug Addiction/Alkoholizm i Narkomania. 2020;33(1):19-42. doi:10.5114/ain.2020.95978. APA Klingemann, J., Wróblewski, M., & Wieczorek, Ł. (2020). Mobile applications for alcohol dependent persons as tools supporting the recovery process. Alcoholism and Drug Addiction/Alkoholizm i Narkomania, 33(1), 19-42. https://doi.org/10.5114/ain.2020.95978 Chicago Klingemann, Justyna Iwona, Michał Wróblewski, and Łukasz Wieczorek. 2020. "Mobile applications for alcohol dependent persons as tools supporting the recovery process". Alcoholism and Drug Addiction/Alkoholizm i Narkomania 33 (1): 19-42. doi:10.5114/ain.2020.95978. Harvard Klingemann, J., Wróblewski, M., and Wieczorek, Ł. (2020). Mobile applications for alcohol dependent persons as tools supporting the recovery process. Alcoholism and Drug Addiction/Alkoholizm i Narkomania, 33(1), pp.19-42. https://doi.org/10.5114/ain.2020.95978 MLA Klingemann, Justyna Iwona et al. "Mobile applications for alcohol dependent persons as tools supporting the recovery process." Alcoholism and Drug Addiction/Alkoholizm i Narkomania, vol. 33, no. 1, 2020, pp. 19-42. doi:10.5114/ain.2020.95978. Vancouver Klingemann J, Wróblewski M, Wieczorek Ł. Mobile applications for alcohol dependent persons as tools supporting the recovery process. Alcoholism and Drug Addiction/Alkoholizm i Narkomania. 2020;33(1):19-42. doi:10.5114/ain.2020.95978.

The efficacy of iCBT added to treatment as usual for alcohol-dependent patients in primary care: study protocol for a randomized controlled trial

BackgroundAlcohol dependence is a common disorder with a continuum regarding severity. Most alcohol-dependent persons have a moderate level of dependence and live under socially orderly conditions. Treatment-seeking in this group is low, mainly due to stigma and because treatment options are seen as unappealing.Alcohol is a relevant topic to discuss in many primary care (PC) consultations and PC is less stigmatizing to visit compared to addiction care units for people with alcohol problems. However, general practitioners (GPs) hesitate to engage in treating alcohol problems due to time constraints and lack of knowledge. Screening and brief interventions are effective for high consumers but there are few studies on dependence.MethodsThis is a two-group, parallel, randomized controlled trial (RCT). The aim is to study whether an Internet-based Cognitive Behavioral Treatment (iCBT) when added to treatment as usual (TAU) is more effective than TAU only for alcohol dependence in PC. Two hundred and sixty adults with alcohol dependence will be included. Participants are randomized to iCBT and TAU or TAU only. The primary study outcome is alcohol consumption in grams per week and heavy-drinking days. Secondary outcomes include alcohol-related problem severity, number of diagnostic criteria for alcohol dependence, depression and anxiety symptoms, health-related quality of life and biochemical markers for high consumption and liver pathology. Data will be analyzed using mixed-effect models.DiscussionInternet-based interventions are attractive to, and have been shown to reach, people with alcohol problems. Yet there are no studies investigating the efficacy of Internet treatment of alcohol dependence in PC. In this study we hypothesize that iCBT when added to TAU will improve treatment outcome for alcohol dependence in PC, compared to TAU only. If effective, iCBT can be distributed to the public to a low cost for a stakeholder and has the opportunity to reduce both short-term and long-term public health costs.Trial registrationISRCTN69957414. Retrospectively registered on 7 June 2018.

The role of forgiveness and gratitude in the quality of life of alcohol-dependent persons

Background: Despite a growing number of studies confirming the positive role of forgiveness and gratitude in alcohol addiction treatment, there is a scarcity of research involving groups of alcohol-dependent individuals who do not attend alcohol addiction therapy. The aim of this study was to examine the role of forgiveness and gratitude in the quality of life among persons who have just started alcohol addiction therapy and alcohol-dependent individuals who have never attended this kind of treatment. Method: Using propensity score matching, individuals beginning an outpatient alcohol treatment program (n = 166) were matched with patients of detoxification wards who have never participated in alcohol addiction therapy (n = 166). The Forgiveness Scale, the GQ-6, and the SF-36v2 were used to assess the patients’ moral virtues and health-related quality of life (HRQoL). Results: Alcohol-dependent individuals who have never participated in alcohol addiction therapy had higher self-forgiveness and feeling forgiven by God, and were less grateful than patients who have just started an outpatient alcohol treatment program. Furthermore, a multiple mediation analysis revealed that: (1) Being uninterested in beginning alcohol addiction therapy correlated with lower gratitude that, in turn, decreased both physical and mental HRQoL; (2) For mental HRQoL, however, this indirect effect was canceled out by higher self-forgiveness and feeling forgiven by God, which increased HRQoL. Conclusions: The results suggest there is a need to diagnose forgiveness and gratitude in order to effectively motivate alcohol-dependent individuals to begin therapy.

Alcohol Abstinence Prediction on the Basis of Conservation of Resources Theory by Stevan E. Hobfoll a Study of Polish Alcohol-Dependent Persons in the Early Phase of Recovery

Striving for permanent alcohol abstinence can be difficult to achieve or even impossible, which in turn often results in discontinuation of treatment. The main area of interest among researchers dealing with the problem of alcohol dependence is the ability to maintain abstinence. Despite numerous studies in this area, there is still no unambiguous data on the factors affecting the recovery process of alcohol-dependent persons. The main goal of this publication is to present the Conservation of Resources Theory (COR) by S. Hobfoll as an alternative concept to understanding alcohol dependence and to answer whether maintaining abstinence can be predicted, and what kind of resources play a key role in alcohol dependence recovery. A series of two comparisons of independent variables (level, gain and loss of resources) were made in the first and sixth month after the beginning of therapy. Questionnaire longitudinal studies of 350 alcohol-dependent persons were used. Research results show that distribution of resources is of great significance in maintaining abstinence. It is important for the alcohol-dependent person’s recovery process to have the opportunity to gain resources. Experiencing loss of resources in the beginning of treatment often determines their return to drinking. The project provides empirical support for research on the role of supportive factors in an alcohol-dependent person’s recovery process.

Extended-release vs. oral naltrexone for alcohol dependence treatment in primary care (XON)

BackgroundExtended-release naltrexone (XR-NTX, Vivitrol®) and daily oral naltrexone tablets (O-NTX) are FDA-approved mu opioid receptor antagonist medications for alcohol dependence treatment. Despite the efficacy of O-NTX, non-adherence and poor treatment retention have limited its adoption into primary care. XR-NTX is a once-a-month injectable formulation that offers a potentially more effective treatment option in reducing alcohol consumption and heavy drinking episodes among persons with alcohol use disorders. MethodsThis pragmatic, open-label, randomized controlled trial examines the effectiveness of XR-NTX vs. O-NTX in producing a Good Clinical Outcome, defined as abstinence or moderate drinking (<2 drinks/day, men; <1 drink/day, women; and < 2 heavy drinking occasions/month) during the final 20 of 24 weeks of primary care-based Medical Management treatment for alcohol dependence. Secondary aims will estimate the cost effectiveness of XR-NTX vs. O-NTX, in conjunction with primary-care based Medical Management for both groups, and patient-level characteristics associated with effectiveness in both arms. Alcohol dependent persons are recruited from the community into treatment in a New York City public hospital primary care setting (Bellevue Hospital Center) for 24 weeks of either XR-NTX (n = 117) or O-NTX (n = 120). ResultsWe describe the rationale, specific aims, design, and recruitment results to date. Alternative design considerations and secondary aims and outcomes are reported. ConclusionsXR-NTX treatment in a primary care setting is potentially more efficacious, feasible, and cost-effective than oral naltrexone when treating community-dwelling persons with alcohol use disorders. This study will estimate XR-NTX's treatment and cost effectiveness relative to oral naltrexone.