Internet Therapy Versus Internet Self-Help Versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial
Internet Therapy Versus Internet Self-Help Versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial
复制标题
DOI：
10.1037/a0023498
复制
发表时间：
2011-06-01
影响因子：
5.9
通讯作者：
Schippers, Gerard M.
中科院分区：
文献类型：
--
作者：
Blankers, Matthijs;Koeter, Maarten W. J.;Schippers, Gerard M.
目的：酒精使用问题是全球疾病负担的第三大诱因，部分原因是大多数问题饮酒者未接受治疗。基于互联网的酒精干预措施吸引了原本未接受治疗的人群，但其有效性尚未确定。本研究检验了基于互联网的治疗（在线酒精治疗；TAO）和基于互联网的自助（在线酒精自助；SAO）对酒精使用问题者的有效性。
方法：成年问题饮酒者（n = 205；51%为女性；平均年龄 = 42岁；平均酒精使用障碍识别测试分数 = 20）被随机分配到TAO组、SAO组或未接受治疗的等待名单对照组（WL）。TAO组的参与者接受7次基于文本的单独聊天治疗课程。TAO和SAO干预措施基于认知行为疗法和动机性访谈技术。在基线以及随机分组后3个月和6个月进行评估。主要结局指标是饮酒量和治疗反应。次要结局指标包括生活质量的测量。
结果：使用广义估计方程回归模型，意向性治疗分析表明，在随机分组后3个月，TAO组与WL组相比（p = 0.002）以及SAO组与WL组相比（p = 0.03）在饮酒量上有显著效果。在随机分组后3个月，TAO组和SAO组之间的差异不显著（p = 0.11），但在随机分组后6个月差异显著（p = 0.03），TAO组效果更明显。治疗反应和生活质量结局指标也有类似的结果模式。
结论：结果支持认知行为疗法/动机性访谈基于互联网的治疗和基于互联网的自助对酒精使用问题者的有效性。在随机分组后6个月，基于互联网的治疗比基于互联网的自助效果更好。
Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the effectiveness of Internet-based therapy (therapy alcohol online; TAO) and Internet-based self-help (self-help alcohol online; SAO) for problematic alcohol users. Method: Adult problem drinkers (n =205; 51% female; mean age = 42 years; mean Alcohol Use Disorders Identification Test score = 20) were randomly assigned to TAO, SAO, or an untreated waiting-list control group (WL). Participants in the TAO arm received 7 individual text-based chat-therapy sessions. The TAO and SAO interventions were based on cognitive-behavioral therapy and motivational interviewing techniques. Assessments were given at baseline and 3 and 6 months after randomization. Primary outcome measures were alcohol consumption and treatment response. Secondary outcome measures included measures of quality-of-life. Results: Using generalized estimating equation regression models, intention-to-treat analyses demonstrated significant effects for TAO versus WL (p = .002) and for SAO versus WL (p = .03) on alcohol consumption at 3 months postrandomization. Differences between TAO and SAO were not significant at 3 months postrandomization (p = .11) but were significant at 6 months postrandomization (p = .03), with larger effects obtained for TAO. There was a similar pattern of results for treatment response and quality-of-life outcome measures. Conclusions: Results support the effectiveness of cognitive-behavioral therapy/motivational interviewing Internet-based therapy and Internet-based self-help for problematic alcohol users. At 6 months postrandomization, Internet-based therapy led to better results than Internet-based self-help.