Alcohol Relapse and Change Needs a Broader View than Counting Drinks.
Alcohol Relapse and Change Needs a Broader View than Counting Drinks.
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DOI：
10.1111/acer.13288
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Crisafulli MA
中科院分区：
文献类型：
--
作者：
DiClemente CC;Crisafulli MA
Maisto和他的同事们对酒精使用障碍复发的调查(2016，本卷)有望结束将复发定义和理解为由一定数量的饮料组成的单一事件的努力。作者发现，在治疗期间饮酒更多预示着治疗结束时和一年后饮酒更多，这似乎反映了经常使用的一句话，即“对未来行为的最好预测是过去的行为”。然而，正如文章中指出的，各种基于数量的复发定义高度相关，与未来饮酒只有轻微到中等(尽管统计上显著)的关系，并且它们之间没有重大差异。最普遍的复发衡量标准--治疗期间的“饮酒”--并不能很好地预测未来的饮酒情况，这表明它可能更多地是一种堕落的衡量标准，而不是复发，或者可能只是反映了戒酒的非线性过程。正如作者总结的那样，这些对复发的定义并不是强有力的预测因子，也不能帮助我们理解什么本质上是一个动态的过程或一系列事件。在这篇评论中，我们提供了一些基于数量的定义失败的原因，然后讨论了在能够识别复发之前定义成功行动的必要性。接下来，我们考虑在定义治疗目标和复发时包括做出改变的人的观点的重要性。最后，我们建议，必须从更广泛的角度来理解复发，包括考虑脆弱性、回收以及如何从客户、提供者和研究人员的失败中学习的变化过程。
The investigation of alcohol use disorder relapse by Maisto and colleagues (2016, this volume) hopefully will end efforts to define and understand relapse as a single event consisting of some number of drinks. The authors’ finding that heavier drinking during treatment predicted heavier drinking at the end of treatment and 1 year later seems to reflect the often-used phrase that “the best predictor of future behavior is past behavior”. However, as noted in the article, the various quantity-based definitions of relapse were highly intercorrelated, had only a small to moderate (though statistically significant) relationship with future drinking, and had no important differences between them. The most general measure of relapse,“some drinking” during treatment, was not as good predictor of future drinking, suggesting that it may be more a measure of lapse than relapse or may simply reflect the non-linear process of becoming abstinent. As the authors conclude, these definitions of relapse are not powerful predictors and do not help us to understand what essentially is a dynamic process or series of events.In this commentary we offer some reasons for the failure of quantity-based definitions and then discuss the need to define successful action prior to being able to identify relapse. Next we consider the importance of including the perspective of the person making the change when defining both treatment goals and relapse. Finally we suggest that relapse has to be understood using a broader view of the change process that considers vulnerability; recycling; and how to learn from client, provider, and researcher failures.
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DOI：
10.1111/acer.13173
发表时间：
2016-10-01
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Maisto, Stephen A.;Roos, Corey R.;Witkiewitz, Katie
通讯作者：
Witkiewitz, Katie
影响因子：
4.6
作者：
Kirchner, Thomas R.;Shiffman, Saul;Wileyto, E. Paul
通讯作者：
Wileyto, E. Paul
DOI：
10.1111/j.1530-0277.2007.00489.x
发表时间：
2007-10-01
影响因子：
3.2
作者：
DiClemente, Carlo C.
通讯作者：
DiClemente, Carlo C.
影响因子：
4.2
作者：
Prince, Mark A.;Maisto, Stephen A.
通讯作者：
Maisto, Stephen A.
DOI：
10.1111/j.1530-0277.2007.00536.x
发表时间：
2007-12-01
影响因子：
3.2
作者：
Dawson, Deborah A.;Goldstein, Rise B.;Grant, Bridget F.
通讯作者：
Grant, Bridget F.