Do Alcohol Relapse Episodes During Treatment Predict Long-Term Outcomes? Investigating the Validity of Existing Definitions of Alcohol Use Disorder Relapse
Do Alcohol Relapse Episodes During Treatment Predict Long-Term Outcomes? Investigating the Validity of Existing Definitions of Alcohol Use Disorder Relapse
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DOI：
10.1111/acer.13173
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发表时间：
2016-10-01
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影响因子：
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通讯作者：
Witkiewitz, Katie
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文献类型：
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作者：
Maisto, Stephen A.;Roos, Corey R.;Witkiewitz, Katie
背景复发的概念广泛应用于酒精使用障碍（AUD）治疗的临床研究和实践中。本研究的目的是测试实证文献中常见的 AUD 复发定义的预测有效性。方法根据单次饮酒期间的饮酒量，使用 7 种复发定义对来自 Project MATCH 和 COMBINE 的数据进行二次分析：任何饮酒；女性/男性至少饮酒 4/5；女性/男性至少 4.3/7.1 杯饮料；女性/男性至少饮酒 6/7；至少 6 杯饮料；女性/男性至少 7/9 饮酒；女性/男性至少饮酒 8/10。复发用于预测治疗结束时和治疗后一年内的饮酒量、相关后果和不饮酒结果（生活质量、心理社会功能）。结果回归分析表明，治疗内复发定义可显着预测治疗结束时的饮酒量和酒精相关后果。重度饮酒定义通常比任何饮酒定义都更具预测性，但没有任何一个重度饮酒定义能够始终如一地更好地预测结果。复发定义对长期酒精相关结果以及短期和长期非饮酒结果（包括健康和心理社会功能）的预测能力较差。结论 复发的一个特定定义并不总是成为最佳预测因子。 AUD 研究的进展可能需要将复发重新概念化为一个多方面的动态过程，并且在检查 AUD 个体的变化过程时可能会考虑更广泛的相关行为（例如健康和心理社会功能）。
BackgroundThe construct of relapse is used widely in clinical research and practice of alcohol use disorder (AUD) treatment. The purpose of this study was to test the predictive validity of commonly appearing definitions of AUD relapse in the empirical literature.MethodsSecondary analyses of data from Project MATCH and COMBINE were conducted using 7 definitions of relapse based on drinking quantity within a single drinking episode: any drinking; at least 4/5 drinks for women/men; at least 4.3/7.1 drinks for women/men; at least 6/7 drinks for women/men; at least 6 drinks; at least 7/9 drinks for women/men; and at least 8/10 drinks for women/men. Relapse was used to predict alcohol consumption, related consequences, and nonconsumption outcomes (quality of life, psychosocial functioning) at the end of treatment and up to 1year posttreatment.ResultsRegression analyses indicated within-treatment relapse definitions significantly predicted end-of-treatment alcohol consumption and alcohol-related consequences. Heavy drinking definitions were generally more predictive than the any drinking definition, but no single heavy drinking definition was consistently a better predictor of outcomes. Relapse definitions were less predictive of longer-term alcohol-related outcomes and both shorter- and longer-term nonconsumption outcomes, including health and psychosocial functioning.ConclusionsOne particular definition of relapse did not consistently stand out as the best predictor. Advances in AUD research may require reconceptualization of relapse as a multifaceted dynamic process and may consider a wider range of relevant behaviors (e.g., health and psychosocial functioning) when examining the change process in individuals with AUD.