Relapse Among Severely Mentally Ill Alcohol Abusers

这项拟议研究的长期目标是开发有效的方法，减少严重精神病（SMI）酒精滥用者治疗后的酒精参与。本研究建议的具体目的是测试概念路径模型中总结的特定假设：1。探讨精神病学对精神分裂症患者治疗后饮酒的直接和间接影响。 将通过几个变量评估酒精参与结局，包括酒精使用复发、戒酒天数百分比、每日饮酒量和酒精使用的负面后果。 预计精神症状将有直接影响治疗后酒精参与和间接影响，通过双诊断治疗和应对技能的因素。2.研究酒精和其他物质使用问题对治疗后酒精参与的直接和间接影响。 据预测，酒精和其他物质使用问题将有两个直接影响酒精参与的结果和间接影响，通过双重诊断，治疗和应对技能的因素。3.研究双诊断治疗对治疗后酒精参与结果的直接和间接影响。 据预测，双诊断治疗将有一个直接的影响酒精参与的结果，也通过应对技能因素的间接影响。4.探讨一般应对技能和特定酒精应对技能对治疗后酒精参与结果的直接影响。 据预测，较差的应对技能将导致更糟糕的酒精参与的结果。5.进行探索性分析，检查性别，种族背景，抗精神病药物和酒精药物对我们的中介路径模型和酒精参与结果的预测变量之间的关联的调节作用。纵向设计将用于在治疗开始时评估关键结构的多项指标，此后每两个月评估一次，持续6个月。 关键结构包括背景特征、精神病学、酒精和其他物质使用问题、治疗、应对技能和酒精参与结果。 重要的是，本研究的结果将用于了解导致重度精神障碍患者治疗后饮酒的因素。

The long-term goal of this proposed research is to develop effective methods for reducing posttreatment alcohol involvement among severely mentally ill (SMI) alcohol-abusing individuals. The specific aims of this research proposal are to test specific hypotheses summarized in a conceptual path model: 1. To examine the direct and indirect effects of psychiatric symptomatology on posttreatment alcohol involvement in schizophrenic individuals. Alcohol involvement outcome will be assessed by several variables including relapse to alcohol use, percent days abstinent, drinks per drinking day, and negative consequences due to alcohol use. It is anticipated that psychiatric symptoms will have both a direct influence on posttreatment alcohol involvement and an indirect effect through the dual-diagnosis treatment and coping skills factors. 2. To examine the direct and indirect effects of alcohol and other substance use problems on posttreatment alcohol involvement. It is predicted that alcohol and other substance use problems will have both a direct influence on alcohol involvement outcomes and an indirect effect through the dual- diagnosis treatment and coping skills factors. 3. To examine the direct and indirect effects of dual-diagnosis treatment on posttreatment alcohol involvement outcomes. It is predicted that dual-diagnosis treatment will have a direct influence on alcohol involvement outcomes and also an indirect effect through the coping skills factor. 4. To examine the direct influence of general and alcohol- specific coping skills on posttreatment alcohol involvement outcomes. It is predicted that poorer coping skills will lead to worse alcohol involvement outcomes. 5. To conduct exploratory analyses examining the moderating effects of gender, ethnic background, antipsychotic medications, and alcohol medications on the association between predictor variables derived from our mediational path model and alcohol involvement outcomes. A longitudinal design will be used to assess multiple measures of key constructs at treatment entry, and every two months thereafter for a period of six months. Key constructs include background characteristics, psychiatric symptomatology, alcohol and other substance use problems, treatment, coping skills, and alcohol involvement outcomes. Importantly, the results of this study will be used to gain an understanding of factors leading to posttreatment alcohol involvement among SMI individuals.