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Reconceptualizing Dependence Severity in Project MATCH

重新概念化项目 MATCH 中的依赖性严重性

基本信息

批准号：
7009284
负责人：
LESLIE C MOREY
金额：
$ 13.27万
依托单位：
TEXAS A&M UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-02-01 至 2009-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7009284
关键词：
alcoholism /alcohol abuse behavioral /social science research tag clinical research data collection methodology /evaluation human data substance abuse epidemiology substance abuse related behavior

项目摘要

DESCRIPTION (provided by applicant): Individuals with alcohol use problems represent a heterogeneous group with respect to variables relevant to classification and treatment. Failure to account for this heterogeneity would be expected to compromise treatment outcome and matching effects. With this in mind, Project MATCH hypothesized several treatment matching relationships based on alcoholic type, alcohol severity, psychiatric severity, and alcohol dependence, but found limited effects of client heterogeneity. However, it is possible that the existing examinations of Project MATCH data have not fully characterized the nature of severity of alcohol dependence, as these analyses have typically examined dependence severity as an additive symptom count similar to the diagnostic strategy represented in the DSM-IV. We propose to examine dependence severity as a latent trait hypothesized to have a characteristic developmental progression, and that this conceptualization may result in a dimension that may represent an important source of variance in treatment response and outcome, both directly and as a moderator of other important typological variables. We seek to identify salient markers of dependence severity on this putative developmental continuum using techniques of Item Response Theory (IRT), and examine the implications of this approach to severity scaling in the Project MATCH data with respect to its effect on treatment and treatment matching outcomes. Specifically, this project seeks to (1) use IRT to establish scaled severity markers that may theoretically reflect milestones in the developmental course of alcoholism; (2) test the generalizability of the scaled continuum across gender and ethnic background; and (3) scale Project MATCH participants based upon their empirical fit with (traitedness) and their placement on (severity) this identified latent severity trait, and then use this information to re-examine the treatment effects and matching hypotheses central to that project.

描述（由申请人提供）：有酗酒问题的个体在与分类和治疗相关的变量方面代表了一个异质群体。如果不考虑这种异质性，预计会损害治疗结果和匹配效果。考虑到这一点，MATCH 项目根据酒精类型、酒精严重程度、精神严重程度和酒精依赖假设了几种治疗匹配关系，但发现客户异质性的影响有限。然而，现有的 MATCH 项目数据检查可能尚未完全表征酒精依赖严重程度的性质，因为这些分析通常将酒精依赖严重程度检查为与 DSM-IV 中所示的诊断策略类似的附加症状计数。我们建议将依赖严重程度作为一种潜在特征进行检查，假设其具有特征性的发展进程，并且这种概念化可能会产生一个维度，该维度可能代表治疗反应和结果的重要方差来源，无论是直接的还是作为其他重要类型变量的调节因子。我们试图使用项目反应理论（IRT）技术来识别这个假定的发展连续体上依赖性严重程度的显着标记，并检查这种方法对项目匹配数据中的严重程度缩放的影响，以及它对治疗和治疗匹配结果的影响。具体来说，该项目旨在 (1) 使用 IRT 建立按比例衡量的严重程度标记，理论上可以反映酗酒发展过程中的里程碑； (2) 测试跨性别和种族背景的尺度连续体的普遍性； (3) 根据他们对这一已确定的潜在严重性特征的经验契合度（特质）和他们在（严重性）上的定位，对项目 MATCH 参与者进行规模调整，然后使用此信息重新检查治疗效果和匹配该项目的核心假设。