Exploring Personal Change Mechanisms in Modifying Drinking Behavior

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DESCRIPTION (provided by applicant): To increase the effectiveness of interventions of alcohol use disorders developmental research is needed to understand and assess critical mechanisms of change that influence the modification of drinking behavior. The proposed R21 research project will examine mechanisms as well as mediators and moderators of the personal process of change that underlies the modification of drinking both in natural or self-change as well as in treatment. Candidate constructs to be considered in this project include stages and processes of change, self-control and executive cognitive functioning, commitment, self-efficacy, craving, affect management, stress, expectancies, and relevant change history. The three phases of this research will 1) explore these candidate change process variables in secondary analyses of Project MATCH and COMBINE data sets examining them within treatment and for relationships with changes in drinking over time; 2) create and evaluate a structured interview assessment, the Change Tasks and Mechanisms Interview (CTMI), designed to capture how well critical tasks of the personal process of change are accomplished by individual drinkers that will be developed with 40 participants currently in treatment, 10 clinical staff and several independent raters of audio taped interviews; and 3) combining both self-report and interview measures we will assemble and evaluate a Comprehensive Change Assessment Battery (CCAB) that measures critical self-regulation and change process dimensions in a pilot study with 80 alcohol treatment patients from two clinical outpatient settings who will be evaluated at baseline, 2, 4, 6, 8, 12 and 24 weeks after enrollment. This pilot will refine and finalize a novel assessment battery that can evaluate the personal change process in order to better understand mechanisms of change that are active both in natural and intervention-assisted change of drinking behaviors.