Elucidating the Effect of Alcohol-Related Services on Abstinence, Recovery and Familial Functioning: A Propensity Score Matching Approach

摘要 酒精使用障碍（AUD）造成巨大的全球负担，并对经济产生重大影响。 和社会功能，1因为它影响了1510万成年人。2对AUD的有效治疗已经很好- 在文献中建立和研究，并且有许多基于证据的选择 治疗。3，4 AUD最常见的治疗方法是与酒精相关的服务，如自助 团体，门诊诊所和戒毒中心。4，5评估这些酒精相关的有效性研究 服务已经发现，虽然这些服务在治疗AUD方面是有效的，但是存在许多差异， 接受酒精相关服务的个人和不接受酒精相关服务的个人之间的差异。 在有效性研究中造成固有的选择偏差，混淆结果。 此外，目前对酒精相关服务的研究经常将恢复结果定义为戒酒 7然而，这种方法减少了可行的恢复结果的可变性，例如减少 将饮酒行为降低到适度水平，有效减少与酒精有关的问题。 饮酒行为和与酒精有关的问题理论上应该对更广泛的方面产生影响， 功能，特别是心理和社会心理功能。特别是家庭功能， 家庭环境的改善有能力减少 风险的家庭成员，谁是否则在情绪和行为问题的高风险， 与患有AUD的家庭成员生活在一起。10然而，这些功能指数很少在酒精相关的 11目前的建议旨在调查酒精相关服务的影响， 通过使用倾向分数匹配方法来消除选择偏差，以创建比较组， 在所有测量变量上与酒精相关服务组相匹配。此外，目前的建议将 通过扩大对结果的评估以包括饮酒的变异性来进一步增加文献 行为，以及家庭功能。

ABSTRACT Alcohol use disorder (AUD) causes immense global burden and has a significant impact on economic and societal functioning,1 as it affects 15.1 million adults.2 Efficacious treatments for AUDs have been well- established and researched within the literature, and there are numerous options for evidence-based therapies.3,4 The most commonly accessed treatments for AUD are alcohol-related services, such as self-help groups, outpatient clinics, and detoxification centers.4,5 Effectiveness studies assessing these alcohol-related services have found that though these services are effective at treating AUDs, there are numerous differences between individuals who receive alcohol-related services and individuals who do not.5,6 These differences cause inherent selection bias in studies of effectiveness, confounding findings regarding outcomes. Furthermore, current studies of alcohol-related services frequently define recovery outcomes as abstinence from drinking.7 However, this approach reduces variability in viable recovery outcomes, such as reduction of drinking behaviors to moderate levels, effectively reducing alcohol-related problems.8 In addition, reduction in drinking behaviors and alcohol-related problems should theoretically have an impact on broader aspects of functioning, particularly psychological and psychosocial functioning. Familial functioning in particular is an important aspect of daily life that is impacted by AUDs.9 Improved familial context has the capacity to reduce risk to family members, who are otherwise at heightened risk for emotional and behavioral problems when living with a family member with AUD.10 Yet these indices of functioning are rarely evaluated in alcohol-related services research.11 The current proposal seeks to investigate the effect of alcohol-related services after eliminating selection bias by using a propensity score matching approach to create a comparison group that is matched to the alcohol-related services group on all measured variables. Moreover, the current proposal will further add to the literature by broadening the assessment of outcomes to include variability in drinking behaviors, as well as familial functioning.