Testing CBT models and change mechanisms for Alcohol Dependent Women

测试酒精依赖女性的 CBT 模型和变革机制

• 批准号: 7526639
• 负责人: Elizabeth Ellen Epstein
• 金额: $ 69.17万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7526639
• 关键词: Abstinence; Address; Advertisements; Affect; Alcohol abuse; Alcohol dependence; Alcoholic beverage heavy drinker; Alcoholism; Ambulatory Care Facilities; Behavioral; Clinical; Clinical Research; Cognitive; Cognitive Therapy; Communities; Community Outreach; Condition; Coping Skills; Female; Goals; Group Therapy; Health; Health Services Research; Individual; Literature; Maintenance; Manuals; Mediator of activation protein; Modeling; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Newspapers; Outcome; Outpatients; Participant; Patients; Persons; Process; Public Health; Randomized; Recovery; Recruitment Activity; Relative (related person); Research; Running; Self Efficacy; Services; Social Network; Social support; Testing; Underserved Population; United States National Institutes of Health; Woman; Work; alcohol abuse therapy; alcohol use disorder; base; coping; cost; cost effectiveness; disorder later incidence prevention; drinking; follow-up; response; skills; skills training; sobriety

DESCRIPTION (provided by applicant): This is a first revision of application 1 R01 AA017163-01, "Testing CBT Models and Change Mechanisms for Alcohol Dependent Women," originally submitted 02/07. The overall goal of the proposed research is to develop empirically supported and cost-effective models of treatment for women with alcohol use disorders. The proposed research will address three gaps in the scientific literature and clinical options for treatment of alcohol problems, including a. limited research on and understanding of alcohol dependent women, b. limited understanding of what change mechanisms make alcohol treatment work to help patients reduce drinking and maintain sobriety, and c. a dearth of clinical research to develop and test cost-effective group therapy models for alcohol use disorders. The proposal is in response to PA-07-066, "Alcohol Use Disorders: Treatment, Services Research, and Recovery," and is consistent with several recent emphases within NIH, including community-friendly health services research (e.g., NIDA, 2002, 2003), underserved populations (i.e. women) (Longabaugh & Wirtz, 2001), and a focus on the mechanisms that underlie the process of change in therapy (NIAAA, 2006a). The study has 4 specific aims: (1) To modify our existing Individual Female Specific Cognitive Behavioral Therapy (I -FSCBT) approach to treat women with alcohol dependence in a group format (GFSCBT); (2) To test the relative efficacy of Individual and Group FSCBT; and (3) To test hypothesized mechanisms of change in drinking that are common to both treatments, including (a) coping skills and enhanced self-efficacy for abstinence; (b) enhanced sense of autonomy; (c) alleviation of negative affect, and (d) increased social network support for abstinence, and (4) To assess the relative cost-effectiveness of the individual and group treatment. To accomplish these specific aims, 200 alcohol dependent women will be recruited via newspaper advertisement and community outreach to our outpatient clinic. The participants will complete baseline assessments, and then will be randomly assigned to 12 weekly outpatient manual guided sessions of either Individual or Group FSCBT. Recruitment will span 37 months, over which we will run 16 therapy groups each comprised of 6 women, and also treat 100 individual cases. Both treatment conditions will be cognitive-behavioral in focus and adapted specifically for women. Both the group and individual treatments will be abstinence based, and include motivational enhancement, coping skills training, management of negative affect, skills to manage heavy drinkers in the social network, relapse prevention and themes related to autonomy. Participants will be assessed during treatment to track temporal changes in proposed mediator and outcome variables. Participants will complete in-person follow up assessments at 3, 9, and 15 months post-baseline, to assess maintenance of gains. The proposed clinical research is directly relevant to public health. Ultimately, availability of effective and affordable group therapy models to treat alcohol dependent women based on an understanding of how and why the therapy works, will enhance health delivery services and help reduce the personal and societal consequences of alcoholism.

描述（由申请人提供）：这是申请1 R01 AA017163-01的首次修订，“测试CBT模型和依赖酒精妇女的变更机制”，最初提交了02/07。拟议的研究的总体目标是为饮酒障碍的妇女开发经验支持且具有成本效益的治疗模型。拟议的研究将解决科学文献中的三个差距和治疗酒精问题的临床选择，包括a。对依赖酒精的妇女的研究和理解有限，b。对哪种变化机制的了解有限，使酒精治疗可帮助患者减少饮酒和维持清醒，以及c。缺乏临床研究，以开发和测试针对酒精使用障碍的成本效益小组治疗模型。 The proposal is in response to PA-07-066, "Alcohol Use Disorders: Treatment, Services Research, and Recovery," and is consistent with several recent emphases within NIH, including community-friendly health services research (e.g., NIDA, 2002, 2003), underserved populations (i.e. women) (Longabaugh & Wirtz, 2001), and a focus on the mechanisms that underlie the process of change in therapy （NIAAA，2006a）。该研究具有4个具体目的：（1）修改我们现有的女性特异性认知行为疗法（I -FSCBT）方法来治疗以群体格式（GFSCBT）治疗酒精依赖的妇女； （2）测试个体和组FSCBT的相对疗效； （3）测试两种治疗方法共有的饮酒变化机制，包括（a）应对技巧和戒酒的自我效能增强； （b）增强的自主感； （c）减轻负面影响，（d）增加社交网络对禁欲的支持，以及（4）评估个人和团体治疗的相对成本效益。完成 这些具体的目标是，将通过报纸广告和我们的门诊诊所通过报纸广告和社区宣传来招募200名饮酒妇女。参与者将完成基线评估，然后将其随机分配给个人或组FSCBT的12个每周门诊手动指导会议。招聘将跨越37个月，我们将在其中运行16个治疗组，每个治疗组由6名妇女组成，还可以治疗100例单独的病例。两种治疗条件都将是重点的认知行为，并专门针对女性。小组和个人治疗方法都将基于禁欲，包括动机增强，应对技能培训，负面影响的管理，在社交网络中管理重型饮酒者的技能，预防复发和与自治有关的主题。将在治疗期间评估参与者，以跟踪提议的调解人和结果变量的时间变化。参与者将在基线后3、9和15个月完成面对面的随访评估，以评估收益的维持。拟议的临床研究与公共卫生直接相关。最终，有效且负担得起的小组疗法模型可根据对治疗方法的理解以及为什么运作的方式来治疗依赖酒精的妇女，这将增强医疗服务，并有助于减少酒精中毒的个人和社会后果。