Behavioral Couples Therapy for Women Alcoholic Patients

描述(由申请人提供)： 在男性酗酒和吸毒患者中，行为伴侣疗法(BCT)是参与治疗的家庭，拥有最强大的研究支持，比典型的基于个人的治疗(IBT)产生更大的禁欲和更好的关系功能，并减少社会成本、伴侣暴力和夫妇子女的情感问题。尽管人际冲突和关系因素在女性饮酒问题中扮演着特别重要的角色，但还没有发表过关于女性酗酒患者最佳酒精疗法的对照研究。在包括女性酒精中毒患者的少数BCT研究中，女性患者太少，无法分别检查BCT对男性和女性患者的疗效。最近的研究提供了相互矛盾的结果。一份会议报告报告说，女性酒精中毒患者的BCT和IBT没有区别，因为在这两种治疗后的6个月里，戒酒天数增加了类似的情况。相比之下，Pl对BCT的自然主义研究发现：(A)女性酗酒者在戒酒天数、酒精相关问题以及治疗期间和治疗后一年的关系调整方面都有显著改善，(B)女性酗酒者在BCT治疗后的结果与男性酗酒患者的结果没有差异。此外，Co-Pis对照研究表明，对于被诊断为原发药物滥用的女性患者，BCT比IBT产生更多的戒断天数和更好的关系结果。这些女性药物滥用患者中的大多数都被诊断出患有酒精问题。 该项目将对女性酒精中毒患者进行随机临床试验，比较BCT加IBT和单纯IBT。已婚或同居的女性酒精依赖患者(N=160)将在20周内被随机分配到26个疗程中，其中包括：(A)BCT+IBT；或(B)单独接受IBT。我们将通过在治疗过程中和治疗后立即收集的患者和配偶以及为期12个月的季度随访中收集的数据来测试BCT+IBT将产生比单独IBT更好的结果的预测。成果领域将包括物质使用和问题、关系调整和伙伴暴力以及社会成本。我们将探索在他们的父母接受BCT以及潜在的结果调解人和调节者后，儿童功能可能得到的改善。

DESCRIPTION (provided by applicant): Among male alcoholic and drug abusing patients, behavioral couples therapy (BCT), the family involved treatment with the strongest research support, produces greater abstinence and better relationship functioning than typical individual-based treatment (IBT) and reduces social costs, partner violence, and emotional problems of the couple's children. Although interpersonal conflict and relationship factors play a particularly important role in the drinking problems of women, there have been no published, controlled studies of BCT with women alcoholic patients. The few studies of BCT that have included female alcoholic patients had too few female patients to examine the efficacy of BCT separately for male and female patients. Recent studies offer conflicting results. A conference presentation reported that BCT and IBT did not differ for women alcoholic patients because days abstinent increased similarly in the 6 months after both treatments. In contrast, the Pl's naturalistic study of BCT found that (a) women alcoholics improved significantly on days abstinent, alcohol-related problems, and relationship adjustment during treatment and in the year after treatment and (b) women alcoholics' outcomes after BCT did not differ from outcomes for male alcoholic patients. Further, the Co-PIs controlled study showed that BCT produced more days abstinent and better relationship outcomes than IBT for women patients with a primary drug abuse diagnosis. The majority of these women drug abuse patients had a comorbid alcohol problem diagnosis. This project will conduct a randomized clinical trial comparing BCT plus IBT with IBT alone for women alcoholic patients. Married or cohabiting female alcohol-dependent patients (N=160) will be randomly assigned to 26 treatment sessions over a 20-week period consisting of either: (a) BCT plus IBT; or (b) IBT for the patient alone. We will test the prediction that BCT+IBT will produce better outcomes than IBT alone as shown by data collected from patients and spouses during and immediately after treatment and at quarterly follow-ups for 12 months. Outcome domains will include substance use and problems, relationship adjustment and partner violence, and social costs. We will explore possible improvements in children's functioning after their parents receive BCT and potential mediators and moderators of outcome.