Behavioral Couples Therapy for Women Alcoholic Patients

描述（由申请人提供）： 在男性酒精和药物滥用患者中，行为夫妻疗法（BCT），家庭参与治疗的最强有力的研究支持，产生更大的禁欲和更好的关系功能比典型的个人为基础的治疗（IBT），并减少社会成本，伴侣暴力，和夫妇的孩子的情感问题。虽然人际冲突和关系因素在女性饮酒问题中起着特别重要的作用，但目前还没有发表过关于女性酒精患者BCT的对照研究。少数纳入女性酗酒患者的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。一份会议报告称，BCT和IBT对女性酗酒患者没有差异，因为两种治疗后6个月内禁欲天数增加相似。相比之下，Pl的BCT自然主义研究发现，（a）女性酗酒者在治疗期间和治疗后一年的戒酒天数、酒精相关问题和关系调整方面有显著改善，（B）BCT后女性酗酒者的结局与男性酗酒者的结局没有差异。此外，Co-PI对照研究表明，对于主要药物滥用诊断的女性患者，BCT比IBT产生更多的禁欲天数和更好的关系结局。这些女性药物滥用患者中的大多数都有合并酒精问题的诊断。 本项目将进行一项随机临床试验，比较BCT联合IBT与单独IBT治疗女性酒精中毒患者的效果。已婚或同居女性酒精依赖患者（N=160）将在20周内随机分配至26个治疗阶段，包括：（a）BCT + IBT;或（B）患者单独IBT。我们将检验BCT+IBT将产生比单独IBT更好的结局的预测，如在治疗期间和治疗后立即以及在12个月的季度随访中从患者和配偶收集的数据所示。成果领域将包括药物使用和问题、关系调整和伴侣暴力以及社会成本。我们将探讨父母接受BCT后儿童功能的可能改善以及潜在的结果调节剂和调节剂。

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.