Objective-As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, the aim of the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD).Method-A prospective study investigated whether emotion-regulation skills were associated with AD and whether these skills predicted alcohol use during and after treatment for AD. Participants were 116 individuals treated for AD with cognitive behavioral therapy. Emotion regulation and severity of AD symptoms were assessed by self-report. Alcohol use during treatment was assessed by breathalyzer and urine analysis for ethyl glucuronid; alcohol use during the 3-month follow-up interval was assessed by self-report.Results-Pretreatment emotion-regulation skills predicted alcohol use during treatment, and posttreatment emotion-regulation skills predicted alcohol use at follow-up, even when controlling for other predictors potentially related to emotion regulation. Among a broad range of specific emotion-regulation skills, the ability to tolerate negative emotions was the only skill that negatively predicted subsequent alcohol consumption when controlling for the other skills. Individuals in the AD sample reported significantly more deficits in emotion-regulation skills than did those in a non-clinical control sample, but significantly less than did those in a sample of individuals exclusively meeting criteria for major depressive disorder.Conclusions-Enhancement of general emotion-regulation skills, especially the ability to tolerate negative emotions, appears to be an important target in the treatment of AD. Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/ccp NIH Public Access Author Manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2012 June 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAlcohol dependence (AD) is the most serious form of alcohol-use disorder. AD is associated with intense mental, physical, and functional impairment; high societal costs; and long-term suffering by both the dependent individual and the individual's family members (e.g., Caetano, Nelson, & Cunradi, 2001). However, AD is also fairly widespread, with a 12-month prevalence rate of nearly 4% in the general population (Hasin, Stinson, Ogburn, & Grant, 2007). Despite the development and implementation of several empirically supported treatments, only about 25% of clients have been found to remain abstinent during the first year following treatment terminat...

Aims: The assessment of relapses is widely used as an outcome measure of alcohol dependence treatment. However, the methods of assessing relapses range from questionnaires to biological markers of alcohol for different time spans. The aim of this study was to compare the relapse rates of weekend home stays during long-term alcohol dependence treatment, assessed by ethyl glucuronide (EtG), breath alcohol tests and self-reports. Methods: Two hundred and ninety-seven alcohol-dependent patients receiving a long-term inpatient treatment programme participated. After a weekend at home (Friday to Sunday) they were evaluated for relapse by personal interviews and with breath alcohol tests. A concomitantly collected urine sample was later assessed for EtG with liquid chromatography-tandem mass spectrometry (LC-MS/MS analysis). Results: Of the total, 37.7% of the patients were positive for EtG at least once. Breath alcohol tests had been positive in only 4.4% and in personal interviews only 5.7% of the patients had admitted relapse. 15.6% of EtG tests were positive, but breath alcohol tests were negative (Cohen's kappa = 0.056). Ninety-three per cent of the relapses were only detected by EtG. Conclusion: In addition to breath alcohol tests and interviews, urinary EtG can clearly improve the verification of relapse in inpatient treatment programmes allowing for weekend stays at home. Without EtG testing, a high amount of relapses will stay undetected.

Hintergrund: Therapeutische Veränderungsschritte stellen für die Patienten häufig einen Konflikt zwischen aversiv erlebten kurzfristigen und positiv bewerteten langfristigen Konsequenzen dar. Dieser Konflikt hemmt oft negativ die tatsächliche Durchführung von Veränderungsschritten, die zuvor in der Therapie erarbeitet wurden. Ziel der Studie ist es zu klären, inwieweit sich durch eine gezielte Förderung motivationaler und volitionaler Prozesse (Entschlussfassung) die Wahrscheinlichkeit erhöhen lässt, dass Patienten die geplanten Veränderungsschritte tatsächlich ausführen. Methode: Auf allgemein motivationspsychologischen Grundlagen wurde das präskriptive Entschlussmodell «PRÄMO» erstellt. Aus diesem wurde die Entschlussförderungsintervention «EFI» abgeleitet, deren Effektivität exemplarisch bei 63 Patienten mit Selbstdurchsetzungsdefiziten in einem randomisierten Kontrollgruppendesign evaluiert wurde. Ergebnisse: Der Anteil der Patienten, die eine zuvor in der stationären Therapie erarbeitete Selbstdurchsetzungshandlung nach der Therapie tatsächlich durchführten, lag in der Entschlussförderungsgruppe mit 91% deutlich höher als in der Kontrollgruppe, bei der eine klassische kognitiv- verhaltenstherapeutische Intervention durchgeführt wurde (66%). Schlussfolgerungen: Aus einer gezielten Analyse der Prozesse, welche die Selbstverpflichtung zu vereinbarten Veränderungsschritten beeinflussen, lassen sich spezifische Entschlussförderungsinterventionen ableiten. Diese erleichtern es den Patienten, vereinbarte Veränderungsschritte auch tatsächlich durchzuführen.