Alcohol expectancy changes over a 12-week cognitive–behavioral therapy program are predictive of treatment success

Young, Ross McD.; Connor, Jason P.; Feeney, Gerald F.X.

doi:10.1016/j.jsat.2010.08.003

Cited by 32 publications

(27 citation statements)

References 46 publications

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“…One recent examination of a CBT program for alcohol dependent individuals found that post-treatment, expectancies related to use had changed (Young, Connor, & Feeney, 2011). Thus, the evaluation of similar interventions on the impact of PTSD-related alcohol expectancies may be indicated.…”

Section: Discussionmentioning

confidence: 99%

PTSD-related alcohol expectancies and impulsivity interact to predict alcohol use severity in a substance dependent sample with PTSD

Schaumberg

Vinci

Raiker

et al. 2015

Addictive Behaviors

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Introduction Problematic alcohol use is highly comorbid with posttraumatic stress disorder (PTSD), and prior work has demonstrated that individuals with PTSD may self-medicate with alcohol in an effort to reduce their symptoms. The combination of impulsivity and alcohol-related expectancies influences the development of problematic drinking patterns. When examining individuals diagnosed with PTSD, PTSD-related alcohol expectancies may be particularly relevant to the etiology of problematic drinking. To date, no studies have specifically examined PTSD-specific alcohol expectancies as they relate to alcohol use severity in a clinical sample. Methods The current study examined the relationship between impulsivity, PTSD-related alcohol expectancies, and severity of alcohol use in a sample of 63 individuals diagnosed with comorbid PTSD and substance use disorders who were receiving treatment in a residential substance use treatment program. Results Results indicated that PTSD-related alcohol expectancies moderated the relationship between impulsivity and alcohol use severity. Specifically, at low to moderate levels of positive PTSD-related alcohol expectancies, impulsivity significantly predicted alcohol use severity, while impulsivity had no impact on the prediction of alcohol use severity when such expectancies were high. Additionally, the relationship between impulsivity, expectancies, and alcohol use severity was significant for positive, but not negative, PTSD-related alcohol expectancies. Conclusions Overall, these results suggest that impulsivity and PTSD-related alcohol expectancies interact to predict alcohol use severity in a comorbid PTSD and substance dependent sample.

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Section: Discussionmentioning

confidence: 99%

PTSD-related alcohol expectancies and impulsivity interact to predict alcohol use severity in a substance dependent sample with PTSD

Schaumberg

Vinci

Raiker

et al. 2015

Addictive Behaviors

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“…Results from the models evaluating the influences of discharge status and during-treatment change converge to suggest that self-efficacy is an important predictor of short-term outcome. Self-efficacy measured at various points over treatment has been consistently associated with outcomes (Adamson et al, 2009; DiClemente et al, 2001; Long et al, 2000; McKay and Weiss, 2001; Morgenstern et al, 1997; Project MATCH Research Group, 1997; Young et al, 2011). Thus, evidence suggests, therefore, that self-efficacy likely represents a clinically meaningful summary indicator for monitoring progress and relapse potential during early recovery among young adults.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of research on during-treatment change in these common process variables has been conducted with adults. Longitudinal naturalistic studies have documented significant improvements in motivation, self-efficacy, coping skills, and commitment to 12-step groups, as well as decreases in psychological distress (Feeney et al, 2006; Finney et al, 1998; Kelly et al, 2005; Morgenstern et al, 1997; Young et al, 2011). In many cases, authors have noted fairly high sample means for constructs such as motivation, self-efficacy, and 12-step-related beliefs and intentions at treatment entry (Finney et al, 1998; Kahler et al, 2006; Morgenstern et al, 1996), and pre-treatment levels of self-efficacy, motivation, coping, and psychological symptoms have consistently predicted post-treatment outcomes (Adamson et al, 2009; McKay and Weiss, 2001; Project MATCH Research Group, 1997).…”

Section: Introductionmentioning

confidence: 99%

“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

Kelly

Urbanoski

Hoeppner

et al. 2012

Drug and Alcohol Dependence

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Background Young adulthood represents a key developmental period for the onset of substance use disorder (SUD). While the number of young adults entering treatment has increased, little is known about the mechanisms of change and early recovery processes in this important clinical population. This study investigated during-treatment change in key therapeutic processes (psychological distress, motivation, self-efficacy, coping skills, and commitment to AA/NA), and tested their relation to outcome at 3 months post-treatment. Methods Young adults undergoing residential treatment (N=303; age 18–24; 26% female; 95% Caucasian) were enrolled in a naturalistic prospective study and assessed at intake, mid-treatment, discharge, and 3 months following discharge. Repeated-measures and regression analyses modeled during-treatment change in process variables and impact on outcome. Results Statistically significant medium to large effect sizes were observed for changes in most processes during treatment, with the exception of motivation, which was high at treatment intake and underwent smaller, but still significant, change. In turn, these during-treatment changes all individually predicted 3-month abstinence to varying degrees, with self-efficacy emerging as the sole predictor in a simultaneous regression. Conclusions Findings help to clarify the mechanisms through which treatment confers recovery-related benefit among young adults. At treatment intake, high levels of abstinence motivation but lower coping, self-efficacy, and commitment to AA/NA, suggests many entering treatment may be “ready and willing” to change, but “unable” to do so without help. Treatment appears to work, in part, by helping to maintain motivation while conferring greater ability and confidence to enact such change.

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“…17 Through the use of cognitive behavioral therapy, participants who decreased their positive alcohol-related outcome expectancies were less likely to report binge drinking recidivism. 12 Further, research has revealed that higher levels of positive outcome expectancies combined with negative personality characteristics [e.g., negative urgency (the tendency to behave rashly because one’s current emotional state)] are related to behavioral outcomes such as a greater number of alcoholic beverages per week. 10 Depending on the gravity of the health behavior, along with an individual’s personality characteristics, outcome expectancies may create a large challenge in behavior change.…”

Section: Outcome Expectanciesmentioning

confidence: 99%

Addressing Outcomes Expectancies in Behavior Change

Reesor

Vaughan

Hernandez

et al. 2017

American Journal of Lifestyle Medicine

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Individuals commonly seek help for problem health behaviors, such as excessive drinking, smoking, and weight gain. Yet, there is a high rate of recidivism in these behaviors because outcome expectancies are either too high, negative outcome expectancies are not considered, or outcome expectancies are not properly addressed. Healthcare providers are recommended to list the outcome expectancy for the problem behavior and corresponding treatment for their patient. Through the process it is important to acknowledge both the positive and negative outcomes of engaging in the problem behavior. Healthcare providers are then encouraged to have their patient identify the goals and objectives that will assist in achieving the desired outcome. By recognizing and addressing outcome expectancies, it is more likely that the patient will be less resistant to the healthcare provider’s recommendations to change problematic behavior.

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Alcohol expectancy changes over a 12-week cognitive–behavioral therapy program are predictive of treatment success

Cited by 32 publications

References 46 publications

PTSD-related alcohol expectancies and impulsivity interact to predict alcohol use severity in a substance dependent sample with PTSD

PTSD-related alcohol expectancies and impulsivity interact to predict alcohol use severity in a substance dependent sample with PTSD

“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

Addressing Outcomes Expectancies in Behavior Change

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