Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool

Christina Schell, Lena C. Quilty, John A. Cunningham
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Abstract

ObjectiveAlexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use.MethodAs part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator.ResultsThe current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher).ConclusionThese results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects.Plain Language TitleDoes difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?
在一项针对抑郁和酗酒并发症的在线干预的随机对照试验中,研究 Alexithymia 对结果的调节作用。
目的情感障碍的特点是难以识别和/或描述情绪、想象过程减少以及思维以外部为导向。高水平的情感障碍可能会增加对同时患有抑郁症和酗酒的人提供支持的难度。作为随机对照试验的一部分,988 名参与者被随机分配到接受抑郁和酗酒双重干预,或仅接受抑郁干预。预先设定的中介假设是,随访 3 个月时饮酒量的变化将影响干预措施与 6 个月时抑郁症变化之间的关联。结果目前的分析表明,将情感障碍作为调节因素会产生有条件的直接效应。具体来说,接受抑郁和酒精联合干预的参与者在 6 个月后的抑郁评分有了更大的改善,但只有当他们在基线时的情感障碍评分也很高(60.5 或更高)时,才会产生干预效果。这一点尤其值得注意,因为情感障碍会导致治疗联盟更弱、更多的痛苦和焦虑、更短的戒断时间和更严重的抑郁,从而增加了支持合并症患者的复杂性。需要进行更多的研究来系统地调查这些可能的调节作用。纯文字标题难以识别/描述情绪或外向型思维是否会影响对同时患有抑郁症和酗酒的人进行干预的效果?
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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