Testing adaptations to contingency management for alcohol use disorders: A randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2025-06-26 DOI:10.1037/ccp0000960

Michael G McDonell, Sara Parent, Julianne D Jett, Mohammad Keshtkar, Katharine Palmer, Rachael Beck, Diana Tyutyunnyk, Michael Williams, Douglas L Weeks, Naomi S Chaytor, Sterling McPherson, Sean M Murphy, Richard K Ries, John M Roll

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引用次数: 0

Abstract

Objective: To determine if adults with an alcohol use disorder (AUD), who had a preintervention urine ethyl glucuronide (uEtG) level predictive of nonresponse to contingency management (CM), would respond to two intervention modifications (https://clinicaltrials.gov/ ID: NCT03481049).

Method: One hundred fifty-eight adults (53.2% female) with AUD, serious mental illness, and a mean uEtG ≥ 350 ng/mL over a 4-week induction period were randomized to (a) usual CM (uEtG-negative [<150 ng/mL] samples reinforced with $1,686); (b) high magnitude CM (uEtG-negative samples reinforced with $2,983); or (c) shaping CM (reduced drinking [uEtG < 500 ng/mL] samples reinforced for 4 weeks, then uEtG-negative samples reinforced for 12 weeks with $1,686). The primary outcome was uEtG-negative samples during induction and Weeks 5-16 of CM. The relationship between outcomes and uEtG-defined heavy drinking (≥ 500 ng/mL) immediately prior to randomization was assessed.

Results: CM conditions did not differ in uEtG-negative samples during the intervention period, Wald, χ²(2) = 1.96, p = .46. Participants were 4.2 times (95% CI [3.02, 5.92], p < .01) more likely to submit a uEtG-negative sample during CM, relative to induction. Those with a heavy drinking uEtG result immediately before randomization were less likely to submit uEtG-negative samples during CM, Wald, χ²(1) = 15.33, p < .01.

Conclusions: CM modifications were not associated with lower levels of alcohol use. Participants engaged in less alcohol use during CM, relative to induction. Two patterns of response to CM were observed based on uEtG-defined heavy drinking immediately prior to CM. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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酒精使用障碍应急管理适应性测试：一项随机对照试验

目的：确定干预前尿乙基葡萄糖醛酸苷（uEtG）水平预测对应急管理（CM）无反应的酒精使用障碍（AUD）成人是否会对两种干预修改（https://clinicaltrials.gov/ ID: NCT03481049）有反应。方法：在4周的诱导期内，158名患有AUD、严重精神疾病、平均uEtG≥350 ng/mL的成年人（53.2%为女性）随机分为(a)正常CM （uEtG阴性）组[结果：干预期间，uEtG阴性样本的CM情况无差异，Wald, χ²(2)= 1.96,p = 0.46。与诱导相比，参与者在CM期间提交uetg阴性样本的可能性高出4.2倍（95% CI [3.02, 5.92], p < 0.01）。随机分组前尿检结果为重度饮酒的患者在CM期间提交尿检阴性样本的可能性较小，Wald, χ²(1)= 15.33,p < 0.01。结论：CM改变与较低水平的酒精使用无关。相对于诱导，参与者在CM期间较少饮酒。两种对CM的反应模式是基于uetg定义的在CM之前立即大量饮酒。（PsycInfo Database Record (c) 2025 APA，版权所有）。

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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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.