D M Donovan, R M Kadden, C C DiClemente, K M Carroll, R Longabaugh, A Zweben, R Rychtarik
{"title":"Issues in the selection and development of therapies in alcoholism treatment matching research.","authors":"D M Donovan, R M Kadden, C C DiClemente, K M Carroll, R Longabaugh, A Zweben, R Rychtarik","doi":"10.15288/jsas.1994.s12.138","DOIUrl":"https://doi.org/10.15288/jsas.1994.s12.138","url":null,"abstract":"<p><p>There are a large number of possible approaches to the treatment of alcohol abuse and dependence. From a practical and methodological standpoint, however, only a limited number of interventions can realistically be included in research studies of treatment matching. A key question in planning studies of matching is what treatments to include. The recent book by Beutler and Clarkin on systematic treatment selection in general psychotherapy provides a framework within which to discuss alcoholism treatment matching and the criteria applied to decisions concerning (1) modes of treatment, (2) treatment format, (3) specific therapeutic strategies and the (4) treatment setting. The methodological and practical issues raised and the decisions reached in Project MATCH are presented in each of these areas. The therapies chosen for Project MATCH, based on these criteria, are described.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"12 ","pages":"138-48"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1994.s12.138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18725391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K M Carroll, R M Kadden, D M Donovan, A Zweben, B J Rounsaville
{"title":"Implementing treatment and protecting the validity of the independent variable in treatment matching studies.","authors":"K M Carroll, R M Kadden, D M Donovan, A Zweben, B J Rounsaville","doi":"10.15288/jsas.1994.s12.149","DOIUrl":"https://doi.org/10.15288/jsas.1994.s12.149","url":null,"abstract":"<p><p>Treatment matching research is predicated on heterogeneity among subjects and their differential response to treatments. The sine qua non of a treatment matching study is the integrity of the treatment variable, since detection of client-treatment interactions requires delivery of treatments that are highly specific, consistent and distinct. Matching research thus presents particular challenges in treatment implementation, as greater heterogeneity in subjects may generate a broader array of problems than study treatments are designed to address, leading to several potential threats to treatment integrity. Moreover, as practiced outside of research settings, treatments for alcoholism are marked by ideological heterogeneity and a lack of purity across approaches. In this article we describe the strategies used in Project MATCH to protect treatment integrity while treating a large and heterogeneous sample of alcoholics in a number of geographically distant sites. These include: strategies for treating a variety of alcoholics within a single treatment approach; development of clinical care guidelines and clinical deterioration criteria; specification of treatments in manuals with minimization of overlapping active ingredients; selection criteria for therapists intended to enhance both generalizability of findings as well as treatment integrity; and extensive therapist training and monitoring.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"12 ","pages":"149-55"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1994.s12.149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18725392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alternative analytical methods for detecting matching effects in treatment outcomes.","authors":"J P Carbonari, P W Wirtz, L R Muenz, R L Stout","doi":"10.15288/jsas.1994.s12.83","DOIUrl":"https://doi.org/10.15288/jsas.1994.s12.83","url":null,"abstract":"<p><p>Project MATCH presented a unique opportunity for a team of statisticians, data analysts and content experts to come together and explore the strengths and weaknesses of the application of various statistical models to the data of the type being collected in this large trial. The following models were evaluated: multilevel models, event history models, multiple were structural equation modeling, time series models, ordinal repeated measures designs and generalized estimating equations. No one model was found to be the perfect solution and each seemed to have something to recommend it. Future research on these methods will shed light on many issues raised. It is hoped that alcohol researchers will find useful guidelines within this chapter as they plan and carry out their studies.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"12 ","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1994.s12.83","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18726089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D C Blanchard, R Veniegas, I Elloran, R J Blanchard
{"title":"Alcohol and anxiety: effects on offensive and defensive aggression.","authors":"D C Blanchard, R Veniegas, I Elloran, R J Blanchard","doi":"10.15288/jsas.1993.s11.9","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.9","url":null,"abstract":"<p><p>Inconsistencies in the effects of alcohol on aggression in rodent models suggest that this effect is mediated through some other factor that is differentially involved in the various tests. The patterning of alcohol enhancement of aggression suggests that this may be most apparent in tests in which defensiveness or anxiety act to reduce aggression. Thus, an understanding of the relationship between alcohol and aggression may also involve determination of alcohol effects on anxiety. New ethoexperimental models of anxiety in rodents involve the measurement of a range of defensive behaviors to approaching, contacting predators, or to situations associated with (absent) predators. A Fear/Defense Test Battery, measuring the former, showed little, and inconsistent, response to traditional (benzodiazepine) or nontraditional (5-HT1A agonist) anxiolytics. However, an Anxiety/Defense Test Battery, measuring the latter, produced an \"anxiolytic profile\" of changes seen consistently to both traditional and nontraditional anxiolytics, but not to nonanxiolytic drugs. Alcohol (0.6 and 1.2 g/kg) altered the four behaviors of the \"anxiolytic profile\" in a manner consistent with the effects of diazepam (2.0 and 4.0 mg/kg), indicating that it is also anxiolytic. The consistency of alcohol and diazepam effects on anxiety provide a possible mechanism for their somewhat similar effects on aggression. However, alcohol at nonsedative doses, but not diazepam, additionally enhances defensive attack. Although defensive attack is behaviorally and neurally different from offensive aggression, the two are not separated in analyses of human \"aggression,\" suggesting that alcohol effects in the latter may also be mediated by changes in defensive attack.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"9-19"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19395875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol, aggression and the stress of subordination.","authors":"R J Blanchard, E B Yudko, D C Blanchard","doi":"10.15288/jsas.1993.s11.146","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.146","url":null,"abstract":"<p><p>In individual resident-intruder or novel arena confrontations alcohol enhancement of aggression appears less robust than when groups of animals receive the drug. Patterns of effects in the latter situations, such as enhanced attack on familiar animals, particularly familiar females, suggest that group living engenders attack inhibitions, perhaps based on enhanced anxiety/defensiveness, that may be overcome by alcohol. Male rats living in natural, mixed-sex groups in seminatural situations develop strong dominance-subordination relationships that appear to strongly stress subordinates. Subordinate males show strongly and chronically increased defensive behaviors, increased corticosterone and reduced testosterone levels and, often, early mortality. When allowed access to both alcohol and water, they increase voluntary alcohol consumption, in comparison to dominants. Analyses of relationships between voluntary consumption and defensive behaviors support a view that the voluntary consumption increases of subordinate rats are mediated by the anxiolytic effect of alcohol in highly stressed animals.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"146-55"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19394631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A biosocial model of the alcohol-aggression relationship.","authors":"R O Pihl, J B Peterson, M A Lau","doi":"10.15288/jsas.1993.s11.128","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.128","url":null,"abstract":"<p><p>Four of alcohol's dose- and rate-dependent pharmacological properties may increase the likelihood of human aggression. As an anxiolytic, alcohol is capable of reducing the inhibitory effect of fear on manifestation of aggressive behavior. As a psychomotor stimulant, alcohol can potentiate aggressive behavior, once evoked, or lower the threshold for such evocation. Alcohol-related disruption of certain higher order cognitive functions may reduce the inhibitory control generally exercised by previously established knowledge and decrease ability to plan in the face of threat or punishment. Finally, alcohol's ability to increase pain sensitivity may increase the likelihood of defensive aggression. Discussion of the nature and relevance of these pharmacological properties is structured according to a heuristic and synthetic schema, predicated upon consideration of an inhibitory neuropsychological structure--the individually and culturally determined general expectancy set.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"128-39"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19394629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol and Aggression. Symposium proceedings. Rutgers, New York, October 8-9, 1992.","authors":"","doi":"10.15288/jsas.1993.s11.7","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.7","url":null,"abstract":"","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"7-194"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19098189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effects of alcohol on free-operant aggressive behavior.","authors":"T H Kelly, D R Cherek","doi":"10.15288/jsas.1993.s11.40","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.40","url":null,"abstract":"<p><p>Although strong correlations between alcohol use and the frequency and intensity of social aggression have been observed in many populations, the relationship between these two events remains complex. Aggressive behavior is not always associated with alcohol or drug use, and substantial amounts of alcohol are consumed in social settings without the occurrence of violent or aggressive behavior. The relationship between alcohol and human aggressive behavior has been investigated using a free-operant procedure developed from the experimental tradition of behavioral pharmacology. The reliability of the free-operant procedure is evidenced by the similarity in experimental outcomes across laboratories using similar experimental procedures. Evidence for the validity of the procedure comes from recent studies with populations varying in histories of violent behavior, as well as from similarities in the outcome of studies using different experimental paradigms. Recent studies indicate clearly that both antecedent and consequent variables, such as the schedule of provocation and the response requirement for both aggressive and nonaggressive behavior, as well as the social context in which provocation occurs, influence the relationship between alcohol and aggressive behavior. The implications of the role of contextual factors for social policy regarding violence and alcohol use are discussed.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"40-52"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19395870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol, drugs and human physical aggression.","authors":"S P Taylor, S T Chermack","doi":"10.15288/jsas.1993.s11.78","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.78","url":null,"abstract":"<p><p>Research on the relationship between alcohol, drugs and aggression is reviewed. The findings indicate that alcohol is a potent antecedent of aggressive behavior. Studies conducted in our laboratory demonstrate that aggressive behavior is related to the quantity of alcohol ingested, that the effect of social pressure to aggress and of intense provocation is enhanced by alcohol, that the instigating effect of alcohol depends upon the aggressive disposition of the alcohol consumer, that the aggressive behavior of the intoxicated person can be regulated by altering cues that affect cognitive processes and that other depressant increase aggressive responding. A hypothetical model is described that summarizes the experimental findings and provides a vehicle for discussing the major factors and psychological processes involved in alcohol-induced aggression.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"78-88"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.78","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19395873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol and premarital aggression among newlywed couples.","authors":"K E Leonard, M Senchak","doi":"10.15288/jsas.1993.s11.96","DOIUrl":"https://doi.org/10.15288/jsas.1993.s11.96","url":null,"abstract":"<p><p>The present study examined the relationship between husband and wife alcohol use and premarital aggression, and evaluated a social learning model of alcohol and aggression that posited a moderating role for alcohol beliefs and aggressive motivations. Couples (age 18 to 29) entering their first marriage were approached after they had applied for a marriage license and interviewed concerning demographic factors and premarital aggression. These couples were recruited for the longitudinal study and given questionnaires assessing hostility, marital dissatisfaction, alcohol use and alcohol beliefs. Overall, 76% of the couples who agreed to participate returned the questionnaires. Husbands (n = 607) were approximately 24 years old, and wives were 1 year younger. Reflecting the urban setting, 72% were white and 24% were black. The results indicated a significant relationship between husband heavy alcohol use and premarital aggression. In addition, there were significant interactions between husband heavy alcohol use and marital dissatisfaction, and between husband heavy alcohol use, husband hostility and husband belief in alcohol as an excuse for aggression. These results suggested that alcohol use and premarital aggression are associated even in the absence of alcohol beliefs, but that the presence of appropriate beliefs strengthens the association.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":"11 ","pages":"96-108"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.1993.s11.96","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19395876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}