ABSTRACT
Investigations of targeted coping skills could help guide initial treatment decisions for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol dependence (AD) who often endorse worse coping skills than those with AD but not PTSD. Although improvement in coping skills is associated with enhanced alcohol use outcomes, no study has evaluated the utility of teaching specific coping skills in the context of comorbid PTSD/AD. We compared the effects of teaching two coping skills (cognitive restructuring [CR] and experiential acceptance [EA]) or an attention control condition on drinking and PTSD symptoms among 78 men and women with comorbid PTSD/AD during a 5-week daily follow-up assessment. Both CR and EA skills were associated with decreased drinking compared to control, and that change in drinking over time did not significantly differ between those who received CR and EA. Individuals who received CR skills, however, consumed less alcohol on a given day than those who received EA skills. Neither CR nor EA was associated with a decrease in PTSD symptom severity. These results provide preliminary support for clinicians to prioritize CR and EA skills during initial treatment sessions when working with individuals with PTSD/AD, and offer ideas for continued investigation and intervention refinement.
Subject(s)
Adaptation, Psychological , Alcohol Drinking/psychology , Alcoholism/psychology , Cognitive Behavioral Therapy , Stress Disorders, Post-Traumatic/psychology , Adult , Alcoholism/diagnosis , Alcoholism/therapy , Diagnosis, Dual (Psychiatry) , Female , Humans , Male , Middle Aged , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/therapyABSTRACT
Prior studies have found discrepancies between daily report and retrospective recall of alcohol use. One possible explanation is that there may be an association between memory impairment and alcohol consumption recall errors. Should this possibility be substantiated it could have implications for the types of assessments conducted in alcohol treatment trials. The current study evaluated the degree to which memory impairment, as measured by the California Verbal Learning Test-II, predicted day-to-day discrepancies between daily Interactive Voice Response monitoring and retrospective recall of alcohol use assessed with a 42-day version of the Form-90. Significant differences were detected in absolute difference in days drinking across the two measurement methods between participants scoring above and below population means on two measures of immediate memory ability. Correlations between the absolute difference in days drinking and immediate memory ability and long-delay memory indices approached significance. There were no significant associations between memory indices and discrepancies in reports of standard drink units. These preliminary results suggest that verbal memory difficulties common in this population may result in inaccurate reports of days drinking for some individuals.
Subject(s)
Alcohol Drinking/psychology , Alcoholism/psychology , Memory Disorders/psychology , Mental Recall/drug effects , Adult , Alcoholism/complications , Female , Humans , Male , Memory Disorders/chemically induced , Memory Disorders/complications , Middle Aged , Pilot Projects , Psychological Tests/statistics & numerical data , Randomized Controlled Trials as Topic/psychology , Self ReportABSTRACT
Most studies comparing frequent self-monitoring protocols and retrospective assessments of alcohol use find good correspondence, but have excluded participants with significant comorbidity and/or social instability, and some have included abstainers. We evaluated the correspondence between measures of alcohol use based on daily interactive voice response (IVR) telephone monitoring and a 28-day modification of the Form-90 (Form-28). Participants were 25 outpatients with alcohol use disorder and significant PTSD symptomatology . Overall correlations between the IVR and Form-28 on days drinking and total standard drink units (SDUs) were strong for the entire sample and the subsample of drinkers (n = 7). Day-to-day correspondence between IVR and Form-28 was modest, but much stronger for the most recent week assessed than for the prior 3 weeks. Finally, the drinkers reported significantly greater total SDUs and heavy drinking days on the Form-28 than via IVR. The results indicate a need for further refinement of IVR methodology for treatment seeking populations as well as caution when retrospectively assessing drinking over time periods longer than a week among these individuals.
