Effects of self reflection on engagement in a 12-step addiction treatment programme: a linguistic analysis of diary entries.

Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal "Feelings" diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group's productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected.

Covariation in addictive behaviours: a study of addictive orientations using the Shorter PROMIS Questionnaire.

Previous research has suggested that different addictive behaviours are linked, such that decreases in one may lead to compensatory increases in another, or even that one addiction may lead to another. Such views on "cross addiction" are encouraged by the prevailing tendency amongst researchers from very different theoretical backgrounds to view different addictions as serving a common function, such as mood alteration, or the "management of hedonic tone." Previous studies have suggested that different addictions may usefully be grouped according to how they covary. The present study, using factor and cluster analyses, confirms the importance of a division between "hedonistic" and "nurturant" addictions, but with the need for further subdivisions within those categories. Hedonism comprises a "drug use" factor and an "interpersonal dominance" factor. Nurturance comprises both "self-regarding" and "other-regarding" factors. Theoretically, the results suggest that different addictions illustrate contrasting techniques of interpersonal manipulation. Clinically, the results indicate the drawbacks of addressing addictive behaviours singly, and the potential importance of addictive orientations in treatment, and relapse prevention.

The Shorter PROMIS Questionnaire: further validation of a tool for simultaneous assessment of multiple addictive behaviours.

There is both a theoretical and clinical need to develop a questionnaire that assesses a range of addictive behaviours. The Shorter PROMIS Questionnaire (SPQ) is a 16-scale self-report instrument assessing the use of nicotine, recreational drugs, prescription drugs, gambling, sex, caffeine, food bingeing, food starving, exercise, shopping, work, relationships dominant and submissive, and compulsive helping dominant and submissive. Clinical cut-off scores using the 90th percentile were derived from a normative group of 508 individuals. These cut-offs correctly identified 78-100% of cases within clinical criterion groups of specific disorders. The clinical sample also completed other validated scales assessing gambling, eating, alcohol, and drug use. Correlations were typically.7 with relevant SPQ scales. The SPQ food, drug, and alcohol scales were at least equivalent to validated comparison scales in the strength of their relationship to relevant clinical criterion groups. Internal consistency was high for all scales, and test-retest reliability was generally good. This clinically useful instrument provides a broad assessment of addictive problems, thereby benefiting both the treatment provider and the client.