Missing Data in Alcohol Clinical Trials with Binary Outcomes.

Background: Missing data are common in alcohol clinical trials for both continuous and binary end points. Approaches to handle missing data have been explored for continuous outcomes, yet no studies have compared missing data approaches for binary outcomes (e.g.

Adding tools to the toolbox: The role of coping repertoire in alcohol treatment.

Objective: Few studies have examined distinct patterns (i.e., repertoires) of coping skills among alcohol use disorder (AUD) populations.

Reproducibility and differential item functioning of the alcohol dependence syndrome construct across four alcohol treatment studies: An integrative data analysis.

Background: The validity of the alcohol dependence syndrome has been supported. The question of whether different measures of the construct are comparable across studies and patient subgroups has not been examined. This study examined the alcohol dependence construct across four diverse large-scale treatment samples using integrative data analysis (IDA).

Guidelines for the Reporting of Treatment Trials for Alcohol Use Disorders.

Background: The primary goals in conducting clinical trials of treatments for alcohol use disorders (AUDs) are to identify efficacious treatments and determine which treatments are most efficacious for which patients. Accurate reporting of study design features and results is imperative to enable readers of research reports to evaluate to what extent a study has achieved these goals. Guidance on quality of clinical trial reporting has evolved substantially over the past 2 decades, primarily through the publication and widespread adoption of the Consolidated Standards of Reporting Trials statement.

Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders.

Background: Over the past 60 years, the view that "alcoholism" is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and nonpharmacological interventions for AUDs.

Indirect Effects of the Fast Track Intervention on Conduct Disorder Symptoms and Callous-Unemotional Traits: Distinct Pathways Involving Discipline and Warmth.

Little is known about intervening processes that explain how prevention programs improve particular youth antisocial outcomes. We examined whether parental harsh discipline and warmth in childhood differentially account for Fast Track intervention effects on conduct disorder (CD) symptoms and callous-unemotional (CU) traits in early adolescence. Participants included 891 high-risk kindergarteners (69% male; 51% African American) from urban and rural United States communities who were randomized into either the Fast Track intervention (n = 445) or non-intervention control (n = 446) groups.

Association between physical pain and alcohol treatment outcomes: The mediating role of negative affect.

Objective: Physical pain and negative affect have been described as risk factors for alcohol use following alcohol treatment. The current study was a secondary analysis of 2 clinical trials for alcohol use disorder (AUD) to examine the associations between pain, negative affect and AUD treatment outcomes.

Method: Participants included 1,383 individuals from the COMBINE Study (COMBINE Pharmacotherapies and Behavioral Interventions for Alcohol Dependence; COMBINE Study Research Group, 2003; 31% female, 23% ethnic minorities, average age = 44.

Pain as a predictor of heavy drinking and any drinking lapses in the COMBINE study and the UK Alcohol Treatment Trial.

Aims: To test the association between pain and heavy drinking lapses during and following treatment for alcohol use disorders (AUD).

Design: Secondary data analysis of data from two clinical trials for AUD.

Setting And Participants: Participants included 1383 individuals from the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study in the United States [69.

Paths to tobacco abstinence: A repeated-measures latent class analysis.

Objective: Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates.

The cusp catastrophe model as cross-sectional and longitudinal mixture structural equation models.

Catastrophe theory (Thom, 1972, 1993) is the study of the many ways in which continuous changes in a system's parameters can result in discontinuous changes in 1 or several outcome variables of interest. Catastrophe theory-inspired models have been used to represent a variety of change phenomena in the realm of social and behavioral sciences. Despite their promise, widespread applications of catastrophe models have been impeded, in part, by difficulties in performing model fitting and model comparison procedures.

Examining temptation to drink from an existential perspective: Associations among temptation, purpose in life, and drinking outcomes.

Temptation to drink (TTD), defined as the degree to which one feels compelled to drink in the presence of internal or external alcohol-related cues, has been shown to predict alcohol-treatment outcomes among individuals with alcohol-use disorders (AUDs). Research examining TTD from an existential perspective is lacking and little is known about how existential issues such as purpose in life (PIL) relate to TTD, which is surprising given the role of existential issues in many treatments and mutual help approaches for AUDs. In the current study, we examined the longitudinal associations in a sample of 1726 among TTD, PIL, and drinking outcomes using data from Project MATCH (1997, 1998).

The indirect effect of the therapeutic alliance and alcohol abstinence self-efficacy on alcohol use and alcohol-related problems in Project MATCH.

Background: Empirical literature indicates that the therapeutic alliance explains a modest but reliable proportion of variance in predicting alcohol-related outcomes among individuals in treatment for alcohol use disorders (AUDs). Hartzler and colleagues (2011) showed in the COMBINE data set that alcohol abstinence self-efficacy is a potentially important statistical mediator of the relationship between the alliance and client outcomes.

Methods: The purpose of this study was to replicate this finding in the Project MATCH data set.

Protective behavioral strategies and future drinking behaviors: Effect of drinking intentions.

Alcohol use is common among United States and Swedish high school students and is related to negative consequences. Whereas drinking intentions are associated with future drinking behaviors, the use of protective behavioral strategies (PBS) is associated with decreased alcohol-related harm among young adults. The interactive effect of PBS and drinking intentions in predicting alcohol outcomes has not been examined.

Social network moderators of naltrexone and behavioral treatment effects on heavy drinking in the COMBINE study.

Background: Oral naltrexone is an efficacious medication for treatment of alcohol dependence, but small effect sizes and variability in outcomes suggest the presence of person-level moderators of naltrexone response. Identification of contextual or psychosocial moderators may assist in guiding clinical recommendations. Given the established importance of social networks in drinking outcomes, as well as the potential effects of naltrexone in reducing cue reactivity which may be especially important among those with more heavy drinkers and more alcohol cues in their networks, we examined pretreatment social network variables as potential moderators of naltrexone treatment effects in the COMBINE study.

Methods to analyze treatment effects in the presence of missing data for a continuous heavy drinking outcome measure when participants drop out from treatment in alcohol clinical trials.

Background: Attrition is common in alcohol clinical trials and the resultant loss of data represents an important methodological problem. In the absence of a simulation study, the drinking outcomes among those who are lost to follow-up are not known. Individuals who drop out of treatment and continue to provide drinking data, however, may be a reasonable proxy group for making inferences about the drinking outcomes of those lost to follow-up.

Randomized controlled trial of web-based decisional balance feedback and personalized normative feedback for college drinkers.

Objective: Web-based personalized feedback interventions, particularly personalized normative feedback (PNF), are efficacious in improving college drinking outcomes; however, no personalized feedback interventions to date have provided college drinkers with feedback about their own decisional balance. This study tested the relative efficacy of a novel decisional balance feedback (DBF) intervention, PNF, and an assessment-only control condition.

Method: Participants (N = 724; 56% female) were undergraduate students at a 4-year university in the U.

Alcohol use disorder clinical course research: informing clinicians' treatment planning now and in the future.

Objective: The clinical course of alcohol use disorder (AUD) has been widely researched over the past half-century and has been used to advance our understanding of the treatment of AUD. Nevertheless, new directions in AUD clinical course research could enhance its value in informing clinical decision-making in patient-centered treatment of AUD.

Method: An overview, a critical analysis, and a discussion of AUD clinical course research are presented.

Development and evaluation of a mobile intervention for heavy drinking and smoking among college students.

Nearly all college student smokers also drink alcohol, and smoking and heavy episodic drinking (HED) commonly co-occur. However, few studies have examined the factors that concurrently influence smoking and HED among college students and, to date, no interventions have been developed that target both HED and smoking in this population. The objective of the current study was to develop and evaluate a mobile feedback intervention that targets HED and smoking.

Alcohol use trajectories among non-treatment-seeking heavy drinkers.

Objective: Heavy drinking, often defined as more than five drinks per occasion, is a major public health problem worldwide, yet most individuals who drink heavily never receive treatment. Focusing on those who receive treatment, numerous studies have found that alcohol use following treatment is discontinuous, with periods of abstinence alternating with periods of heavy drinking. In contrast, little is known about changes in alcohol use among the majority of individuals who engage in heavy drinking and never receive treatment.

Testing the measurement invariance of the Eating Disorder Inventory in nonclinical samples of Hispanic and Caucasian women.

Objective: The factor structure of the Eating Disorder Inventory (EDI) has not been thoroughly tested in Hispanic populations, yet researchers commonly use this instrument in Hispanic samples. Thus, it is important to establish the validity of the EDI in Hispanic populations. This article investigated measurement invariance of the EDI's three eating- and weight-related (eat/wt) scales because they are the most frequently used and are often used in isolation.

Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial.

Importance: Relapse is highly prevalent following substance abuse treatments, highlighting the need for improved aftercare interventions. Mindfulness-based relapse prevention (MBRP), a group-based psychosocial aftercare, integrates evidence-based practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approaches.

Objective: To evaluate the long-term efficacy of MBRP in reducing relapse compared with RP and treatment as usual (TAU [12-step programming and psychoeducation]) during a 12-month follow-up period.

What happens in treatment doesn't stay in treatment: cocaine abstinence during treatment is associated with fewer problems at follow-up.

Objective: Cocaine users often present to treatment with a multitude of problems typically considered addiction related; however, there is little evidence that reductions in cocaine use are followed by reductions in these problems. This study evaluated the relationship between rates of cocaine use during treatment and the level of non-cocaine life problems experienced during a 12-month period following treatment in a pooled sample of 434 cocaine-dependent individuals participating in 1 of 5 randomized controlled trials.

Method: Structural equation modeling and latent growth curve modeling were used to evaluate the relationship between frequency of cocaine use within treatment (8 or 12 weeks) and a latent construct of global problems indicated by the days of problems reported on the Addiction Severity Index across follow-up time points (1, 3, 6, and 12 months after treatment).