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This article summarizes the proceedings of a symposium that was organized and chaired by Richard Longabaugh and presented at the 2004 Research Society on Alcoholism meeting in Vancouver, British Columbia, Canada. The aim of the presentation was to focus on evidence for the active ingredients of behavioral therapies for patients with alcohol use disorders. Dennis M. Donovan, PhD, reviewed evidence for the active ingredients of cognitive behavioral therapy. Barbara S. McCrady, PhD, presented a conceptual model for mechanisms of change in alcohol behavior couples therapy and reviewed evidence for this model. J. Scott Tonigan, PhD, presented data testing three hypothesized mechanisms of change in twelve-step facilitation treatment. Mitchell P. Karno, PhD, presented therapy process data that tested whether matching therapist behaviors to client attribute across three therapies affected drinking outcomes. Jon Morgenstern served as discussant. [ABSTRACT FROM AUTHOR]

This article focuses on application of discriminate analysis to level of performance of alcoholics and nonalcoholics on Wechsler-Bellevue and Halstead-Reitan subtests. A number of authors have compared the performance of alcoholic and nonalcoholic Ss on measures of general intelligence and cognitive impairment. The measures frequently used in such studies have included the Wechsler-Bellevue Intelligence Scale, the Wechsler Adult Intelligence Scale and tests derived from the Halstead-Reitan Neuropsychological Test Battery.

The article focuses on a study that examines the relationship between psychopathology, experienced control and perceived locus of control with respect to psychosocial functioning and drinking behavior among alcoholic subgroups. The results suggested a linear relationship between perceived locus of control and psychosocial adjustment and external individuals tended to exhibit a greater degree of psychopathology. It also was suggested that individuals with an internal locus of control tend to have better impulse control and to utilize more constructive, adaptive behaviors, which provide a greater degree of control over their environments than do external persons.

This article focuses on inpatient alcoholics. The concept of locus of control within an alcoholic population has received much attention in recent literature. However, it appears that no unequivocal relationship has been demonstrated between locus of control and alcoholism. An important aspect of the control orientation issue among alcoholics is the effect of treatment on both perceived and experienced control. One of the basic tenets of treatment is that the individual is to assume greater personal responsibility for his behavior and is to build a repertoire of adaptive responses to both interpersonal and intrapersonal sources of stress.

This article focuses on personality characteristics of alcoholics. A heterogeneous alcoholic population requires a multifaceted therapeutic approach, and the identification of subtypes can serve to increase the probability that individual patients' treatment needs will be met. An important aspect of subtype identification, as well as program evaluation, is to predict potential dropouts among alcoholic inpatients. Little empirical research that utilized objective personality scales has been done in this area Furthermore, the findings have been equivocal.

The article reports on the perceptual differentiation and defense mechanisms in alcoholics. Alcoholics, as a clinical population, have been found to be markedly field-dependent when compared with nonalcoholic normal and hospitalized psychiatric control groups. Further evidence tends to substantiate the presence of cognitive and personality correlates of limited perceptual differentiation in alcoholics. It was assumed that defense mechanisms, like other personality traits, should vary within an alcoholic population in a manner consistent with predictions from differentiation theory.

This article presents information on male alcoholics. There has been a paucity of research concerning the ability of clinical populations to perceive the relative position of themselves and other patients along certain psychological dimensions. The primary purpose of this study was to determine the degree and direction of distortion between alcoholics' self-ratings of depression and the ratings made by staff members and other patients as well as ranks based upon an objective measure of depression.

Aftercare contributes to improved drinking outcome, yet maintenance has been overlooked as a point for intervention. This project evaluated the effect of cognitive-behavioural relapse prevention (RP) and interpersonal process (IP) aftercare groups for recently hospitalized alcoholics, consisting of eight weekly 90 min sessions delivered by three co-therapy teams conducting one group in each condition. Six cohorts of patients were assigned to conditions (N = 39) and assessed at pretreatment, post-treatment, and 6 month follow-up. RP and IP resulted in comparable improvement/outcome on alcohol consumption, alcohol-related impairment, cognitive coping, drinking days, time to first drink, abstinence, and aftercare attendance. In secondary analyses, improvement on temptation was attributed to RP, on behavioural coping to IP, and effects on self-efficacy appeared marginally related to greater short term improvement for RP. The lack of differential outcome is discussed with respect to inadequate power, possible ceiling effects in outcome, the brevity of the follow-up period, and the possibility that treatments may have been more similar in implementation than intended. Suggestions for improving aftercare and relapse prevention research are presented. [ABSTRACT FROM AUTHOR]

The article focuses on a study which investigates the Luria-Nebraska Intellectual Processes Scale as a predictor of Wechsler Adult Intelligence Scale (WAIS) IQs among alcoholic inpatients. Subjects were 28 males who were receiving inpatient alcoholism treatment. Patients were administered the WAIS and the Luria-Nebraska Neuropsychological Battery as part of a more extensive investigation of neuropsychological assessment in alcoholics. Frequency of agreement between obtained IQs and those predicted from the present regression equations was assessed using Wechsler's seven category classification system.

This article discusses the perceived locus of control as a function of level of depression. This contention has direct relevance in comparative studies of control orientation between alcoholics and nonalcoholics because the former group is characterized by a high incidence of clinical depression. The purpose of the present investigation was to confirm previous findings that have related depression to the I-E scale and to cross-validate evidence of the effects of a mood-response bias on a sample of alcoholics and nonalcoholic.

The article discusses the shifts in perceptual differentiation and defense mechanisms in alcoholics. The construct of psychological differentiation allows the prediction of a number of cognitive, behavioral, and personality dimensions from an individual's characteristic, self-consistent style of engaging a perceptual field. Field-dependent persons are those who are unable to make accurate perceptual judgments divorced from contextual cues of the field. The present study investigated the stability of perceptual differentiation and one of its correlates, defense mechanisms, in an alcoholic sample. Defense mechanisms, found to be significantly related to the level of differentiation among alcoholics, have been shown to be relatively stable across time.

The article reports on the shifts in component factors of locus of control as a function of treatment in male alcoholics. The concept of locus of control is related directly to the degree of accountability or responsibility that one perceives oneself to hive for events in one's life. Persons with an internal locus of control perceive life events and their consequences to be directly contingent upon their own behavior. In contrast, persons with an external orientation tend to see events in their lives as beyond personal control and unrelated to their actions.

The primary purpose of the article was to replicate the researcher A. Goss and T.E. Morosko and researcher J. Gozali and J. Sloan studies in an attempt to clarify the ambiguity of their results. A second purpose was to investigate the relationship between MMPI scales and two sets of factor analytically derived subscales of the Locus of Control scale. Psychologist J.B. Rotter's Locus of Control scale and the MMPI were administered to 100 male alcoholic veterans. Significant positive correlations were found betwenn total IE score and the F, D, Pt and Si scales; IE was found to correlate negatively with the L and K scales.

The article reports on the relationship between locus of control and defensive style among alcoholics. Recent investigators have demonstrated a positive relationship between perceived locus of control and defensive style as measured by the Repression-Sensitization Scale. The results indicate that external Ss, those who perceive themselves as having little control over life events, respond to threatening stimuli with sensitizing, approach-oriented defenses such as intellectualization. The present study investigated the relationship between locus of control and defensive style as assessed by the defense mechanism inventory.

The article discusses relationship between locus of control, self-report and non-obstrusive measures of anxiety. The subjects were 52 male alcoholic veteran inpatients who had volunteered to participate in a larger research projects None of the subjects was assessed to have organic brain syndrome or other major psychiatric diagnosis. The significant positive correlation between the Rotter's Locus of Control scale and Activity Preference Questionnaire supports psychologist W.J. Ray and M. Katahn's contention that locus of control and anxiety are conceptually separate, yet correlated, variables.

ABSTRACT. Objective: The current study compared alcoholics who entered treatment for the first time with those who had reported one or more prior treatment experiences using a large sample (N = 1,362) of alcoholics who entered the National Institute on Alcohol Abuse and Alcoholism-sponsored COMBINE (Combining Medications and Behavioral Interventions) Study of pharmacological and behavioral treatment efficacy. Method: Participants were categorized into three prior-treatment groups: (I) treatment naive (n = 691, 50.73%), (2) one to two prior treatments (n 380, 27.90%), or (3) three or more prior treatments (n = 291, 21.37%). Groups were compared at baseline on multiple drinking and psychosocial variables. Results: The treatment-naive group was more likely to be female, educated, married, and employed. They reported the lowest levels of drinks per drinking day, average drinks per day, alcohol dependence, craving, and alcohol-related consequences; but, they had the oldest age at onset of alcohol problems. Both the treatment-naive group and the one-to-two prior-treatment group had lower percentage days abstinent within the prior 30 days, compared with the three-or-more group (22% and 25% vs 32%, respectively). The treatment-naive group reported the least commitment to an abstinence goal (43% vs 70% and 80%, respectively) and the lowest mean number of Alcoholics Anonymous meetings attended (0.86 vs 3.10 vs 6.91, respectively). They also reported fewer psychological symptoms, less distress, and higher levels of quality of life on physical, emotional, and environmental domains, as well as social relationships. Conclusions: Results suggest that a greater understanding of treatment-naive versus treatment-experienced clients may provide a better profile of help-seeking behavior and may suggest different approaches to treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the full range of alcohol treatment effectiveness, it is important to assess secondary nondrinking outcome dimensions in addition to primary alcohol consumption outcomes. Method: We used a large sample (n = 1,226) of alcohol-dependent participants entering the National Institute on Alcohol Abuse and Alcoholism-sponsored COMBINE (Combining Medications and Behavioral Interventions) Study, a multisite clinical trial of pharmacological (naltrexone [ReVia] and acamprosate [Campral]) and behavioral interventions, to examine the effects of specific treatment combinations on nondrinking functional outcomes. We assessed the outcomes at baseline and at the end of 16 weeks of alcohol treatment and again at the 26-week and/or 52-week postrandomization follow-ups. Results: (1) Drinking and secondary outcomes were significantly related, especially at the follow-up periods. A higher percentage of heavy drinking days, more drinks per drinking day, and lower percentage of days abstinent were associated with lower quality-of-life measures. (2) All nondrinking outcomes showed improvement at the end of 16 weeks of treatment and most maintained improvement over the 26-week and 52-week follow- ups. Only two measures returned to pretreatment levels at 52 weeks: percentage of days paid for work and physical health. Improvements of nondrinking Outcomes remained even after adjusting for posttreatment heavy drinking status. (3) Although nondrinking outcomes showed overall improvement, specific pharmacological and behavioral treatment combinations were not differentially effective on specific secondary outcomes. Conclusions: In the current study, changes that resulted from treatment were multidimensional, and improvements in nondrinking outcomes reflected the overall significant improvement in drinking but they were not differentiated between treatment combination groups. Findings from this study support the importance of including secondary nondrinking outcomes in clinical alcohol-treatment trials. [ABSTRACT FROM AUTHOR]

Background: In 2007, the American College of Surgeons (ACS) Committee on Trauma implemented a requirement that Level I trauma centers must have a mechanism to identify patients who are problem drinkers and the capacity to provide an intervention for patients who screen positive. Although the landmark alcohol screening and brief intervention (SBI) mandate is anticipated to impact trauma practice nationwide, a literature review revealed no studies that have systematically documented SBI practice pre-ACS requirement.Study Design: Trauma programs at all US Level I trauma centers were contacted and asked to complete a survey about pre-ACS requirement trauma center SBI practice.Results: One hundred forty-eight of 204 (73%) Level I trauma centers responded to the survey. More than 70% of responding centers routinely used laboratory tests (eg, blood alcohol concentration) to screen patients for alcohol and 39% routinely used a screening question or standardized screening instrument. Screen-positive patients received a formal alcohol consult or had an informal alcohol discussion with staff members approximately 25% of the time.Conclusions: The investigation observed marked variability across Level I centers in the percentage of patients screened and in the nature and extent of intervention delivery in screen-positive patients. In the wake of the ACS Committee on Trauma requirement, future research could systematically implement and evaluate training in the delivery of evidence-based alcohol interventions and training in development of trauma center organizational capacity for sustained delivery of SBI. [ABSTRACT FROM AUTHOR]