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This article reports on the psychometric evaluation of the Spouse Situation Inventory (SSI), a role-play measure of coping skills in women with alcoholic partners. The study examined the generalizability, alternate form reliability, test-retest reliability, and construct validity of the measure in 472 women from both treatment and nontreatment populations. The SSI had acceptable generalizability and reliability. SSI performance also had predicted relationships with measures of general escape coping, alcohol-related coping behaviors, the woman's drinking, the partner's drinking in the treatment group, and the partner's problem recognition in the nontreatment group. The SSI shows promise as a reliable and valid measure of coping skills in this population and has direct implications for development and evaluation of skill training programs. [ABSTRACT FROM AUTHOR]

This report discusses the development of a coping skill training program for parents of substance-abusing adolescents and presents preliminary data on the effects of the program on parent functioning and adolescent substance use. The behavioral-analytic model of program development was used to sample representative problematic situations experienced by parents of substance-abusing adolescents, obtain an effectiveness-scaling of responses to these situations, and derive alternate forms of a situational role-play measure of parental coping. These situations and scoring guidelines were then used to create the skill training program. Parents of substance-abusing adolescents not in treatment subsequently were randomly assigned in a pilot investigation to either a skill training or delayed treatment condition. Skill training resulted in significant improvement in parental coping skills relative to delayed treatment. Moderate to large improvement in the parent's report of their own functioning, family communication, and the teen's marijuana use also favored the skill training group.

This study compared inpatient, intensive outpatient, and standard outpatient treatment settings for persons with alcoholism and tested a priori hypotheses about the interaction of setting with client alcohol involvement and social network support for drinking. Participants (N = 192) were assigned randomly in cohorts to 1 of the 3 settings. The settings did not differ in posttreatment primary drinking outcomes, although inpatients had significantly fewer jail and residential treatment days combined than outpatients. Clients high in alcohol involvement benefited more from inpatient than outpatient care; the opposite was true at low alcohol involvement levels. Network drinking support did not moderate setting effects. Clients low in cognitive functioning also appeared to benefit more from inpatient than outpatient care. Improved outcomes might be achieved by matching degree of alcohol involvement and cognitive functioning to level of care.

Eligible participants and decliners in a randomized study of inpatient, intense outpatient, and standard outpatient treatments for alcoholics were compared and contrasted on a series of demographic, social stability, psychological, legal, drug use, problem severity, and treatment history variables. Among 302 individuals meeting eligibility requirements, those agreeing to participate, compared with decliners, were more likely to be unemployed, be residentially less stable, have legal problems, use other drugs, have a more severe alcohol problem, have a recent treatment history, and were less likely to have problems with violence. Participants also were more likely to be male and non-white, although gender and racial effects were not significant when other variables were controlled for. The implications of these findings for generalizing the results of inpatient-outpatient studies are discussed, and the need for routine reporting of decliner characteristics in research reports is stressed.

This study was designed to explore three primary facets of reactivity to alcohol-relevant stimuli among alcoholics: (a) comparison of exposure to an alcohol-containing beverage vs. an appropriate, standardized control beverage; (b) efficacy of imaginally presented cues to elicit reactivity, alone and in combination with beverage cues; and (c) examination of the recovery process. Forty-eight male veterans attending an inpatient alcohol treatment program served as participants and were randomly assigned to one of four groups in a 2 (Alcohol vs. Lemonade Beverage) X 2 (High-Risk vs. Low-Risk Imagery) design. Heart rate reactivity to Beverage cues was consistent with previous research. An interaction of Beverage and Imagery manipulations during recovery revealed both experimental manipulations influenced heart rate, although the Alcohol/High-Risk Imagery exposure group did not demonstrate enhanced effects. Both manipulations also had an impact on ratings of desire to consume alcohol. These findings provide further support for the reliability of cue reactivity effects, and suggest the utility of imaginal exposure procedures as a component of a comprehensive cue reactivity assessment.

The present study represents a long-term follow-up of elderly persons who completed a behavioral treatment program for alcohol problems. Subjects over the age of 60 at the time they obtained treatment for alcohol abuse were contacted two to four years after discharge. Interviews with the alcohol abuser and a significant other were conducted in an effort to identify the percentage of persons for whom treatment had sustained beneficial effects, differences in outcome for early-versus late-onset alcohol abusers, and demographic and daily activity variables that distinguish abstinent from nonabstinent individuals. Results suggest that beneficial effects of the program maintained for 50% of the patients two or more years following completion of the program. An additional 12% reported significant modification of their drinking. Directions for future research are suggested.

The effect of an appointment-keeping intervention on attendance at aftercare was examined for 50 male participants in an inpatient alcohol treatment program. Subjects received either a calendar prompt and home-based attendance contract intervention (Experimental group, N = 25) or standard aftercare treatment arrangements (Control group, N = 25). Participants were followed for eight aftercare sessions over a 6-month period. Results showed significant attendance differences between groups for the first seven aftercare sessions, with nearly twice as many experimental subjects as control subjects attending aftercare sessions. Further, significantly fewer experimental than control subjects (24% fewer) were dropped from the alcohol program for three consecutive nonattendances. The present study provides an effective technology for increasing aftercare attendance and thus potentially increasing the probability of long term maintenance of alcohol treatment effects.

An abbreviated breath test for detecting the disulfiram metabolite carbon disulfide (CS2) was evaluated in an analogue investigation of the sensitivity of the test in identifying disulfiram and non-disulfiram intake in a group of 14 alcoholic inpatients. Disulfiram (250 mg) was administered within an ABAB repeated measures design over a 12-day period with corresponding breath tests administered during morning and afternoon time periods. Dependent measures included spectrophotometric analysis of reacted test samples and visual ratings of sample color. Results indicated that the test was highly sensitive in discriminating disulfiram administration for the group as a whole, as well as for individual subjects. Moreover, visual ratings were more accurate than spectrophotometric cut-off scores in identifying disulfiram administration. The test shows considerable promise as a rapid means of assessing disulfiram compliance.

The utility of disulfiram in the treatment of alcohol abuse has been limited by the high frequency with which clients refuse the regimen. The present study identified variables influencing disulfiram acceptance/rejection within the framework of the theory of reasoned action. Eighty male inpatients on an alcohol treatment unit completed a questionnaire operationalizing the components of the model. The theoretical components were then used to predict requests for the drug. Multiple regression analyses revealed significant correlations among components of the model consistent with the assumptions of the theory. In addition, significant differences were found between disulfiram requestors and rejectors in terms of behavioral and normative beliefs about the consequences of being placed on the drug. Implications of these results for the design of effective interventions are discussed.

Developed and evaluated a home-based contracting program to determine its effect on the compliance rates of discharged alcohol patients to a disulfiram (antabuse) regimen. The three comparison groups included (a) no contract/no recording; (b) contract/recording; and (c) contract/recording plus instructions for positive reinforcement. Twenty-five patients who had been treated in a behaviorally oriented inpatient alcohol dependence treatment program and who lived with a significant other (i.e., spouse, sibling, parent) participated in the study. At the end of the 3-month period for which the disulfiram was prescribed, those Ss who were involved in contracting and recording reached criterion more frequently than those who were in the minimal treatment group. Furthermore, 84% of this S sample were abstinent at the 3-month follow-up according to collateral reports. The discussion centers on the use of home-based contracting as an inexpensive alternative to other, more costly disulfiram programs. Additional methods for obtaining measures of reliability on self-report of disulfiram usage also are discussed.

The impact of televised use of alcoholic beverages on children's behavior was evaluated in this study. Children were randomly assigned to one of three experimental conditions: (a) television with drinking depicted, (b) television without drinking, or (c) a no television control condition. Segments of the syndicated television show M.A.S.H. were used as the viewing stimulus. The impact of the various conditions was evaluated in a choice task requiring subjects to choose either martini or regular glasses of either "whiskey" or "water" to serve pictured adults and children. Results indicated that subjects who viewed television drinking were significantly more likely to choose alcoholic beverages for pictured adults but not children. No effect was found for glass preference. Results and implications of these findings and directions for future research are discussed.

Aftercare to prevent relapse following alcohol treatment has not received adequate experimental investigation. The present study monitored alcohol intake of 50 patients following assignment to either an intensive aftercare recruitment procedure or regular clinic aftercare. The results indicated that those who received the intensive aftercare procedure showed delayed relapse. In addition, regardless of group assignment those who attended aftercare had significantly more success as measured by alcohol intake. The implications of these results for the design of treatment and aftercare programs are discussed.