Document Type

Article

Publication Date

2016

DOI

10.1111/add.13518

Publication Title

Addiction

Volume

111

Issue

12

Pages

2145-2154

Abstract

Aims- To estimate differences in post-treatment psychosocial functioning among treatment failures' (i.e. heavy drinkers, defined as 4+/5+ drinks for women/men) from two large multi-site clinical trials and to compare these levels of functioning to those of the purported treatment successes' (i.e. non-heavy drinkers).

Design- Separate latent profile analyses of data from two of the largest alcohol clinical trials conducted in the United States, COMBINE (Combined Pharmacotherapies and Behavioral Interventions) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), comparing psychosocial outcomes across derived classes of heterogeneous treatment responders.

Setting- Eleven US academic sites in COMBINE, 27US treatment sites local to nine research sites in Project MATCH. ParticipantsA total of 962 individuals in COMBINE (69% male, 77% white, mean age: 44years) treated January 2001 to January 2004 and 1528 individuals in Project MATCH (75% male, 80% white, mean age: 40years) treated April 1991 to September 1994. MeasurementsIn COMBINE, we analyzed health, quality of life, mental health symptoms and alcohol consequences 12 months post-baseline. In Project MATCH, we examined social functioning, mental health symptoms and alcohol consequences 15 months post-baseline.

Findings- Latent profile analysis of measures of functioning in both samples supported a three-profile solution for the group of treatment failures', characterized by high-, average- and low-functioning individuals. The high-functioning treatment failures' generally performed better across measures of psychosocial functioning at follow-up than participants designated treatment successes' by virtue of being abstainers or light drinkers.

Conclusions- Current United States Food and Drug Administration guidance to use heavy drinking as indicative of treatment failure' fails to take into account substantial psychosocial improvements made by individuals who continue occasionally to drink heavily post-treatment.

Comments

NOTE: This is the author's pre-print version of a work that was published in Addiction. The final version was published as:

Wilson, A. D., Bravo, A. J., Pearson, M. R., & Witkiewitz, K. (2016). Finding success in failure: Using latent profile analysis to examine heterogeneity in psychosocial functioning among heavy drinkers following treatment. Addiction, 111(12), 2145-2154. doi:10.1111/add.13518

Available at: http://dx.doi.org/10.1111/add.13518

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Original Publication Citation

Wilson, A. D., Bravo, A. J., Pearson, M. R., & Witkiewitz, K. (2016). Finding success in failure: Using latent profile analysis to examine heterogeneity in psychosocial functioning among heavy drinkers following treatment. Addiction, 111(12), 2145-2154. doi:10.1111/add.13518

ORCID

Bravo (0000-0002-4630-6449)

Download

Share

COinS