DRINKING OUTCOMES OF ALCOHOL ABUSERS DIAGNOSED AS ANTISOCIAL PERSONALITY-DISORDER

被引:83
|
作者
LONGABAUGH, R
RUBIN, A
MALLOY, P
BEATTIE, M
CLIFFORD, PR
NOEL, N
机构
[1] BUTLER HOSP, PROVIDENCE, RI 02906 USA
[2] VET AFFAIRS MED CTR, CTR HLTH CARE EVALUAT, MENLO PK, CA USA
[3] UNIV N CAROLINA, DEPT PSYCHOL, WILMINGTON, NC 28401 USA
关键词
ANTISOCIAL PERSONALITY DISORDER; TREATMENT OUTCOME; SOCIAL SUPPORT; PATIENT-TREATMENT MATCHING; COGNITIVE BEHAVIORAL TREATMENT;
D O I
10.1111/j.1530-0277.1994.tb00040.x
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Clinical research and wisdom suggest that alcoholics with antisocial personality (ASPs) disorders have poorer drinking outcomes after treatment than alcoholics without this disorder. The present study challenges this wisdom, suggesting that poor prognosis and response to treatment have been confounded by not covarying on pretreatment drinking measures. Thirty-one ASPs are compared with 118 non-ASPs randomly assigned to extended cognitive behavioral and relationship enhancement treatments. Thirteen to 18 months after treatment initiation, ASPs average more abstinent days than do non-ASPs. Drinking intensity is a function of a patient-treatment matching effect: ASPs treated with cognitive behavioral treatment (CB) drink less/drinking day than do either non-ASPs treated in CB or ASPs treated in relationship enhancement. This finding is supportive of a comparable matching effect for CB and ASP found by Kadden et al. (1989). Examination of the process indicates that, irrespective of drinking index, ASPs respond poorly when they experience high posttreatment support for abstinence, whereas no?ASPs respond better with support. We conclude that early pessimism for successful treatment of ASP alcoholic drinking outcomes may be unwarranted.
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页码:778 / 785
页数:8
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