Coping and self-efficacy as predictors of substance use during the first few critical months following substance abuse treatment completion

The literature suggests that the interaction between the exposure to high-risk situations, coping skills and self-efficacy underlie the relapse process. Research has also shown that self-efficacy is related to the avoidance of alcohol use and smoking and that high self-efficacy ratings exhibited during follow-up are associated with less substance use. The present study extended the existing research in these ways. First, self-efficacy was assessed in former substance abusers who had completed out-patient treatment at four follow-up points: 30 days, 60 days, 90 days, and 120 days post-discharge. The results revealed significant inverse correlations between self-efficacy and drug use at the 30 days, 60 days, and 90 days follow-up intervals. At the 30 day follow-up, there was a significant difference in the mean total perceived self-efficacy score between those who remain abstinent and those who do not remain abstinent. Lastly, there was a significant correlation between the number of successful coping strategies endorsed and number of days of primary drug use at the 30-day interval. To investigate more thoroughly the coping successes and failures of participants during the first four months post treatment, subjects were asked to describe high-risk situations they had encountered and coping strategies they employed. Responses were analyzed qualitatively and subsequently related to post-treatment drug use

Alcohol use and risky sexual behavior among problem drinking men who have sex with men: a comparison of two data collection methods

Self-reports are the primary method for collecting data on alcohol use and risky sexual practices among men-who-have-sex-with-men (MSM). The TimeLine FollowBack method (TLFB) has been considered the gold standard for collecting data on alcohol use and risky sexual behavior. Interactive Voice Response (IVR) technology has become increasingly popular as a new data collection method and offers several advantages. Given this background, three aims were posited for the present study that was conducted among a sample of problem drinking MSM to: 1) examine the correspondence between the IVR and TLFB methods for the assessment of alcohol use and risky sexual behavior; 2) identify factors that influence correspondence between methods for select alcohol use and risky sex variables; and, 3) examine the conditional relationship between alcohol use and engagement in unprotected anal intercourse (UAI) using IVR daily data. Participants (N = 84) were problem drinking MSM, who were participating in a combined pharmacotherapy and psychotherapy clinical trial to moderate their alcohol consumption. Participants reported on their alcohol use and sexual risk behavior daily for 90-days using the IVR system. At treatment completion, participants were administered the TLFB interview and reported on their behavior during the same 90 day time frame. Study findings revealed moderate correlations between the IVR and TLFB methods for each of the alcohol use and sexual risk variables. T-tests indicated greater aggregate reports of drinking on the IVR, whereas greater aggregate reports for the sexual risk variables were generated from the TLFB method. A visual inspection of the limits of agreement indicated substantial individual variation for self-reports between methods across each of the alcohol use and sexual risk variables. Exploratory analyses revealed that TLFB-IVR correspondence for variables specific to alcohol use was affected by participant’s alcohol dependence severity, daily negative affect, and number of standard drinks consumed prior to or during data collection on the IVR. Multilevel analyses indicated that the risk of engaging in UAI was greater on days in which any alcohol use was consumed by the participant, regardless of the quantity of use. Findings are discussed regarding the utility of IVR data collection technology among MSM.Ph.D.Includes bibliographical references (p. 114-122)by Brett T. Hagman, M.A

Does Negative Affect Mediate the Relationship Between Daily PTSD Symptoms and Daily Alcohol Involvement in Female Rape Victims? Evidence from 14 Days of Interactive Voice Response Assessment

The negative reinforcement model of addiction posits that individuals may use alcohol to reduce negative affective (NA) distress. The current study investigated the mediating effect of daily NA on the relationship between daily PTSD symptoms and same-day and next-day alcohol involvement (consumption and desire to drink) in a sample of 54 non-treatment-seeking female rape victims who completed 14 days of interactive voice response assessment. The moderating effect of lifetime alcohol use disorder diagnosis (AUD) on daily relationships was also examined. Multilevel models suggested that NA mediated the relationship between PTSD and same-day, but not next-day alcohol involvement. NA was greater on days characterized by more severe PTSD symptoms, and alcohol consumption and desire to drink were greater on days characterized by higher NA. Furthermore, daily PTSD symptoms and NA were more strongly associated with same-day (but not next-day) alcohol consumption and desire to drink for women with an AUD than without. Results suggest that NA plays an important role in female rape victims’ daily alcohol use. Differences between women with and without an AUD indicate the need for treatment matching to subtypes of female rape victims