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Biomedical subjects

Paula D Rippens

Publications and source records attributed to Paula D Rippens.

5 recordsLinked to original sources

Significance of a behavioral economic index of reward value in predicting drinking problem resolution.

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more preresolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and preresolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes.

Alcohol Drinking↗

Different variables are associated with help-seeking patterns and long-term outcomes among problem drinkers.

This study investigated variables associated with help-seeking for drinking problems and with long-term drinking outcomes. In a 3 x 2 design, problem drinkers (N=167) were selected according to their help-seeking history [no assistance (NA), Alcoholics Anonymous (AA) only, or treatment plus AA (TxAA)] and current drinking status [resolved abstinent (RA) for >2 years or non-resolved (NR) active drinkers]. Drinking practices and problems, influences on help-seeking, and life events were assessed retrospectively during structured interviews. Participant reports were verified through collateral or reliability interviews. Stable resolution was associated with heavier drinking and greater negative life events before resolution. Seeking help, especially from treatment, was associated with greater psychosocial problems and higher dependence levels. The results indicate that different dimensions of drinking problems are associated with help-seeking and drinking outcomes, and suggest ways to increase help-seeking.

Adult↗

A factor analytic study of influences on patterns of help-seeking among treated and untreated alcohol dependent persons.

Influences on seeking help from professional alcohol treatment and from Alcoholics Anonymous (AA) were investigated using problem drinkers (N = 167) with different help-seeking experiences (no assistance, AA only, or treatment plus AA) and current drinking statuses (sustained abstinence for > 2 years or active problem drinking). Depending on their help-seeking experiences, participants rated barriers to or reasons for seeking help from treatment and AA, which were factor analyzed. Common impediments to help-seeking included privacy concerns and participants' beliefs that they could solve their problem on their own and that it was not serious enough to seek help. Common reasons for help-seeking included social and other functional problems related to drinking. There were also influences unique to treatment (e.g., cost) and to AA (e.g., group format). Help-seeking factors did not vary by drinking status. The implications for increasing help-seeking among problem drinkers are discussed.

Alcoholics Anonymous↗

Predicting natural resolution of alcohol-related problems: a prospective behavioral economic analysis.

This study investigated whether the relative allocation of discretionary monetary expenditures to alcoholic beverages versus savings (presumed to reflect relative preferences for immediate vs. delayed rewards) before quitting abusive drinking predicted natural resolution among untreated problem drinkers. Drinking, life events, income, and expenditures were assessed for the year before resolution and again 1 and 2 years later (N = 50). Compared with those who relapsed, participants who remained resolved at 2 years reported proportionally more pre-resolution discretionary expenditures on savings and less on alcohol. Income and expenditures were similar across groups. The findings support the predictive utility of this functional index of relative reward preferences that operate over variable time horizons and suggest that temporal discounting is an important process in addictive behavior change.

Adult↗

Environmental contexts surrounding resolution of drinking problems among problem drinkers with different help-seeking experiences.

OBJECTIVE: This study investigated whether similar environmental contexts surround abstinent resolutions associated with different intervention experiences, including no assistance. METHOD: Participants were selected in a 3 x 2 design (25-30 per group, N = 167) according to their help-seeking experiences (no assistance, Alcoholics Anonymous [AA] only, treatment plus AA) and current drinking status (resolved abstinent [RA] for >2 years or nonresolved [NR] controls). Life events were assessed retrospectively over a 4-year period that spanned the 2 years before and 2 years after the initiation of stable abstinence by RA participants or over a matched interval for NR participants. Collateral or reliability interviews were conducted for 84% of the sample as checks on participant reports. RESULTS: Across help-seeking groups, RA participants reported decreased negative events and increased positive events from the pre- through the post-resolution period. Interventions, especially treatment, enhanced the postresolution improvements in RA participants' life circumstances. This pattern was absent among NR participants. CONCLUSIONS: The findings suggest that a similar molar environmental context surrounds resolutions achieved with and without interventions and that interventions are associated with enhanced improvements during maintenance.

Adult↗