Alternatives to regression residuals as measures of change after the intake of alcohol.
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Drug Tolerance↗
Biomedical subjects
T J O'Farrell
Publications and source records attributed to T J O'Farrell.
Dose-related effects of alcohol among male alcoholics, problem drinkers and nonproblem drinkers.
Cognitive variables, such as expectancies regarding the usefulness of alcohol, have been receiving increased attention in recent years because these expected effects can influence decisions to drink and mediate responses to alcohol. In the present study, alcohol expectancies were assessed using the Alcohol Beliefs Scale, a measure that yields dose-related data on expected effects of alcohol. The subjects were male alcoholics, problem drinkers and nonproblem drinkers. The central finding was that drinker group membership and rated dose level interacted in predicting subjects' estimates of the usefulness of alcohol for them. On the "useful for feeling better" factor, the greatest benefit was expected from a moderate dose, particularly among alcoholics. On the "useful for relieving emotional distress" factor, usefulness ratings increased with dose, with alcoholics expecting the greatest rate of increase. A similar pattern was found for the "useful for feeling in charge" factor, except that the ratings for problem drinkers and alcoholics paralleled each other. These findings have implications for our efforts to understand drinkers' motivations to initiate and continue drinking.
Alcohol Drinking↗
Antabuse contracts for married alcoholics and their spouses: a method to maintain antabuse ingestion and decrease conflict about drinking.
Antabuse is widely used in alcoholism treatment as a deterrent to impulsive drinking when the alcoholic encounters some temporary life crisis or other stressful situation. Unfortunately, Antabuse therapy often is not effective because the alcoholic discontinues the drug prematurely. Marital conflicts and arguments, frequently about past drinking or the likelihood of future drinking, are an important stressor that can lead the newly abstinent alcoholic to relapse. The Antabuse Contract procedure is designed to maintain Antabuse ingestion and abstinence from alcohol and to decrease alcohol-related arguments and interactions between the alcoholic and his/her spouse. In the Antabuse contract the alcoholic agrees to take Antabuse each day while the spouse observes. The spouse, in turn, agrees to record the observation of the Antabuse-taking on a calendar provided by the therapist. Finally, the couple agree to refrain from discussions about the alcoholic's past or possible future drinking. This report describes the Antabuse contract procedure in detail, discusses resistances and problems commonly encountered in using the procedure, and presents two case illustrations of successful use of the procedure.
Adaptation, Psychological↗
Alcohol expectancies among male alcoholics, problem drinkers, and nonproblem drinkers.
Drinkers' expectancies regarding alcohol effects are cognitive factors hypothesized to affect decisions to drink and responses to alcohol. Recent research in this area has yielded descriptive data mostly on nonalcoholic drinkers' motives for drinking and alcohol expectancies. Much less attention has been focused on assessing the extent to which these findings generalize to a broader array of drinkers. Alcohol expectancies were assessed in this report among 260 alcoholics, 79 problem drinkers, and 81 nonproblem drinkers (all subjects were male) using a comprehensive alcohol expectancy measure. Alcoholics almost uniformly scored higher than the problem and nonproblem drinkers in their endorsements of alcohol's effects in different domains (e.g., alcohol acts as a global positive transforming agent, enhances physical and social pleasure, engenders assertiveness, reduces tension). Problem drinkers also tended to score higher than the nonproblem drinkers in these domains. A multiple discriminant analysis yielded two functions which together were moderately successful in classifying these subjects according to drinker group. Taken together, these data suggest that important individual differences exist in drinkers' expectations regarding alcohol's utility, and that alcohol expectancies vary considerably as a function of problem drinking severity. The clinical implications of these findings are discussed.
Adult↗
Differences between alcoholic couples accepting and rejecting an offer of outpatient marital therapy.
Following an extensive initial evaluation, 35 couples with alcoholic husbands decided to participate in couples therapy (acceptors) and 28 couples did not (rejectors). A significant discriminant function indicated that acceptors were characterized by husbands with more education, better marital adjustment, full-time employment, and larger number of alcohol-related arrests. Acceptors also had sought more outpatient help in the past year. Rejectors were characterized by wives with better marital adjustment, greater living distance from clinic, and husbands with more alcohol-related hospitalizations. Rejector husbands also tended to be older. Practical implications for recruiting alcoholics and spouses into marital therapy are discussed.
Age Factors↗
Pain changes among men from before to after drinking: effects of expectancy set and dose manipulations with alcohol and tonic as mediated by prior experience with alcohol.
In an experiment that manipulated the set that one would consume (or not consume) an alcoholic beverage, pain reduction occurred among men (N = 52) told that they had consumed alcohol if they reported customarily drinking in large amounts or drinking in order to attain positive emotional states. When the men's belief that they had or had not consumed alcohol was taken into account, the propensity to drink for social-celebratory and personal-deficiency reasons was also associated with pain reduction.
Adult↗
Comment on the validity of Watson et al.'s "Do alcoholics give valid self-reports?".
This is a critique of a study by Watson et al. on the validity of alcoholics' self-reports that suggested that clinical researchers and clinicians abandon the use of such data for now. It is shown, however, through an analysis of the rationale, procedures and data analyses reported by Watson et al., that their conclusions are not warranted. It is argued that the use of a situational and convergent validity approach to the collection and interpretation of self-report data is likely to continue to be a productive research and clinical strategy.
Alcohol Drinking↗
Marital interactions and the duration of alcoholic husbands' sobriety.
Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands' sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety couples (duration of sobriety: less than 4 months) revealed that high sobriety husbands asked fewer questions, stated fewer disagreements, and emitted fewer aggressive behaviors than husbands in the low sobriety group. In addition, high sobriety husbands displayed a trend toward more active talk time, and their wives showed a trend toward asking fewer questions than their low sobriety counterparts. The results suggest that marital functioning is superior in couples with longer periods of sobriety. The need for examining possible causal links in this relationship is emphasized.
Adult↗
Behavioral marital therapy couples groups for male alcoholics and their wives.
This article presents in detail the clinical procedures for a behavioral marital therapy (BMT) couples group for male alcoholics. Methods used to recruit and prepare couples for therapy are presented. In the BMT couples group, therapists use behavioral rehearsal and weekly homework assignments to help couples decrease drinking and alcohol-related interactions by making an Antabuse Contract and discussing relapse prevention; plan shared recreational activities; notice, acknowledge, and initiate daily caring behaviors; learn communication skills of listening, expressing feelings directly, and the use of planned communication sessions; and negotiate desired changes using positive specific requests, compromise, and written agreements. Methods for dealing with resistance and noncompliance in the group are also described. Finally, modifications in the BMT treatment package presented here that may be helpful in other settings are described.
Alcohol Drinking↗
Relationship between reasons for drinking and customary drinking behavior.
In 80 subjects (28 women), a factor-analytic investigation of the relationship between the reasons for drinking and customary drinking behavior revealed that solitary drinking is associated with drinking in order to forget personal shortcomings, drinking to forget problems and disappointments, and drinking to be less concerned with what others think. Positive skewness proved to be a valid index of deviant drinking practices and motives. Some incidental findings indicated that heavy beer consumption occurs most among young men.
Adult↗
Addictive behaviors among hospitalized psychiatric patients.
A survey was conducted to assess the extent of alcohol abuse, drug abuse, obesity, and smoking among patients hospitalized on other than substance abuse treatment wards of a large psychiatric hospital. The results revealed extensive addictive behavior problems in the sample with nearly 90% of the patients having at least one of the problems. Prevalence rates for smoking and alcohol abuse substantially exceeded, and for obesity was equivalent to, the prevalence of these behaviors in the general population. Drug abuse was the least frequent problem and comparisons to the general population could not be made. Another major finding was that a relatively small proportion of patients was receiving any treatment for their addictive problems that was likely to be effective. For the most part, it seemed that patients receiving treatment were cases in which the addictive problem caused a serious immediate danger to the patient or others on the ward or seriously disrupted the ward routine.
Adult↗
Services for the families of alcoholics. A survey of treatment agencies in Massachusetts.
A survey of treatment agencies showed that alcohol misusers' families remain on the periphery of the treatment process. When the spouses or children did receive services, it was usually in the form of individual counseling. Despite their growing popularity, conjoint couples therapy, group couples therapy and family treatment were seldom used.
Adult↗
Obtaining driver's license records for use in evaluating alcoholism treatment.
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Alcoholism↗
A Closeness to Divorce Scale for wives of alcoholics.
A 15-item Guttman scale, Closeness to Divorce, was developed to describe and quantify how close an alcoholic's wife is to divorce at a given point in time. A detailed precoded interview schedule guided extensive interviews with 60 women, varying in marital status, who were current or former wives of men treated of alcoholism in Veterans Administration Hospitals. The interview contained 24 items on various aspects of marital stability gathered from the literature and from pilot interviews. These items were factor analysed and 15 items, loading 0.40 or better on the first principal component, were chosen for further analysis. A Guttman scale computer program was used to arrange the 15 items to form a Closeness to Divorce Scale, i.e. a unidimensional, cumulative scale with divorce at the endpoint and sequential psychological, interpersonal, geographic and legal steps toward divorce as the other items. Preliminary evidence of construct validity, potential clinical and research uses for scale, its limitations, and suggestions for future studies are described.
Alcoholism↗
Marital stability among wives of alcoholics: an evaluation of three explanations.
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Adolescent↗
Relapse precipitants and behavioral marital therapy.
The major purpose of this study was to provide descriptive data on the first relapse episodes and reasons for terminating relapses of subjects who completed a course of behavioral marital therapy (BMT) for alcoholism. Another aim of the study was to compare the relapse episodes and relapse terminations of subjects who received BMT with or without additional relapse prevention (RP) treatment for one year. The subjects were selected from a sample of 74 men who began an outpatient Department of Veterans Affairs BMT program. These men were evaluated pre- and post-BMT, and at 3, 6, 9, and 12 months after completing BMT. A total of 31 subjects relapsed at least once after they began BMT. The data showed that these men tended to report more than one situational or personal precipitant of their first relapses. Similarly, they tended to report more than one reason for ending their relapse episodes. Comparison of the subjects assigned to the two RP conditions revealed an equal number (12) of relapse episodes, but RP subjects' relapses tended to last fewer days than did no-RP subjects'. The consistency of these findings with previous research on cognitive-behavioral models of relapse and the implications of these findings for the concept of high-risk situation, are discussed.
Adult↗
Sexual adjustment of male alcoholics: changes from before to after receiving alcoholism counseling with and without marital therapy.
Married male alcoholics (N = 36), who had recently begun individual outpatient alcoholism counseling, were randomly assigned to a no-marital-treatment control group or to 10 weekly sessions of either a behavioral marital therapy (BMT) or an interactional couples therapy group. Impotence decreased from before to after counseling irrespective of whether the alcoholic patients received additional marital therapy. Husbands who received BMT reported increased frequency of wives' orgasm during intercourse and greater increases in satisfaction with the privacy and context of their sexual activities than did couples in the other two treatment groups. These findings support a biopsychosocial formulation of alcoholics' sexual problems that implicates the physical effects of acute and chronic alcohol intake as most relevant to the elevated rates of impotence and marital conflict as a major contributing factor to most sexual problems of alcoholics. The improvement observed in sexual adjustment was rather limited. Despite the improvements in impotence, the alcoholics still experienced over twice the rate of impotence reported by demographically similar nonalcoholics. In terms of sexual satisfaction, BMT produced only modest gains as viewed by husbands and no gains from the wives' perspective. Perhaps sexual adjustment is one of the last areas of the alcoholic's marriage to improve after treatment. The limited time frame of the present study may have precluded observing further improvements in sexual adjustment that would emerge later after a longer period of recovery.
Adult↗
A Sexual Adjustment Questionnaire for use in therapy and research with alcoholics and their spouses.
Despite evidence of extensive sexual problems among alcoholics, sexual adjustment is an area of alcoholics' behavior that often has been neglected in both treatment and research. To facilitate work on alcoholics' sexual adjustment, we needed a self-report questionnaire on sexual behavior that we could use in our couples treatment program with alcoholics and in our longitudinal research on the course of alcoholics' sexual problems over time. Pilot work found that available sexual adjustment measures were either too long or too sexually explicit to be useful. This paper describes the 38-item Sexual Adjustment Questionnaire we developed by combining selected items from two existing measures. Factor analysis reduced the questionnaire to the 15 measures of sexual satisfaction and sexual dysfunction described herein. Preliminary normative data and evidence of construct validity, potential clinical and research uses of the questionnaire, and suggestions for future studies are described.
Adult↗