Predictors of outcome in individuals with alcohol use disorder and a treatment goal of controlled drinking

The following abstract involve two studies both currently under review in two respective scientific papers. The first study concerns clinically relevant predictors of treatment outcome in a sample of patients with AUD and the treatment goal of controlled drinking.

The first study is entitled “Predictors of Treatment Outcome for Individuals with Alcohol Use Disorder with a Goal of Controlled Drinking” (in press in Addiction Science and Clinical Practice). 

Background: Research is lacking on predictors of outcome for the treatment of alcohol use disorder (AUD) with a goal of controlled drinking (CD). The aim of the first study was to investigate 52-week outcome in an RCT investigating Behavioral Self-Control Training (BSCT) and Motivational Enhancement Therapy (MET) and predictors of outcome for weekly alcohol consumption, CD and reduction in AUD. Methods: Secondary analyses from a randomized controlled trial (n=250) (52 % men) recruited at specialized addiction clinics in Stockholm, Sweden. Mixed regression models were used for outcomes at 52 weeks, and regression models for the predictor analyses. Results: BSCT was superior in attaining CD; 57 % in BSCT attained CD, as opposed to 43 % in MET. Females reached low-risk drinking levels to a larger extent than men. The predictor for a lower alcohol consumption at 52 weeks was a lower baseline consumption. Predictors of reduction in AUD were lower baseline level of AUD. Conclusions: The study corroborated baseline consumption as an important predictor of outcome in CD treatments. 

Study II: Executive function as a predictor of treatment outcome in alcohol use disorder (under review). 

The association between AUD and EF is established in previous research. EFs involve abilities e.g. planning, decision-making and inhibition; key functions in behavior change. Research on EF in AUD is dominated by studies in severely burdened individuals with high level of psychiatric comorbidity. The present study therefore aimed to investigate EF, and its predictive ability in reducing alcohol consumption in patients with AUD, low levels of psychiatric comorbidity and a goal of CD.  

Methods: Adults with AUD (n = 147), (same sample as study I) underwent neuropsychological testing before entering treatment.  Eight tests from the CANTAB battery were included assessing executive functions. Alcohol use was assessed at baseline,12- and 26 weeks. Healthy controls (n = 72) completed corresponding tests.

Results: The AUD sample showed no EF impairments compared to HC, and EF was not a predictor of favorable outcome.

Overall conclusions: The two studies contribute with important knowledge to advice patients and healthcare in planning treatment for patients with a CD goal. Patients with the clinical characteristics of the sample may not need any adjustment in treatment planning concerning their EF. Future research is needed including patients with more diverse socio-economic background, and other methodologies of measuring EF.