BACKGROUND: Most clinical trials evaluating treatments for alcohol use target individuals meeting diagnostic criteria for alcohol use disorder (AUD), but few address change in diagnostic status following treatment or as a potential outcome indicator. This study evaluated whether DSM-5 AUD total criteria count or severity category was sensitive to change over time and treatment effects. METHODS: Data were drawn from a randomized clinical trial that evaluated the efficacy of computer-based cognitive behavioral therapy program (CBT4CBT) for AUD. Sixty-eight individuals were randomized to 1 of the 3 weekly outpatient treatments for an 8-week period: (i) treatment as usual (TAU), (ii) TAU+CBT4CBT, and (iii) CBT4CBT+brief monitoring. Structured clinical interviews were used to determine current (past 30 days) AUD diagnosis at baseline, end-of-treatment, and 6 months following end-of-treatment. Change in the total number of DSM criteria endorsed, as well as severity categories (mild, moderate, severe), was evaluated across time and by treatment condition. RESULTS: Generalized Poisson's linear mixed models revealed a significant reduction in the number of DSM criteria from baseline to treatment end point [time effect χ2 (1) = 35.54, p < 0.01], but no significant interactions between time and treatment condition. Fewer total criteria endorsed, as well as achieving at least a 2-level reduction in AUD severity category at end-of-treatment, were associated with better outcomes during follow-up. Chi-square results indicated a greater proportion of individuals assigned to TAU+CBT4CBT had at least a 2-level reduction in severity category compared to TAU, at trend-level significance [χ2 (2, 54) = 5.13, p = 0.07], consistent with primary alcohol use outcomes in the main trial. CONCLUSIONS: This is the first study to demonstrate change in DSM-5 AUD total criteria count, as well as severity category, in a randomized clinical trial. These findings offer support for their use as a potential clinically meaningful outcome indicator.
RCT Entities:
BACKGROUND: Most clinical trials evaluating treatments for alcohol use target individuals meeting diagnostic criteria for alcohol use disorder (AUD), but few address change in diagnostic status following treatment or as a potential outcome indicator. This study evaluated whether DSM-5 AUD total criteria count or severity category was sensitive to change over time and treatment effects. METHODS: Data were drawn from a randomized clinical trial that evaluated the efficacy of computer-based cognitive behavioral therapy program (CBT4CBT) for AUD. Sixty-eight individuals were randomized to 1 of the 3 weekly outpatient treatments for an 8-week period: (i) treatment as usual (TAU), (ii) TAU+CBT4CBT, and (iii) CBT4CBT+brief monitoring. Structured clinical interviews were used to determine current (past 30 days) AUD diagnosis at baseline, end-of-treatment, and 6 months following end-of-treatment. Change in the total number of DSM criteria endorsed, as well as severity categories (mild, moderate, severe), was evaluated across time and by treatment condition. RESULTS: Generalized Poisson's linear mixed models revealed a significant reduction in the number of DSM criteria from baseline to treatment end point [time effect χ2 (1) = 35.54, p < 0.01], but no significant interactions between time and treatment condition. Fewer total criteria endorsed, as well as achieving at least a 2-level reduction in AUD severity category at end-of-treatment, were associated with better outcomes during follow-up. Chi-square results indicated a greater proportion of individuals assigned to TAU+CBT4CBT had at least a 2-level reduction in severity category compared to TAU, at trend-level significance [χ2 (2, 54) = 5.13, p = 0.07], consistent with primary alcohol use outcomes in the main trial. CONCLUSIONS: This is the first study to demonstrate change in DSM-5 AUD total criteria count, as well as severity category, in a randomized clinical trial. These findings offer support for their use as a potential clinically meaningful outcome indicator.
Authors: Andrea H Kline-Simon; Constance M Weisner; Sujaya Parthasarathy; Daniel E Falk; Raye Z Litten; Jennifer R Mertens Journal: Alcohol Clin Exp Res Date: 2013-10-07 Impact factor: 3.455
Authors: Brian D Kiluk; Kathleen A Devore; Matthew B Buck; Charla Nich; Tami L Frankforter; Donna M LaPaglia; Brian T Yates; Melissa A Gordon; Kathleen M Carroll Journal: Alcohol Clin Exp Res Date: 2016-08-04 Impact factor: 3.455
Authors: Deborah S Hasin; Melanie Wall; Katie Witkiewitz; Henry R Kranzler; Daniel Falk; Raye Litten; Karl Mann; Stephanie S O'Malley; Jennifer Scodes; Rebecca L Robinson; Raymond Anton Journal: Lancet Psychiatry Date: 2017-04-26 Impact factor: 27.083
Authors: Katie Witkiewitz; Kevin A Hallgren; Henry R Kranzler; Karl F Mann; Deborah S Hasin; Daniel E Falk; Raye Z Litten; Stephanie S O'Malley; Raymond F Anton Journal: Alcohol Clin Exp Res Date: 2016-12-26 Impact factor: 3.455
Authors: Mallory J E Loflin; Brian D Kiluk; Marilyn A Huestis; Will M Aklin; Alan J Budney; Kathleen M Carroll; Deepak Cyril D'Souza; Robert H Dworkin; Kevin M Gray; Deborah S Hasin; Dustin C Lee; Bernard Le Foll; Frances R Levin; Joshua A Lile; Barbara J Mason; Aimee L McRae-Clark; Ivan Montoya; Erica N Peters; Tatiana Ramey; Dennis C Turk; Ryan Vandrey; Roger D Weiss; Eric C Strain Journal: Drug Alcohol Depend Date: 2020-04-26 Impact factor: 4.492
Authors: Samuel W Stull; Leigh V Panlilio; Landhing M Moran; Jennifer R Schroeder; Jeremiah W Bertz; David H Epstein; Kenzie L Preston; Karran A Phillips Journal: Addict Behav Date: 2019-04-29 Impact factor: 3.913
Authors: Erin A McClure; Rachel L Tomko; Claudia A Salazar; Saima A Akbar; Lindsay M Squeglia; Evan Herrmann; Matthew J Carpenter; Erica N Peters Journal: Exp Clin Psychopharmacol Date: 2018-12-17 Impact factor: 3.157
Authors: Michelle A Silva; Yudilyn Jaramillo; Manuel Paris; Luis Añez-Nava; Tami L Frankforter; Brian D Kiluk Journal: J Subst Abuse Treat Date: 2019-12-13