Kevin A Hallgren1, Cathryn G Holzhauer2, Elizabeth E Epstein2, Barbara S McCrady3, Sharon Cook4. 1. Behavioral Research in Technology and Engineering (BRiTE) Center. 2. Department of Psychiatry. 3. Department of Psychology, Center on Alcohol, Substance use, And Addictions. 4. Institute for Health, Health Care Policy and Aging Research.
Abstract
OBJECTIVE: Clients who receive alcohol use disorder (AUD) treatment experience variable outcomes. Measuring clinical progress during treatment using standardized measures (i.e., measurement-based care) can help indicate whether clinical improvements are occurring. Measures of mechanisms of behavioral change (MOBCs) may be particularly well-suited for measurement-based care; however, measuring MOBCs would be more feasible and informative if measures were briefer and if their ability to detect reliable change with individual clients was better articulated. METHOD: Three abbreviated measures of hypothesized MOBCs (abstinence self-efficacy, coping strategies, anxiety) and a fourth full-length measure (depression) were administered weekly during a 12-week randomized trial of cognitive-behavioral therapy (CBT) for women with AUD. Psychometric analyses estimated how reliably each measure distinguished within-person change from between-person differences and measurement error. Reliability coefficients were estimated for simulated briefer versions of each instrument (i.e., instruments with fewer items than the already-abbreviated instruments) and rates of reliable improvement and reliable worsening were estimated for each measure. RESULTS: All four measures had good reliability (.86-.90) for detecting within-person change. Many participants (41.4%-62.5%) reliably improved on MOBCs from first to last treatment session. Reliable improvement on MOBCs was associated with reductions in percentage of drinking days (PDD) at 3, 9, and 15-month follow-ups. Simulated briefer versions of each instrument retained good reliability for detecting change with only 3 (self-efficacy), 11 (coping strategies), 5 (anxiety), or 10 items (depression). CONCLUSIONS: Brief MOBC measures can detect reliable change for individuals in AUD treatment. Routinely measuring MOBCs may help with monitoring clinical progress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
OBJECTIVE: Clients who receive alcohol use disorder (AUD) treatment experience variable outcomes. Measuring clinical progress during treatment using standardized measures (i.e., measurement-based care) can help indicate whether clinical improvements are occurring. Measures of mechanisms of behavioral change (MOBCs) may be particularly well-suited for measurement-based care; however, measuring MOBCs would be more feasible and informative if measures were briefer and if their ability to detect reliable change with individual clients was better articulated. METHOD: Three abbreviated measures of hypothesized MOBCs (abstinence self-efficacy, coping strategies, anxiety) and a fourth full-length measure (depression) were administered weekly during a 12-week randomized trial of cognitive-behavioral therapy (CBT) for women with AUD. Psychometric analyses estimated how reliably each measure distinguished within-person change from between-person differences and measurement error. Reliability coefficients were estimated for simulated briefer versions of each instrument (i.e., instruments with fewer items than the already-abbreviated instruments) and rates of reliable improvement and reliable worsening were estimated for each measure. RESULTS: All four measures had good reliability (.86-.90) for detecting within-person change. Many participants (41.4%-62.5%) reliably improved on MOBCs from first to last treatment session. Reliable improvement on MOBCs was associated with reductions in percentage of drinking days (PDD) at 3, 9, and 15-month follow-ups. Simulated briefer versions of each instrument retained good reliability for detecting change with only 3 (self-efficacy), 11 (coping strategies), 5 (anxiety), or 10 items (depression). CONCLUSIONS: Brief MOBC measures can detect reliable change for individuals in AUD treatment. Routinely measuring MOBCs may help with monitoring clinical progress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Authors: Katie Witkiewitz; Matthew R Pearson; Kevin A Hallgren; Stephen A Maisto; Corey R Roos; Megan Kirouac; Adam D Wilson; Kevin S Montes; Nick Heather Journal: Addiction Date: 2017-06-26 Impact factor: 6.526
Authors: Cathryn Glanton Holzhauer; Elizabeth E Epstein; Jumi Hayaki; James S Marinchak; Barbara S McCrady; Sharon M Cook Journal: J Subst Abuse Treat Date: 2017-09-29
Authors: Kevin A Hallgren; Theresa E Matson; Malia Oliver; Ryan M Caldeiro; Daniel R Kivlahan; Katharine A Bradley Journal: Alcohol Clin Exp Res Date: 2022-03 Impact factor: 3.455
Authors: Justin S Tauscher; Eliza B Cohn; Tascha R Johnson; Kaylie D Diteman; Richard K Ries; David C Atkins; Kevin A Hallgren Journal: Addict Sci Clin Pract Date: 2021-06-15