Christine Timko1,2, Michael A Cucciare3,4,5, Kathleen M Grant6,7, Lance Brendan Young8, Fernanda S Rossi1,9, Mai Chee Lor1, Erin Woodhead10. 1. Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, California. 2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. 3. Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas. 4. Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas. 5. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas. 6. Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska. 7. Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska. 8. Department of Communication, Western Illinois University-Quad Cities, Moline, Illinois. 9. Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California. 10. San José State University Department of Psychology, San Jose, California.
Abstract
OBJECTIVE: Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD. METHOD AND RESULTS: The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small. CONCLUSIONS: Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.
OBJECTIVE: Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD. METHOD AND RESULTS: The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small. CONCLUSIONS: Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.
Authors: Holger J Sørensen; Ann M Manzardo; Joachim Knop; Elizabeth C Penick; Wendy Madarasz; Elizabeth J Nickel; Ulrik Becker; Erik L Mortensen Journal: Alcohol Clin Exp Res Date: 2011-04-19 Impact factor: 3.455
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