Premium
Integrative data analysis of self‐efficacy in 4 clinical trials for alcohol use disorder
Author(s) -
Kruger Eric S.,
Serier Kelsey N.,
Pfund Rory A.,
McKay James R.,
Witkiewitz Katie
Publication year - 2021
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.14713
Subject(s) - relapse prevention , abstinence , self efficacy , alcohol use disorder , clinical psychology , psychology , randomized controlled trial , addiction , facilitation , alcohol dependence , medicine , psychiatry , alcohol , psychotherapist , biochemistry , chemistry , neuroscience
Abstract Background Self‐efficacy has been proposed as a key predictor of alcohol treatment outcomes and a potential mechanism of success in achieving abstinence or drinking reductions following alcohol treatment. Integrative data analysis, where data from multiple studies are combined for analyses, can be used to synthesize analyses across multiple alcohol treatment trials by creating a commensurate measure and controlling for differential item functioning (DIF) to determine whether alcohol treatments improve self‐efficacy. Method The current study used moderated nonlinear factor analysis (MNLFA) to examine the effect of treatment on self‐efficacy across four different treatment studies ( N = 3720; 72.5% male, 68.4% non‐Hispanic white). Self‐efficacy was measured using the Alcohol Abstinence Self‐Efficacy Scale (AASE) in the COMBINE Study ( n = 1383) and Project MATCH ( n = 1726), and the Drug Taking Confidence Questionnaire (DTCQ) in two studies of Telephone Continuing Care (TEL Study 1: n = 303; TEL Study 2: n = 212). DIF was examined across time, study, treatment condition, marital status, age, and sex. Results We identified 12 items from the AASE and DTCQ to create a commensurate measure of self‐efficacy using MNLFA. All active treatments, including cognitive–behavioral treatment, a combined behavioral intervention, medication management, motivation enhancement treatment, telephone continuing care, twelve‐step facilitation, and relapse prevention, were associated with significant increases in self‐efficacy from baseline to posttreatment that were maintained for up to a year. Importantly, treatment as usual in community settings, which consisted of weekly group therapy that included addiction counseling and twelve‐step recovery support, was not associated with significant increases in self‐efficacy. Conclusions Alcohol self‐efficacy increases following treatment and numerous evidence‐based treatments are associated with significant increases in self‐efficacy, which are maintained over time. Community treatment that focuses solely on addiction counseling and twelve‐step support may not promote increases in self‐efficacy.