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Behavioral economic indicators of drinking problem severity and initial outcomes among problem drinkers attempting natural recovery: a cross‐sectional naturalistic study
Author(s) -
Tucker Jalie A.,
Cheong JeeWon,
Chandler Susan D.,
Lambert Brice H.,
Kwok Heather,
Pietrzak Brittney
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13492
Subject(s) - cross sectional study , environmental health , psychology , medicine , clinical psychology , psychiatry , pathology
Background and aims Research using different behavioral economic (BE) and time perspective (TP) measures suggests that substance misusers show greater sensitivity to shorter‐term contingencies than normal controls, but multiple measures have seldom been investigated together. This study evaluated the extent to which multiple BE and TP measures were associated with drinking problem severity, distinguished initial outcomes of natural recovery attempts and shared common variance. Hypotheses were (1) that greater problem severity would be associated with greater impulsivity and demand for alcohol and shorter TPs; and (2) that low‐risk drinking would be associated with greater sensitivity to longer‐term contingencies compared with abstinence. Design Cross‐sectional naturalistic field study. Setting Southern United States. Participants Problem drinkers, recently resolved without treatment [ n = 191 (76.44% male), mean age = 50.09 years] recruited using media advertisements. Measurements Drinking practices, dependence levels and alcohol‐related problems prior to stopping problem drinking were assessed during structured field interviews. Measures included the Zimbardo Time Perspective Inventory; BE analogue choice tasks [delay discounting (DD), melioration–maximization (MM), alcohol purchase task (APT)]; and the Alcohol‐Savings Discretionary Expenditure (ASDE) index, derived from real spending on alcohol and voluntary savings during the year before problem cessation. Findings Measures of demand based on real (ASDE) and hypothetical (APT) spending on alcohol were associated with problem severity ( P s < 0.05), but DD, MM and TP measures were not. More balanced pre‐resolution spending on alcohol versus saving for the future distinguished low‐risk drinking from abstinent resolutions (ASDE odds ratio =5.59; P < 0.001). BE measures did not share common variance. Conclusions Two behavioral assessment tools that measure spending on alcohol, the Alcohol Purchase Task and the Alcohol‐Savings Discretionary Expenditure index, appear to be reliable in assessing the severity of drinking problems. The ASDE index also may aid choices between low‐risk and abstinent drinking goals.