Course of functioning 1 year following admission for treatment of alcohol use disorders

Research on alcohol treatment outcomes has the potential to advance knowledge about how treatment combines with other variables to influence post treatment course of functioning. The purpose of this study was to replicate and extend Connors, Maisto, and Zywiak's (1996) [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatment functioning. Addiction, 91 (Suppl.), S173–S189] test of a multivariate model of course by testing the model's fit to data from a larger sample and the use of stronger statistical methods. The participants were 400 men and women presenting for alcohol treatment in two cities in the US. These individuals completed a pretreatment (baseline) assessment battery at treatment initiation and then completed follow-up assessments bimonthly for a period of 1 year. The model included pretreatment, treatment (months 1–6), and post-baseline (months 1–6) factors to predict alcohol use (percent days abstinent, drinks/drinking day, and total number drinks/month, all for months 7–12). The application of structural equation modeling methods revealed that the model fit the data adequately for all three dependent variables, with the major significant findings of direct effects of treatment setting, coping skills, and the mediation of treatment effects through coping skills. Overall, the data replicated several findings from the Connors et al.'s study and point to the importance of investigating the mechanisms underlying treatment effects and the mediation of treatment effects by coping skills in future research.