Abstract
Background: Epidemiological studies and theory implicate drinking to cope (DTC) with anxiety as a potent moderator of the association between anxiety disorder (AnxD) and problematic alcohol use. However, the relevance of DTC to the treatment of alcohol use disorder (AUD) in those with a co-occurring AnxD has not been well studied. To address this, we examined whether DTC moderates the impact of two therapies: (1) a cognitive behavioral therapy (CBT) designed to reduce DTC and anxiety symptoms; (2) a progressive muscle relaxation training (PMRT) program designed to reduce anxiety symptoms only. Methods: Patients undergoing a standard AUD residential treatment with a co-occurring AnxD (N= 218) were randomly assigned to also receive either the CBT or PMRT. DTC in the 30 days prior to treatment was measured using the Unpleasant Emotions subscale of the Inventory of Drinking Situations. Results: Confirming the predicted moderator model, the results indicated a significant interaction between treatment group and level of pre-treatment DTC behavior. Probing this interaction revealed that for those reporting more pre-treatment DTC behavior, 4-month alcohol outcomes were superior in the CBT group relative to the PMRT group. For those reporting less pre-treatment DTC behavior, however, 4-month alcohol outcomes were similar and relatively good in both treatment groups. Conclusions: These findings establish a meaningful clinical distinction among those with co-occurring AUD-AnxD based on the degree to which the symptoms of the two disorders are functionally linked through DTC. Those whose co-occurring AUD-AnxD is more versus less strongly linked via DTC are especially likely to benefit from standard AUD treatment that is augmented by a brief CBT designed to disrupt this functional link.
Original language | English (US) |
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Pages (from-to) | 93-100 |
Number of pages | 8 |
Journal | Drug and alcohol dependence |
Volume | 159 |
DOIs | |
State | Published - Feb 1 2016 |
Bibliographical note
Funding Information:This research was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant R01-AA015069 awarded to Matt G. Kushner as well as a National Institute of Drug Abuse (NIDA) training grant supporting the work of Justin Anker ( T320A037183 ). NIAAA and NIDA had no further role in the study design; in the collection, analysis, and interpretation of data; in writing; nor in the decision to submit the manuscript for publication.
Funding Information:
The authors wish to acknowledge and thank Christopher Hick- man and his staff at the Fairview-Riverside Lodging Plus Chemical Dependency program for their continued support of this and other work. The authors would also like to thank Joani Van Demark, Marc Mooney, Sheila Specker, Mallory Mahaffey, Kari Knefelkamp, and Hoa Le for their technical assistance.
Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
Keywords
- Alcohol
- Anxiety disorder
- CBT treatment
- Comorbidity
- Drinking motives