Role of Relative-Reinforcement Value of Alcohol-Free Activities During Recovery From Alcohol Use Disorder in an Adult Clinical Sample
Behavioral economic theory has been extensively applied to understand alcohol use disorder (AUD). Applications of behavioral economic theory conceptualize AUD as a pattern of harmful alcohol use over extended periods of time in which choices between drinking or engaging in alcohol-free activities fa...
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| Veröffentlicht in: | Experimental and clinical psychopharmacology 2024-08, Vol.32 (4), p.410-417 |
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| creator | Kuhlemeier, Alena Tucker, Jalie A. Witkiewitz, Katie |
| description | Behavioral economic theory has been extensively applied to understand alcohol use disorder (AUD). Applications of behavioral economic theory conceptualize AUD as a pattern of harmful alcohol use over extended periods of time in which choices between drinking or engaging in alcohol-free activities favor drinking. Recovery, in contrast, entails a sustained shift toward a pattern of selecting rewarding alcohol-free activities. The present study examined whether alcohol-free activity engagement and the relative-reinforcement value (RRV) of engaging in those activities predicted AUD treatment outcomes via secondary analysis of data from Project MATCH, a multisite randomized clinical trial examining behavioral treatments for AUD (N = 1,279, 75.8% male, 81.0% non-Hispanic White, 9.5% Black, 7.7% Hispanic/Latino, 1.5% American Indian/Alaska Native, |
| doi_str_mv | 10.1037/pha0000713 |
| format | Article |
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Public Health Significance
Using a large clinical sample of persons with alcohol use disorder (AUD), this secondary data analysis found that posttreatment engagement in alcohol-free activities and the relative-reinforcement value of those activities compared to all activities combined predicted reductions in drinking and positive changes in functional outcomes. Developing community infrastructure for substance-free activities may increase access to health promotive resources for persons with AUD, including the 90% of individuals with AUD who do not receive treatment.</description><identifier>ISSN: 1064-1297</identifier><identifier>ISSN: 1936-2293</identifier><identifier>EISSN: 1936-2293</identifier><identifier>DOI: 10.1037/pha0000713</identifier><identifier>PMID: 38635163</identifier><language>eng</language><publisher>United States: American Psychological Association</publisher><subject>Adult ; Alcohol Drinking - psychology ; Alcohol Treatment ; Alcohol Use Disorder ; Alcoholism - psychology ; Alcoholism - therapy ; Behavior Therapy ; Behavior Therapy - methods ; Behavioral Economics ; Economics, Behavioral ; Female ; Human ; Humans ; Male ; Middle Aged ; Outpatient ; Recovery (Disorders) ; Reinforcement ; Reinforcement, Psychology ; Treatment Outcome</subject><ispartof>Experimental and clinical psychopharmacology, 2024-08, Vol.32 (4), p.410-417</ispartof><rights>2024 American Psychological Association</rights><rights>2024, American Psychological Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a337t-d6f61b08d94c923158b31400b184ab4e4859171f5fd744f50eb7f1dc395656d33</citedby><orcidid>0000-0002-1917-3230</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38635163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Dunn, Kelly</contributor><creatorcontrib>Kuhlemeier, Alena</creatorcontrib><creatorcontrib>Tucker, Jalie A.</creatorcontrib><creatorcontrib>Witkiewitz, Katie</creatorcontrib><title>Role of Relative-Reinforcement Value of Alcohol-Free Activities During Recovery From Alcohol Use Disorder in an Adult Clinical Sample</title><title>Experimental and clinical psychopharmacology</title><addtitle>Exp Clin Psychopharmacol</addtitle><description>Behavioral economic theory has been extensively applied to understand alcohol use disorder (AUD). Applications of behavioral economic theory conceptualize AUD as a pattern of harmful alcohol use over extended periods of time in which choices between drinking or engaging in alcohol-free activities favor drinking. Recovery, in contrast, entails a sustained shift toward a pattern of selecting rewarding alcohol-free activities. The present study examined whether alcohol-free activity engagement and the relative-reinforcement value (RRV) of engaging in those activities predicted AUD treatment outcomes via secondary analysis of data from Project MATCH, a multisite randomized clinical trial examining behavioral treatments for AUD (N = 1,279, 75.8% male, 81.0% non-Hispanic White, 9.5% Black, 7.7% Hispanic/Latino, 1.5% American Indian/Alaska Native, <1% Asian American, and other race/ethnicity). Regression analyses indicated that every additional alcohol-free activity reported at 6 months posttreatment was associated with 7% fewer drinking days, 5% fewer heavy drinking days, and approximately one less drink per drinking day, as well as with significant improvements in depression, purpose in life, and psychosocial functioning at 12 months following treatment. Consistent with behavioral economic theory, higher RRV of alcohol-free activities also predicted significant reductions in drinking and improvements in functioning, and these associations were stronger compared to results for alcohol-free activity frequency only. The findings highlight the importance of understanding environmental contexts conducive to recovery and support the value of increasing alcohol-free activity engagement and the RRV of engaging in such activities to facilitate reductions in drinking and improved functioning among individuals with AUD.
Public Health Significance
Using a large clinical sample of persons with alcohol use disorder (AUD), this secondary data analysis found that posttreatment engagement in alcohol-free activities and the relative-reinforcement value of those activities compared to all activities combined predicted reductions in drinking and positive changes in functional outcomes. Developing community infrastructure for substance-free activities may increase access to health promotive resources for persons with AUD, including the 90% of individuals with AUD who do not receive treatment.</description><subject>Adult</subject><subject>Alcohol Drinking - psychology</subject><subject>Alcohol Treatment</subject><subject>Alcohol Use Disorder</subject><subject>Alcoholism - psychology</subject><subject>Alcoholism - therapy</subject><subject>Behavior Therapy</subject><subject>Behavior Therapy - methods</subject><subject>Behavioral Economics</subject><subject>Economics, Behavioral</subject><subject>Female</subject><subject>Human</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outpatient</subject><subject>Recovery (Disorders)</subject><subject>Reinforcement</subject><subject>Reinforcement, Psychology</subject><subject>Treatment Outcome</subject><issn>1064-1297</issn><issn>1936-2293</issn><issn>1936-2293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0cFu1DAQBmALgWgpXHgAZIlLBUrxxI6TnNBq2wWkSkgL5Wo5zqTryomDnay0D9D3rpdtC9QXW_LnXzMeQt4COwPGy0_jRrO0SuDPyDHUXGZ5XvPn6cykyCCvyyPyKsYbxkDwOn9JjngleQGSH5PbtXdIfUfX6PRkt5it0Q6dDwZ7HCb6S7v5z_3CGb_xLlsFRLowidrJYqTnc7DDdXpu_BbDjq6C7x8wvYpIz230ocVA7UD1QBft7Ca6dHawRjv6Q_ejw9fkRaddxDf3-wm5Wl38XH7NLr9_-bZcXGaa83LKWtlJaFjV1sLUOYeiajgIxhqohG4EiqqooYSu6NpSiK5g2JQdtIbXhSxky_kJ-XzIHeemx9akDoN2agy212GnvLbq_5vBbtS13yqAPP1cJVLC6X1C8L9njJPqbTTonB7Qz1FxJhIFkEWi75_QGz-HIfW3V0wWJStlUh8OygQfY8DusRpgaj9e9Xe8Cb_7t_5H-jDPBD4egB61GuPO6DBZ4zCaOYTU0z5M8VwJJVL2HVIxr_E</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Kuhlemeier, Alena</creator><creator>Tucker, Jalie A.</creator><creator>Witkiewitz, Katie</creator><general>American Psychological Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7RZ</scope><scope>PSYQQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1917-3230</orcidid></search><sort><creationdate>20240801</creationdate><title>Role of Relative-Reinforcement Value of Alcohol-Free Activities During Recovery From Alcohol Use Disorder in an Adult Clinical Sample</title><author>Kuhlemeier, Alena ; Tucker, Jalie A. ; Witkiewitz, Katie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a337t-d6f61b08d94c923158b31400b184ab4e4859171f5fd744f50eb7f1dc395656d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Alcohol Drinking - psychology</topic><topic>Alcohol Treatment</topic><topic>Alcohol Use Disorder</topic><topic>Alcoholism - psychology</topic><topic>Alcoholism - therapy</topic><topic>Behavior Therapy</topic><topic>Behavior Therapy - methods</topic><topic>Behavioral Economics</topic><topic>Economics, Behavioral</topic><topic>Female</topic><topic>Human</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outpatient</topic><topic>Recovery (Disorders)</topic><topic>Reinforcement</topic><topic>Reinforcement, Psychology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kuhlemeier, Alena</creatorcontrib><creatorcontrib>Tucker, Jalie A.</creatorcontrib><creatorcontrib>Witkiewitz, Katie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>APA PsycArticles®</collection><collection>ProQuest One Psychology</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Experimental and clinical psychopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuhlemeier, Alena</au><au>Tucker, Jalie A.</au><au>Witkiewitz, Katie</au><au>Dunn, Kelly</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Relative-Reinforcement Value of Alcohol-Free Activities During Recovery From Alcohol Use Disorder in an Adult Clinical Sample</atitle><jtitle>Experimental and clinical psychopharmacology</jtitle><addtitle>Exp Clin Psychopharmacol</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>32</volume><issue>4</issue><spage>410</spage><epage>417</epage><pages>410-417</pages><issn>1064-1297</issn><issn>1936-2293</issn><eissn>1936-2293</eissn><abstract>Behavioral economic theory has been extensively applied to understand alcohol use disorder (AUD). Applications of behavioral economic theory conceptualize AUD as a pattern of harmful alcohol use over extended periods of time in which choices between drinking or engaging in alcohol-free activities favor drinking. Recovery, in contrast, entails a sustained shift toward a pattern of selecting rewarding alcohol-free activities. The present study examined whether alcohol-free activity engagement and the relative-reinforcement value (RRV) of engaging in those activities predicted AUD treatment outcomes via secondary analysis of data from Project MATCH, a multisite randomized clinical trial examining behavioral treatments for AUD (N = 1,279, 75.8% male, 81.0% non-Hispanic White, 9.5% Black, 7.7% Hispanic/Latino, 1.5% American Indian/Alaska Native, <1% Asian American, and other race/ethnicity). Regression analyses indicated that every additional alcohol-free activity reported at 6 months posttreatment was associated with 7% fewer drinking days, 5% fewer heavy drinking days, and approximately one less drink per drinking day, as well as with significant improvements in depression, purpose in life, and psychosocial functioning at 12 months following treatment. Consistent with behavioral economic theory, higher RRV of alcohol-free activities also predicted significant reductions in drinking and improvements in functioning, and these associations were stronger compared to results for alcohol-free activity frequency only. The findings highlight the importance of understanding environmental contexts conducive to recovery and support the value of increasing alcohol-free activity engagement and the RRV of engaging in such activities to facilitate reductions in drinking and improved functioning among individuals with AUD.
Public Health Significance
Using a large clinical sample of persons with alcohol use disorder (AUD), this secondary data analysis found that posttreatment engagement in alcohol-free activities and the relative-reinforcement value of those activities compared to all activities combined predicted reductions in drinking and positive changes in functional outcomes. Developing community infrastructure for substance-free activities may increase access to health promotive resources for persons with AUD, including the 90% of individuals with AUD who do not receive treatment.</abstract><cop>United States</cop><pub>American Psychological Association</pub><pmid>38635163</pmid><doi>10.1037/pha0000713</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1917-3230</orcidid></addata></record> |
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| ispartof | Experimental and clinical psychopharmacology, 2024-08, Vol.32 (4), p.410-417 |
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| subjects | Adult Alcohol Drinking - psychology Alcohol Treatment Alcohol Use Disorder Alcoholism - psychology Alcoholism - therapy Behavior Therapy Behavior Therapy - methods Behavioral Economics Economics, Behavioral Female Human Humans Male Middle Aged Outpatient Recovery (Disorders) Reinforcement Reinforcement, Psychology Treatment Outcome |
| title | Role of Relative-Reinforcement Value of Alcohol-Free Activities During Recovery From Alcohol Use Disorder in an Adult Clinical Sample |
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