Addictive Behaviors and Quantitative Research at CASAA:Addictive Behaviors and Quantitative Research at CASAA: S di h Sh ld f GiStanding on The Shoulders of GiantsStanding on The Shoulders of Giants

Katie Witkiewitz Megan Kirouac Elizabeth McCallion Corey Roos Adam WilsonKatie Witkiewitz, Megan Kirouac, Elizabeth McCallion, Corey Roos, Adam Wilson, M tth P D id B T F h Al d H ll & A th J O’Si kMatthew Pearson, David Brown, Tessa Frohe, Alexander Hall, & Anthony J. O’SickeyMatthew Pearson, David Brown, Tessa Frohe, Alexander Hall, & Anthony J. O Sickey

ResearchResearch

The Addictive Behaviors and Quantitative research lab D hi h t i ti RREP UKATT MATCH COMBINE Ph i l P i d Al h l T t t O tThe Addictive Behaviors and Quantitative research lab Demographic characteristic RREP UKATT MATCH COMBINE Physical Pain and Alcohol Treatment Outcomesat CASAA focuses on the advancement of quantitative Sample size (total N = 4,415) 563 724 1726 1383 Katie Witkiewitz, Elizabeth McCallion, Tessa Frohe, and Megan Kirouacat CASAA focuses on the advancement of quantitative

th d l d i ti b h i l t t tp ( , )

The prevalence of pain among alcohol use disorder (AUD) patients hasmethodology and innovative behavioral treatment Gender - % Male 58.8% 74.1% 75.7% 69.1%p p g ( ) p

received some attention but few studies have examined the associationapproaches with the primary focus on improving Age – Mean (SD) 34 3 (8 7) 41 6 (10 1) 40 2 (10 9) 44 4 (10 2)

received some attention, but few studies have examined the associationbetween pain and AUD treatment outcomes We examined theapproaches with the primary focus on improving

t t t d t t t t f i di id lAge Mean (SD) 34.3 (8.7) 41.6 (10.1) 40.2 (10.9) 44.4 (10.2) between pain and AUD treatment outcomes. We examined the

i i b h i l i f i d fi d b itreatment and treatment outcomes for individuals Ethnicity - % White 67.3% 95.6% 80.0% 76.8% association between physical experiences of pain, defined by pain

struggling with addictive and unhealthy behaviors As Marital status % Married in relationship 17 9% 54 1% 41 4% 46 3% interference and pain intensity, as predictors of alcohol lapses andstruggling with addictive and unhealthy behaviors. Asd ib d i hi f h h

Marital status - % Married, in relationship 17.9% 54.1% 41.4% 46.3% p y p palcohol use following treatment for AUD. In addition, we examined thedescribed in this poster, most of the research we are Employment status - % Full or part-time 33.7% 34.8% 82.1% 71.4%alcohol use following treatment for AUD. In addition, we examined themediating role of negative affect on pain interference and drinkingp ,

conducting focuses on the re analysis of existing Hi h d ti i l t 34 7% 16 1% 53 4% 70 6%

mediating role of negative affect on pain interference and drinkingt U i d t f UKATT d COMBINE f d th t iconducting focuses on the re-analysis of existing Higher education or equivalent 34.7% 16.1% 53.4% 70.6% outcomes. Using data from UKATT and COMBINE we found that pain

i ifi l di d i fi d i ki d d i fi halcohol use disorder (AUD) treatment outcome datasets, significantly predicted time-to-first drinking day and time-to-first heavyalcohol use disorder (AUD) treatment outcome datasets,many of which were collected initially by CASAA Exploratory and Confirmatory Factor Analysis of drinking day during treatment and following treatment (all p<0.01). Painmany of which were collected initially by CASAA p y y y

the Life Experiences Survey Among Individualsg y g g ( p )

also significantly predicted heavy drinking following treatment (allinvestigators over the past 30 years The advancement the Life Experiences Survey Among Individuals also significantly predicted heavy drinking following treatment (all

p<0 05) Greater pain interference was associated with greater negativeinvestigators over the past 30 years. The advancementf i b d l f i ti d t i t Beginning Treatment for an Alcohol Use Disorder p<0.05). Greater pain interference was associated with greater negative

ff t d i i i i t d ith i i tiof science by secondary analyses of existing data is not Beginning Treatment for an Alcohol Use DisorderMegan Kirouac Anthony J O’Sickey and Katie Witkiewitz

affect and increases in pain were associated with increases in negative

only cost-effective but also provides a rich source ofMegan Kirouac, Anthony J. O Sickey, and Katie Witkiewitz

Lif i h l i l t diaffect. Negative affect significantly mediated the association betweenonly cost-effective, but also provides a rich source of

i f i f i i hLife experiences such as losing employment or ending a pain and drinking outcomes. This effect was moderated by socialinformation for answering numerous questions that romantic relationship are potential sources of stress; yet,

pa a d d g outco es. s e ect was ode ated by soc abehavior network therapy in the UKATT study The results of this studyg q

were not initially conceived when the data were initiallyp p ; y ,

relatively little is known about how specific stressors impactbehavior network therapy in the UKATT study. The results of this studyhave important implications for AUD treatment Clinicians andwere not initially conceived when the data were initially relatively little is known about how specific stressors impact

AUD li i l T d d h i lifhave important implications for AUD treatment. Clinicians and

h h ld f i i f d i i i lcollected. Importantly, our work focuses on innovative AUD clinical course. To understand how certain life researchers should assess for pain interference and intensity as potentialp y,methodological techniques including confirmatory experiences may accumulate together the current study triggers for lapses and heavy drinking as well as the mediating role ofmethodological techniques, including confirmatory experiences may accumulate together, the current study

e amined the factor str ct re of the Life E periences S r egg p y g g

negative affect.factor analyses, latent growth modeling, mixture examined the factor structure of the Life Experiences Survey, negative affect.factor analyses, latent growth modeling, mixture

d li d i i d t t h i f hi h via secondary data analysis of the RREP data. Exploratory andmodeling, and missing data techniques, many of which y y p yconfirmatory factor analyses suggested a 4 factor model of 11

were not available at the time of the original studiesconfirmatory factor analyses suggested a 4-factor model of 11

lif i id d h b fi h d Iwere not available at the time of the original studies. common life experiences provided the best fit to the data. Itemloadings suggested the factor structure represented lifeloadings suggested the factor structure represented lifeexperiences in four domains: (1) legal problems (2) majorexperiences in four domains: (1) legal problems, (2) major

O h d t ll t d b th R ldepression symptoms, (3) employment and relationship

Our research uses data collected by the Relapsep y p , ( ) p y p

problems and (4) changes in hedonic activities Thesey pReplication and Extension Project (RREP; Lowman et

problems, and (4) changes in hedonic activities. Thesed i h ld b i d i f t t di t th iReplication and Extension Project (RREP; Lowman et

l 1996) h i d i d Al h l i ldomains should be examined in future studies to see their

al., 1996), the United Kingdom Alcohol Treatment Trial association with fluctuations in alcohol consumption during the, ), g(UKATT; UKATT Research Team 2001) Project

association with fluctuations in alcohol consumption during thecourse of AUDs Such research could help inform treatment(UKATT; UKATT Research Team, 2001), Project course of AUDs. Such research could help inform treatment

MATCH (Project MATCH Research Group, 1997), and development by highlighting life event domains that are most Predictors of Alcoholics Anonymous AttendanceC ( oject C esea c G oup, 997), a dthe COMBINE study (COMBINE Study Group 2003)

p y g g ginfluential on AUD clinical course

Predictors of Alcoholics Anonymous AttendanceAl d H ll C R Ad Wil M tth R P K ti Witki itthe COMBINE study (COMBINE Study Group, 2003). influential on AUD clinical course. Alexander Hall, Corey Roos, Adam Wilson, Matthew R. Pearson, Katie Witkiewitz

The RREP, MATCH, and COMBINE studies were Client characteristics or affiliation profiles for members ofThe RREP, MATCH, and COMBINE studies wered t d b i ti t t CASAA i l di D

pAlcoholics Anonymous (AA) have been of interest to manyconducted by investigators at CASAA, including Drs. Alcoholics Anonymous (AA) have been of interest to many

h Thi i h j t d MATCH d t tMiller Tonigan Waldron & Westerberg researchers. This senior honors project used MATCH data toMiller, Tonigan, Waldron & Westerberg. replicate the most generally accepted finding; namely, AA•RREP. Participants (n=563) in RREP were recruited from

replicate the most generally accepted finding; namely, AAattendance as positively predicted by problem severity andp ( )

three research sites including CASAA The researchattendance as positively predicted by problem severity, and

ili d l il l f k i h l i hithree research sites, including CASAA. The research i i i d f i f h

utilized a Multilevel framework to examine the relationshipparticipants received treatment from a variety of approaches

pacross 5 follow-ups

over varying lengths of time Follow-up assessments wereacross 5 follow ups.

Attendance by Problem Severityover varying lengths of time. Follow up assessments were conducted 6 and 12 months after entry into the trial Examining Craving from an Existential Perspective 14

Attendance by Problem Severity

conducted 6- and 12-months after entry into the trial. Examining Craving from an Existential PerspectiveCorey Roos Megan Kirouac Matthew R Pearson Brandi Fink Katie Witkiewitz 11.60912

•UKATT Participants (n=724) in the UKATT trial wereCorey Roos, Megan Kirouac, Matthew R. Pearson, Brandi Fink, Katie Witkiewitz

Cra ing has been e amined from a n mber of theoreticalUKATT. Participants (n 724) in the UKATT trial were it d f it d Bi i h C diff d

Craving has been examined from a number of theoretical 10

recruited from seven sites around Birmingham, Cardiff, and perspectives; however, research examining craving from an 8

ndan

ce

Leeds. The participants were randomized to 8 to 12 weeks of p p ; , g gexistential perspective is lacking This study investigated the 6A

Atte

n

p psocial behavior and network therapy (SBNT) or motivation

existential perspective is lacking. This study investigated thei i l h l i i lif (PIL) d 4.148

6

ge in

AA

social behavior and network therapy (SBNT) or motivation h h (MET) F ll

associations among alcohol craving, purpose in life (PIL), and2.746

4

Cha

ng

enhancement therapy (MET). Follow-up assessments were drinking outcomes using data from Project MATCH (N = 0 9851.4012

conducted at 3- and 12-months after entry into the trialdrinking outcomes using data from Project MATCH (N1726) Parallel process latent growth curve analyses indicated

0.985

conducted at 3 and 12 months after entry into the trial.i i ( ) i j

1726). Parallel process latent growth curve analyses indicated -0.67501 10

•MATCH. Participants (n=1726) in Project MATCH were that higher levels of PIL and increases in PIL over time were -2Follow-Up: Baseline, 3, 6, 9, 12, and 15 Months p ( ) j

recruited from treatment centers associated with nine researchg

associated with lower levels of craving and decreases inp , , , , ,

recruited from treatment centers associated with nine research it th U it d St t i l di CASAA P ti i t

associated with lower levels of craving and decreases ini ti Hi h l l f i l l l funits across the United States, including CASAA. Participants craving over time. Higher levels of craving, lower levels of

were recruited from both outpatient (n=952) and inpatient PIL, increases in craving, and decreases in PIL werep ( ) psettings (n=774) and were randomized to Cognitive Behavioral The COMBINE Study Research Group (2003) Testing Combined Pharmacotherapies and

PIL, increases in craving, and decreases in PIL weresignificantly associated with greater intensity and frequency ofsettings (n=774) and were randomized to Cognitive Behavioral

Th (CBT) MET T l S F ili i (TSF)The COMBINE Study Research Group. (2003). Testing Combined Pharmacotherapies and

Behavioral Interventions in Alcohol Dependence : Rationale and Methods Alcoholism:significantly associated with greater intensity and frequency of

Therapy (CBT), MET, or Twelve-Step Facilitation (TSF). Behavioral Interventions in Alcohol Dependence : Rationale and Methods. Alcoholism: Clinical and Experimental Research 27(7) 1107 1122drinking and greater drinking-related consequences at the 12-py ( ) p ( )

Participants received 4 (MET) or 12 (TSF CBT) sessions overClinical and Experimental Research, 27(7), 1107–1122. doi:10 1097/01 alc 0000086765 46408 64

g g g qmonth follow-up Future research is warranted to examineParticipants received 4 (MET) or 12 (TSF, CBT) sessions over

12 k F ll t d t d f 12doi:10.1097/01.alc.0000086765.46408.64

Crumbaugh J C & Maholic L T (1964) An experimental study in existentialism: Themonth follow up. Future research is warranted to examine

h th i i PIL i l t li t f t ti l12 weeks. Follow-up assessments were conducted for 12- Crumbaugh, J. C., & Maholic, L. T. (1964). An experimental study in existentialism: The psychometric approach to Frankl’s concept of noogenic neurosis Journal of Clinicalwhether increases in PIL may inoculate clients from potential

months following treatment.psychometric approach to Frankl s concept of noogenic neurosis. Journal of Clinical Psychology, 20(2), 200–207. doi:0.1002/1097-4679(196404)20:2<200::AID-relapse during craving experiences.g

COMBINE P ti i t ( 1383) i COMBINEPsychology, 20(2), 200 207. doi:0.1002/1097 4679(196404)20:2 200::AIDJCLP2270200203>3.0.CO;2-U

p g g p•COMBINE. Participants (n=1383) in COMBINE were JC 70 00 03 3.0.CO; U

Lowman, C., Allen, J., & Stout, R. L. (1996). Replication and extension of Marlatt’srecruited from 11 research units across the United States,

, , , , , ( ) ptaxonomy of relapse precipitants: overview of procedures and results. The Relapse U S ,

including CASAA The participants received 16 weeks ofy p p p p p

Research Group. Addiction, 91 Suppl, S51–71.including CASAA. The participants received 16 weeks of i f 9 di i hi h i d f

p ppProject MATCH Research Group (1997). Project MATCH secondary a priori hypotheses.

treatment in one of 9 treatment conditions, which consisted of Addiction, 92(12), 1671-1698.

combinations of medications (acamprosate naltrexone UKATT Research Team. (2001). United Kingdom Alcohol Treatment Trial (UKATT): combinations of medications (acamprosate, naltrexone, l b i l t ) d h i l i t ti

Hypotheses, design and methods. Alcohol and Alcoholism, 36, 11–21.placebo-equivalents) and psychosocial interventions Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978). Assessing the impact of life changes: (Combined Behavioral Intervention (CBI) or Medication Development of the life experiences survey. Journal of Consulting and Clinical

h l ( )( ( )Management (MM)) Follow up assessments were conducted

Psychology, 46(5), 932-946.Management (MM)). Follow-up assessments were conducted

10 k 9 h d 12 h f ll iat 10 weeks, 9-months, and 12-months following treatment.

Funding provided by NIAAA R01-AA022328Funding provided by NIAAA R01 AA022328 (Witkie it PI) and T32 AA0018108 (McCrad PI)(Witkiewitz, PI) and T32-AA0018108 (McCrady, PI).

Poster presented at the 25th CASAA Anniversary Celebration at the HotelPoster presented at the 25 CASAA Anniversary Celebration at the Hotel Andaluz Albuquerque NM on November 7 2014Andaluz, Albuquerque, NM on November 7, 2014