title: Predicting post-treatment-initiation alcohol use among patients with severe mental illness and alcohol use disorders.
abstract: Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD). At 6-months follow-up, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment, with participants who lived in supervised settings (41%) reporting significantly more days of treatment (beta = .34, p < .001). In addition, participants with more psychiatric symptoms, as assessed with the Brief Symptom Inventory and Structured Clinical Interview for the Positive and Negative Syndrome Scale, reported significantly fewer treatment days (beta = -.20, p < .001). Number of days that participants attended treatment was indirectly associated with alcohol use outcomes and was mediated by use of alcohol-specific coping skills, such that more frequent use of such skills was associated with less post-treatment-initiation alcohol use (beta = -.34, p < .001). This study emphasizes the favorable prognosis for alcohol outcomes among treated individuals with SMI and AUD and the importance of psychosocial interventions, particularly those that result in better alcohol-specific coping skills.
authors.affiliation: Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY 14203-1016, USA. bradizza@ria.buffalo.edu
authors.forename: Clara M
authors.initials: CM
authors.lastname: Bradizza
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Maisto
authors.forename: Paula C
authors.initials: PC
authors.lastname: Vincent
authors.forename: Paul R
authors.initials: PR
authors.lastname: Stasiewicz
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Connors
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Mercer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking; D000437:Alcoholism / Q000150:complications* / Q000628:therapy*; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis; D016009:Chi-Square Distribution; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011788:Quality of Life; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis; D020377:Self Efficacy; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome