title: The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment.
abstract: BACKGROUND
  Cognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA). The Drinking-Related Cognitions Scale (DRCS) is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS.
  
  
  METHODS
  Participants in this study were 175 middle-aged and elderly Japanese male patients who met the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge.
  
  
  RESULTS
  Of the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low positive alcohol expectancies, high abstinence self-efficacy, high perception level of impaired control over drinking, and high perception level of drinking problems measured by DRCS.
  
  
  CONCLUSIONS
  The DRCS was considered to have satisfactory predictive validity, which further supports our previous findings. It was suggested that DRCS is a promising rating scale for evaluating multidimensional cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment.
authors.affiliation: Department of Psychiatry, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa 252-0380, Japan. sawayama@kitasato-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Sawayama
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoneda
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Norihito
authors.initials: N
authors.lastname: Shirakawa
authors.forename: Enami
authors.initials: E
authors.lastname: Sawayama
authors.forename: Taichiro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Susumu
authors.initials: S
authors.lastname: Higuchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyaoka
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology* / Q000628:therapy; D003071:Cognition; D015331:Cohort Studies; D003717:Denial, Psychological; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D020377:Self Efficacy; D057566:Self Report; D011795:Surveys and Questionnaires; D013695:Temperance / Q000523:psychology*; D016896:Treatment Outcome