title: End-of-treatment abstinence self-efficacy, behavioral processes of change, and posttreatment drinking outcomes in Project MATCH.
abstract: This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was moderated by utilization of behavioral processes of change (coping activities used during a behavior change attempt). It was hypothesized that self-efficacy would be differentially important in predicting posttreatment drinking outcomes depending on the level of behavioral processes, such that the relation between self-efficacy and outcomes would be stronger for individuals who reported low process use. Analyses were also estimated with end-of-treatment abstinence included as a covariate. Data were analyzed from alcohol-dependent individuals in both treatment arms of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N = 1,328), a large alcohol treatment study. Self-efficacy was moderated by behavioral process use in predicting drinking frequency 6 and 12 months posttreatment and drinking quantity 6 months posttreatment such that self-efficacy was more strongly related to posttreatment drinking when low levels of processes were reported than high levels, but interactions were attenuated when end-of-treatment abstinence was controlled for. Significant quadratic relations between end-of-treatment self-efficacy and 6- and 12-month posttreatment drinking quantity and frequency were found (p < .001, ƒ² = 0.02-0.03), such that self-efficacy most robustly predicted outcomes when high. These effects remained significant when end-of-treatment abstinence was included as a covariate. Findings highlight the complex nature of self-efficacy's relation with drinking outcomes. Although the interaction between self-efficacy and behavioral processes was attenuated when end-of-treatment abstinence was controlled for, the quadratic effect of self-efficacy on outcomes remained significant. The pattern of these effects did not support the idea of "overconfidence" as a negative indicator.
authors.affiliation: Department of Psychology, University of Maryland Baltimore County.
authors.forename: Taylor Berens
authors.initials: TB
authors.lastname: Crouch
authors.affiliation: Department of Psychology, University of Maryland Baltimore County.
authors.forename: Carlo C
authors.initials: CC
authors.lastname: DiClemente
authors.affiliation: Department of Psychology, University of Maryland Baltimore County.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Pitts
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D064829:Alcohol Abstinence / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D000431:Ethanol; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011379:Prognosis; D011613:Psychotherapy; D020377:Self Efficacy; D016896:Treatment Outcome
chemical_list: D000431:Ethanol