Gender, Treatment and Self-Help in Remission from Alcohol Use Disorders

Center for Health Care Evaluation, Department of Veterans Affairs and Stanford University, Palo Alto, California 94025, USA.
Clinical Medicine & Research 10/2006; 4(3):163-74. DOI: 10.3121/cmr.4.3.163
Source: PubMed


To examine gender differences in the influence of treatment, self-help groups and life context and coping factors on remission among initially untreated individuals with alcohol use disorders.
A naturalistic study in which individuals were assessed at baseline and 1, 8 and 16 years later.
Participants initiated help-seeking with the alcoholism service system by contacting an information and referral service or detoxification program.
A total of 461 individuals with alcohol use disorders (50% women).
Participants were assessed by mail surveys and telephone interviews on participation in professional treatment and Alcoholics Anonymous (AA), alcohol-related functioning and indices of life context and coping.
Compared to men, women were more likely to participate in treatment and AA, and to experience better alcohol-related and life context outcomes. In general, women and men who participated in treatment and/or AA for a longer duration were more likely to achieve remission. However, women benefited somewhat more than men from extended participation in AA. Continuing depression and reliance on avoidance coping were more closely associated with lack of remission among men than among women.
Compared to men, women with alcohol use disorders were more likely to obtain help and achieve remission. Women tended to benefit more from continued participation in AA and showed greater reductions in depression and avoidance coping than men did. These findings identify specific targets for clinical interventions that appear to be especially beneficial for women and that may also enhance the likelihood of recovery among men.

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    • "We purposely separated number of meetings attended from AA involvement to see how the two compared in our longitudinal models. Neither of these measures addresses duration or pattern of attendance, known correlates of AA participation and outcomes (Moos et al., 2006 "
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    ABSTRACT: Given the widespread use of Alcoholics Anonymous (AA) and other similar groups in the United States and the increasing membership of women, this study compares women with men on their meeting attendance and AA-prescribed behaviors, factors associated with that AA participation, and tests how these relate to women's and men's abstinence across time. All consecutive new admissions (age ≥ 18) from county-wide public and private treatment programs representing the larger population of treatment seekers were approached to be in the study at treatment entry. Those consenting at baseline (n = 926) were sought for follow-up interviews 1, 3, 5, and 7 years later. Generalized linear models were used to test whether various help-seeking factors were associated with AA participation differentially by gender and, controlling for AA and other confounders, whether women differ from men on abstinence. At each follow-up interview, women and men attended AA at similar rates and similarly practiced specific AA behaviors, and they were alike on most factors associated with AA participation and abstention across time including abstinence goal, drink volume, negative consequences, prior treatment, and encouragement to reduce drinking. Relative to men, women with higher drug severity were less likely to participate in AA. Although higher AA participation was a predictor of abstinence for both genders, men were less likely to be abstinent across time. Men were also more likely to reduce their AA participation across time. These findings add to an emerging literature on how women compare with men on factors related to AA participation and subsequent drinking outcomes across time. Findings have clinical implications for service providers referring clients to such groups.
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    • "Over the last decades, a limited number of studies have reported treatment outcome in alcohol-dependent patients with follow-up periods extending beyond 15 years (Hyman, 1976; O'Connor and Daly, 1985; McCabe, 1986; Nordström et al., 2004; Mann et al., 2005; Moos et al., 2006). Most of these have been conducted in English-speaking countries (Hyman, 1976; O'Connor and Daly, 1985; McCabe, 1986; Moos et al., 2006) and have followed cohorts in which relatively few women, if any, were included (McCabe, 1986; Mann et al., 2005), with the exception of one American study that followed up a sample of 232 women for 16 years (Moos et al., 2006). The limited representation of women in such studies explains the lack of gender-specific data on drinking outcome and our ignorance of potential gender differences in the long-term course of the illness following treatment. "
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    • "Women in the present study were more likely than men to change risky alcohol and drug behaviours. This finding is consistent with other studies [22-24] reporting better treatment results in women with alcohol problems. However, a problem in the present sample is the low numbers of risky alcohol and drug habit levels, resulting in a probable risk of not detecting significant differences in change. "
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