It is vital to understand how patient factors, namely sociodemographic, psychological, and social factors, are associated with treatment outcomes in alcohol use disorder (AUD) treatment. The current study examined predictors of outcome in group treatment of AUD. The overarching principle behind the project was to study real-life patients and treatments to enhance ecological validity. Therefore, we conducted a multi-site study of patients treated in routine practice within specialist health services in Norway. Data were collected from three clinics and four treatment sites in Eastern Norway.
The following series of papers explored various aspects of sociodemographic, psychological, and cognitive functioning in treatment-seeking patients with AUD and assessed potential predictors associated with treatment outcomes and discontinuation.
Paper I investigated the usefulness of the Montreal Cognitive Assessment (MoCA) as a tool for detecting cognitive impairment (CI) in patients with AUD. The study found that MoCA's performance was inconsistent, due to difficulties in balancing sensitivity and specificity. Further, MoCA only exhibited a moderate agreement with the reference tests, suggesting it does not effectively measure cognitive functioning in patients with AUD. This suggests apparent limitations in using MoCA to screen for CI in this population, and advocates for alternative assessments specifically tailored to patients with AUD.
Paper II focused on gender differences in patients with AUD, particularly noting that women showed similar levels of harmful alcohol use but more psychological distress compared to men. Women also exhibited more maladaptive personality traits and lower general intellectual functioning. This indicates a vulnerability necessitating gender-specific adjustments for women in AUD treatment.
Paper III examined predictors of treatment discontinuation among patients with AUD and identified executive functioning (EF) as a significant predictor. Lower EF was associated with increased risk of discontinuation, underscoring the importance of EF assessment in AUD treatment.
Paper IV examined short-term outcome predictors, identifying low Responsibility in personality as a predictor for at-risk drinking post-treatment. The percentage of group therapy attended was found to have minimal impact on drinking levels, highlighting personality factors over engagement in group therapy as critical to treatment outcomes.
Overall, these studies underscore the need for nuanced and individualized screening and intervention strategies for treatment-seeking patients with AUD. With a particular emphasis on cognitive function, personality traits, and gender-specific differences.