A pilot study of the Moving On In My Recovery program for people in recovery from substance use.

Background: This study pilot tested Moving On In My Recovery (MOIMR), a 12-session, acceptance-based, cognitive-behavioral, manual-guided group program for individuals in recovery from substance use. MOIMR aims to bridge the gap between formal treatment and sustained recovery. Method: Participants were 61 people in recovery from substance use and in the catchment area of the Betsi Cadwaladr Health Board, North Wales, United Kingdom. Using a variety of questionnaires, participants' psychological flexibility and wellbeing were assessed at baseline, post-treatment, and a three-month follow-up. Participants who dropped out were contacted at the follow-up and interviewed about their experience. Results: The study successfully recruited participants from real-world treatment services. During the study, significant improvements were observed in participants' social functioning, experiential avoidance, recovery capital, low mood, and anxiety. The proportion of participants who achieved abstinence also improved. Qualitative feedback confirmed the benefits that participants derived from attending the MOIMR groups. Conclusion: The program offered significant benefits for the participants despite many of them having apprehensions about undertaking a group-based approach. The gains established by quantitative analysis appeared to be supported by the qualitative findings. These findings suggest that a full randomized controlled trial of MOIMR would be feasible.

Evaluating Two Brief Motivational Interventions for Excessive-Drinking University Students.

OBJECTIVE: Two brief computerized motivational interventions for excessive-drinking university students were evaluated. METHOD: Participants (N = 88, females = 61.5%, mean age = 21.05 years) were randomly assigned to a control group or one of two experimental groups: Computerized Brief Intervention (CBI) or Computerized Brief Intervention-Enhanced (CBI-E). CBI followed the principles of Motivational Interviewing to motivate participants to change their drinking behavior. CBI-E additionally used the principles of Systematic Motivational Counseling to identify and discuss with participants their dysfunctional motivational patterns that were interfering with their attainment of emotional satisfaction. At baseline and a three-month follow-up, the participants completed a battery of measures of alcohol consumption and related problems. RESULTS: At baseline, the participants were confirmed to be heavy drinkers with many drink-related negative consequences. Males and females responded differently to the interventions. During follow-up, males' alcohol use was ordered: CBI-E < CBI < Controls. The females in all three groups reduced their alcohol use, but there were no significant group differences. CONCLUSIONS: Males responded to the interventions as expected. For females, the assessment itself seemed to serve as an effective intervention, and there were no post-intervention differences among the three groups. Suggestions for future research using CBI and CBI-E are discussed.

Prevalence of insomnia and poor sleep quality in the prison population: A systematic review.

Insomnia is a public health concern with several associated negative health-related outcomes. Risk factors for insomnia place the prison population at an increased risk of inadequate sleep. This paper systematically reviewed the literature reporting on the prevalence of insomnia and poor sleep quality in the prison population. Following a comprehensive database search and screening process, 12 studies were eligible for inclusion in this review. Six studies provided prevalence rates for insomnia and nine for poor sleep quality. Varied prevalence rates were found for insomnia (i.e. 26.2%-72.5%) and poor sleep quality (i.e. 42.8%-88.2%). Evaluation of the prevalence rates revealed varied measurement of sleep quality, inconsistent parameters of standardised measures, and methodological heterogeneity. Other considerations were given to geographical differences, the use of self-report data, gender difference, environmental factors and comorbidities of insomnia. The review highlighted an increase in the quantity of studies and some improved quality; although the findings were highly variable, in the main, inadequate sleep amongst prisoners was higher than the general population. Limitations of the review and implications for further research are discussed.

Identifying the Main Components of Substance-Related Addiction Recovery Groups.

OBJECTIVES: Mutual-aid groups are a central part of many individuals' recovery journeys from substance addiction, and this research aimed to identify the key ingredients of a diverse range of recovery groups. METHODS: Individuals from 30 different substance addiction recovery groups across the UK (N = 151, 66% male, M age = 42.5 years) completed a survey, which asked participants to provide a narrative about their recovery group experiences. Participants were also asked to rate the extent to which theorized ingredients of addiction recovery groups were offered by their group, and how important each was to them. Both qualitative and quantitative data were collected and analyzed. RESULTS: The results indicated that the recovery group components suggested in previous literature were both present and rated as important. Component ratings did not differ depending on the type of group, the length of time the person had been in recovery, nor the length of time they had been involved in the group. The qualitative results identified other important components of recovery groups that had not been identified in the previous literature: presence of like-minded individuals and developing self-awareness and reflection skills. An updated list of recovery group components was thereby created. CONCLUSIONS: Overall, the findings provide an in-depth, person-focused perspective on what makes an addiction recovery group successful. Asking group members directly about their experiences allowed us to refine and expand on previously theorized components. The updated components can be used as a template for developing future mutual-aid groups.

Accurately Estimating Alcohol Consumption: A Comparison of Self-Administrated and Interview Methods.

Background: There have been two methods of gaining retrospective self-report estimates of alcohol consumption, quantity frequency (QF) and retrospective diary (RD), offering distinct advantages and disadvantages. The typical and atypical drinking diary (TADD) was developed to benefit from each method's advantages. Objectives: To compare estimates obtained from the TADD with corresponding estimates obtained from a QF measure (Khavari alcohol test; KAT) and an RD measure, the timeline follow-back (TLFB). It was hypothesized that the TADD's alcohol consumption estimates would correlate strongly with those obtained from the TLFB; and the strength of the TADD-TLFB correlation would be significantly stronger than the KAT-TLFB correlation. Method: One hundred and sixty-eight (168) undergraduates (73% female) estimated their alcohol consumption for the preceding 12 weeks using all three measures. Results: The TADD (r = 0.83, p < .001) and the KAT (r = 0.066, p < .001) produced estimates of total alcohol consumption that correlated very strongly and strongly, respectively, with the TLFB. Notably, the TADD-TLFB correlation was significantly stronger than the KAT-TLFB correlation (Z = 5.10, p < .001). Moreover, the TADD's estimates of number of drinking days (r = 0.70, p < .001) and heavy drinking episodes per week (0.77, p < .001) correlated strongly with corresponding estimates from the TLFB. The TADD and KAT provided higher estimates of alcohol consumption than the TLFB. Conclusion: Clinicians and researchers should consider using the TADD to estimate alcohol consumption in time-limited situations.

The Recovery Strengths Questionnaire for alcohol and drug use disorders.

INTRODUCTION AND AIMS: The Recovery Strengths Questionnaire (RSQ) is a 15-item self-report questionnaire that assesses an addicted individual's recovery strengths. This study aimed to validate the RSQ as a measure of recovery capital. DESIGN AND METHODS: As part of a larger study, 151 participants in addiction recovery groups from across the UK completed the RSQ. Participants also completed the Assessment of Recovery Capital questionnaire and provided some demographic information. RESULTS: The RSQ was found to be psychometrically sound, with high internal consistency and concurrent validity with the Assessment of Recovery Capital. RSQ scores were positively correlated with length of time in recovery and length of membership in recovery groups, and the scores could be used to discriminate between those in early and late recovery. Principal components analysis revealed a two-factor structure of recovery capital. These two factors were named 'within-group recovery strengths' and 'externally generated recovery strengths', and it was found that only the within-group factor scale (i.e. resources developed within recovery groups) predicted length of time in recovery and recovery groups. DISCUSSION AND CONCLUSIONS: These results highlight the important role that recovery groups can play in an individual's recovery, and they provide an alternative factor structure to the one-factor structure of the Assessment of Recovery Capital.

A comparison between two retrospective alcohol consumption measures and the daily drinking diary method with university students.

BACKGROUND: There are two main categories of retrospective self-report alcohol consumption measures: summary and daily drinking. Time-efficient summary measures have been criticized for being less able to capture sporadic and unpatterned drinking. A novel retrospective summary measure, the Typical and Atypical Drinking Diary (TADD), may produce more precise estimates of alcohol consumption than the gold-standard daily measure, the Timeline Followback (TLFB). OBJECTIVE: To establish how accurately the TADD and TLFB retrospectively capture alcohol consumption compared to the Daily Drinking Diary (DDD) method. METHOD: Forty-three university undergraduates (77% female) concurrently recorded their daily alcohol consumption for 28 consecutive days using daily drinking diaries. Participants then retrospectively estimated their alcohol consumption using both the TADD and TLFB 28 days following completion of the 28-day daily consumption period. RESULTS: When compared against the drinking data obtained from the DDD method, the TADD consistently produced accurate retrospective estimates of total alcohol consumption, number of drinking days, and number of heavy drinking episodes. Contrariwise, the TLFB significantly underestimated all aspects of drinking. Underreporting on the TLFB was hypothesized to be associated with social desirability bias. CONCLUSION: The TADD is a valid and reliable instrument for retrospectively measuring alcohol consumption and drinking variability in the university student population.

Negative attentional bias for positive recovery-related words as a predictor of treatment success among individuals with an alcohol use disorder.

INTRODUCTION: This study assessed relationships between clients' attentional bias (AB) for different types of stimuli and their treatment outcomes. Alcohol AB during detoxification has previously been shown to predict relapse, but further research was needed to clarify this relationship. The current study determined whether AB for recovery-related words would also predict treatment outcome. METHODS: Participants were 45 clients undergoing alcohol detoxification, and a control group of 36 staff members. They rated words for personal relevance in four categories (alcohol-related, neutral, positive change-related, and negative change-related). Participants completed an individualized Stroop task containing their chosen words. They were also assessed on readiness-to-change, difficulties with emotion regulation, drinking problems, anxiety, and depression. Clients were interviewed at a three-month follow-up to determine their treatment outcome. RESULTS: As predicted, questionnaire measures did not predict clients' treatment outcome (p > .05). A logistic regression model indicated that the best predictor of treatment outcome was AB for positive change-related words (p = .048), with successful individuals having less AB for these words than for the other word categories. Although this finding was unexpected, it was supported by significant relationships between positive change-related interference scores and continuous measures of drinking at follow-up [i.e. number of units drunk (p = .039) and number of drinking days (p = .018)]. CONCLUSIONS: The results suggest that positive change-related words are a better predictor of treatment outcome than are either alcohol-related words or negative change-related words.

Alcohol attentional bias as a predictor of alcohol abusers' treatment outcome.

Alcohol abusers' and non-abusers' attentional distraction for alcohol-related, concern-related, and neutral stimuli was assessed with the emotional Stroop paradigm. Alcohol abusers (n=14) were tested on admission to inpatient treatment and immediately before discharge, 4 weeks later; non-abusers (n=16) were also tested twice, with a 4-week intervening interval. Alcohol abusers were assessed for alcohol use 3 months after discharge. Unlike control participants and alcohol abusers whose treatment was successful, alcohol abusers whose treatment was unsuccessful (who relapsed or did not maintain post-discharge outpatient contact) had a significant increase in attentional distraction for alcohol stimuli during the 4 weeks of inpatient treatment. Compared to control participants and alcohol abusers who completed the 4 weeks of treatment, those who did not complete treatment (n=9) were highly distracted by concern-related stimuli at treatment admission. The results have implications for understanding the cognitive and motivational processes underlying successful treatment for alcohol abuse.