This Mentored Patient-Oriented Research Career Development Award (K23) will serve as the foundation for a career devoted to developing and testing novel therapeutic interventions for women diagnosed with alcohol dependence and co-occurring major depression (AD-MD). AD-MD is a serious and common public health problem, yet one that is largely unaddressed. Among alcohol dependent patients, co-occurring depression is associated with poorer treatment outcomes, increased risk for relapse, worse long-term social and functional adjustment, and higher probability of dire outcomes such as suicide. Treatment research on AD-MD women is needed to inform effective practice. This K23 is devoted to enhancing the research development of the Candidate and to initially testing the applicability of Interpersonal Psychotherapy for alcohol dependent women with major depression (IPT-ADMD). The proposed education plan provides targeted coursework, training, and supervision to prepare the Candidate as an independent investigator of therapeutic interventions for AD-MD women. Mentored career development and research activities are designed to develop the Candidate's expertise in: 1) the measurement and classification of alcohol dependence and major depression, 2) interventions relevant for AD-MD women and 3) clinical trials methodologies. The goal of the proposed research project is to refine and test a behavioral intervention that addresses women's co-occurring alcohol dependence and depression within a cohesive interpersonal frame. In Phase 1 of the project, IPT-ADMD will be piloted with 15 AD-MD women enrolled in a* MICA (mentally-ill chemical abusers) group treatment program. Findings from Phase 1 will be used to refine the treatment, assessment, and therapist training procedures. In Phase 2, a randomized controlled trial with 60 AD-MD women will be conducted 1) to determine IPT-ADMD's feasibility and acceptability as an adjunct to standard MICA group treatment, and 2) to assess the comparative effects of IPT-ADMD to treatment-as usual individual therapy (TAU-IT). Compared to TAD-IT, IPT-ADMD is hypothesized to lead to greater reductions in women's drinking frequency, drinking intensity, and depressive symptoms, and to improved interpersonal functioning. Results will lay the foundation for a career-long program of interventions research devoted to improving the lives of this important but underserved and understudied population.
