The long term research objective is a valid experimental evaluation of two supplemental aversion therapy alcoholism treatments. The subjects will be men and women volunteers from the Augusta, Georgia VA's traditional program of alcoholism treatment. Chemical (emetic) aversion therapy is a long standing alcoholism treatment that, despite numerous reports of promising clinical outcomes, has yet to be subjected to rigorous scientific evaluation. Covert sensitization (verbal aversion) therapy, a less used treatment, likewise has been associated with some positive outcomes and a paucity of experimental scrutiny. Emetic therapy repeatedly pairs the subjects' ingestion of measured amounts of alcoholic beverages with emetine hydrochloride induced nausea and emesis. Covert sensitization, a verbal aversion analog of emetic therapy, repeatedly pairs the subjects' desire for, and the imagined sensory/behavioral antecedents and concomitants of, alcohol ingestion with verbally induced nausea. These consummatory aversion treatments share the common objective of abstinence facilitation through the induction of conditioned nausea reactions to and/or negative hedonic shifts in the palatabilities of alcoholic beverages. A baseline control procedure will consist of only the traditional milieu inpatient alcoholism treatment that is shared by all subjects. A placebo/expectancy and treatment exposure control procedure will involve individual relaxation training from a member of the research staff. the subjects will satisfy rigorous medical criteria prior to random group assignments. All subjects will receive extensive psychological testing plus dual-axis psychiatric diagnoses. All individual treatments will be psychophysiologically monitored in an attempt to identify individual subject variables that may be predictors of treatment outcome. Twelve months of follow-up will include drinking status and additional multidimensional reports of posttreatment adjustment from collateral contacts and from breathalyzer screened subjects. Follow-up blood and urine will be collected for liver function tests and screens of psychoactive substance use. The need for improved and experimentally validated treatments of alcohol dependence is manifest. The successful follow-up of 55 treated subjects of each of the four groups is a major specific aim. It is hypothesized that both of these experimental treatments will have a significant positive impact on posttreatment abstinence maintenance and on other broadly based indices of successful adjustment.
| Whitford, Jennifer L; Widner, Sabina C; Mellick, Davis et al. (2009) Self-report of drinking compared to objective markers of alcohol consumption. Am J Drug Alcohol Abuse 35:55-8 |
