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A Meta-Analysis of the Alcohol Treatment Outcome Literature: 1993 to 2000

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A Meta-Analysis of the Alcohol Treatment Outcome Literature: 1993 to 2000 Utah State University DigitalCommons@USU All Graduate Theses and Dissertations Graduate Studies 5-2002 A Meta-analysis of the Alcohol Treatment Outcome Literature: 1993 to 2000 Anthony Phillip Tranchita Utah State University Follow this and additional works at: https://digitalcommons.usu.edu/etd Part of the Psychology Commons Recommended Citation Tranchita, Anthony Phillip, "A Meta-analysis of the Alcohol Treatment Outcome Literature: 1993 to 2000" (2002). All Graduate Theses and Dissertations. 6366. https://digitalcommons.usu.edu/etd/6366 This Thesis is brought to you for free and open access by the Graduate Studies at DigitalCommons@USU. It has been accepted for inclusion in All Graduate Theses and Dissertations by an authorized administrator of DigitalCommons@USU. For more information, please contact [email protected]. A META-ANALYSIS OF OF THE THE ALCOHOL ALCOHOL TREATMENT TREATMENT OUTCOME LITERATURE: 1993 TO 2000 by Anthony PhillipPhillip Tranchita A thesis submitted in partial fulfillment of the requirementsrequirements for for the degree oof f MASTER OF SCIENCE in Psychology Approved : ~,1v,,$ ca;; - ~~~ Oavid M: Stein. Ph.D~ - Carolyn if.Barcus. Ed.D. Major Professor Committee Member L1._&wf~ /2]~)µ- SusanL. Crowley, Ph.D. / ThqdlasL. Kent. Ph .D. ' Committee Member Dean of Graduate Studies UTUTAH AH STATE UNIVERSITYUNIVERSITY Logan.Logan, Utah 2002 INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. ProQuest Information and Learning 300 North Zeeb Road, Ann Arbor, Ml 48106-1346 USA 800-521-0600 UMI® UMI Number: 1410494 UMI® UMI Microform 1410494 Copyright 2002 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest Information and Learning Company 300 North Zeeb Road P.O.Box 1346 Ann Arbor, Ml 46106-1346 ABSTRACT A Meta-analysis o f the Alcohol Treatment Outcome Literature: 1993 to 2000 by Anthony Phillip Tranchita, Master o f Science Utah State University, 2002 Major Professor: Dr. David Stein Department: Psychology Alcohol misuse is a very common problem with high financial and personal costs. Treatment requires allocation o f limited resources for optimal impact. Responsible decision making in this area should be based upon reasoned weighing o f research evidence. Miller and colleagues completed a meta-analytic review of all controlled studies published before 1992 to help clinicians do just that. The coding system they employed examined methodological quality, as well as outcome, to obtain a rank­ ordering o f treatments that seem to have the most quality research support. The current study attempts to extend this work utilizing the same coding on studies published since 1992, and combine both databases of articles. Revised rank orderings o f treatments and conclusions regarding variables related to outcomes are reported. Implications are discussed, along with limitations of this review. An upward trend in methodological quality over time was also discovered. (144 pages) ACKNOWLEDGMENTS I would like to thank David Stein for his guidance and patience working with me on this project. Further, I would like to thank Susan Crowley and Carolyn Barcus for their participation on my committee, their helpful suggestions, and their occasional questions/reminders regarding my progress toward completion. I would also like to thank Karen Ranson for her hard work in helping to format and prepare this document. Lastly, I want to thank my wife for tolerating me on those nights when it felt as though I would never finish. I could not have done it without you. Anthony Phillip Tranchita CONTENTS Page ABSTRACT ............................................................................................................................ ii ACKNOWLEDGMENTS .................................................................................................. iii LIST OF TABLES ............................................................................................................... vi LIST OF FIGURE .................................................................................................................. viii INTRODUCTION ............................................................................................................... I REVIEW OF LITERATURE ............................................................................................ 4 Reviews of Pharmacological Treatments ............................................................. 4 Reviews o f Single Nonpharmacological Treatments ......................................... 7 Reviews of Meta-Analyses Comparing Different Treatment Modalities 15 RATIONALE FOR CURRENT STUDY ....................................................................... 22 Procedures for Current Study .................................................................................. 22 Analysis ......................................................................................................................... 25 RESULTS ............................................................................................................................... 32 Reliability o f New Codings ....................................................................................... 32 Notes on Combining Databases .............................................................................. 33 Psychometric Properties o f Coded Variables ...................................................... 35 Summary o f Cumulative Evidence Scores ........................................................... 36 Summary of Ratings by Article for Each Modality ............................................. 40 Treatment Modalities Included in This Review .................................................. 40 Trend o f Methodological Quality ........................................................................... 62 Variables Predictive o f Outcome ............................................................................ 67 DISCUSSION ........................................................................................................................ 70 Efficacy of Psychosocial and Behavioral Treatment Modalities ..................... 70 Efficacy o f Pharmacological Treatments ............................................................... 74 Trends in Methodological Quality .......................................................................... 77 Variables Predictive o f Outcome ............................................................................ 77 Clinical Implications .................................................................................................... 78 Implications for Research .......................................................................................... 80 V Page Limitations and Future Directions ................................................................................ 81 The “Take Home” Message ..................................................................................... 83 REFERENCES ...................................................................................................................... 85 APPENDIXES ....................................................................................................................... 115 Appendix A: Coding Manual from Miller et al........................................................... 116 Appendix B: All New Codings, Including All Disagreements for Inter-Rater Reliability ......................................................................... 129 LIST OF TABLES Table Page 1 Top Five Ranked Treatment Modalities in Three Meta-Analyses ............... 17 2 Comparison of Initial Ratings by Present Author to Those of Miller et al. (1995) ....................... 7 ..................................................................................... 24 3 Computation of MQS and Product Score for Change, Wilkins-Haug, Berman, and Goetz (1999) .................................................................................... 29 4 Summary o f Inter-Rater Reliability o f Codings ................................................ 33 5 Values Listed of Methodological Quality Scores in Modality Tables and Appendix o f Miller et al. (1995) .................................................................. 34 6 Psychometric Characteristics of Coded Variables for Entire Database ...... 36 7 Summary of Cumulative Evidence Scores and Methodological Quality for All Modalities ..................................................................................... 38 8 Summary of Treatment Modalities ...................................................................
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