A Behavioral Economic Reward Index Predicts Drinking Resolutions: Moderation Revisited and Compared With Other Outcomes

• Published in: Journal of consulting and clinical psychology 2009-04, Vol.77 (2), p.219-228
• Main Authors: Tucker, Jalie A, Roth, David L, Vignolo, Mary J, Westfall, Andrew O
• Format: Article
• Language: English
• Subjects: Abstinence; Addictive behaviors; Adult and adolescent clinical studies; Alcohol Abuse; Alcohol Drinking - prevention & control; Alcohol Treatment; Alcoholism; Behavior Change; Behavioral Economics; Biological and medical sciences; Choice Behavior; Clinical outcomes; Comparative Analysis; Economics; Expenditure; Female; Follow-Up Studies; Human; Humans; Indexes; Intervals; Male; Medical sciences; Middle Aged; Moderation; Money Management; Outcomes of Treatment; Patient Acceptance of Health Care - psychology; Prediction; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression (Statistics); Regression analysis; Relapse; Relapse (Disorders); Resolutions; Resource Allocation; Reward; Rewards; Sobriety; Token Economy
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0014968

Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation ( n = 30), abstinent ( n = 95), and unresolved ( n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer term objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this "Alcohol-Savings Discretionary Expenditure" index predicted higher rates of abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation.