A meta-analytic investigation of emotional intelligence and alcohol involvement

The relationship between emotional intelligence (EI) and alcohol involvement has been investigated by numerous studies. The present meta-analysis analyzed the findings of these studies. The meta-analysis, based on 16 effect sizes from 11 studies with a total of 2,271 participants, showed that lower EI was significantly related to higher alcohol involvement, r = -.18. Lower EI was significantly associated with both alcohol-related problems, r = -.32 and level of alcohol use, r = -.10, but the association was significantly higher with alcohol-use-related problems. The results suggest that future research would most profitably examine the role of EI in alcohol consumption-related problems.     

Cue-elicited craving and human Pavlovian-to-instrumental transfer

Abstract

Background: Drug cue-reactivity can be measured by the well-established cue-elicited craving model, or by the more recently developed Pavlovian to instrumental transfer (PIT) procedure, which quantifies the impact of drug cues on drug-seeking behaviour. It remains unclear whether these two models produce similar cue reactive effects.

Method: To test this, 38 young adult beer drinkers completed an alcohol cue-elicited craving procedure followed by a specific PIT procedure with alcohol cues.

Results: There was a significant effect of alcohol cues on craving (p = .007) and on alcohol-seeking behaviour in the PIT procedure (p < .001). Contrary to expectations, these two indices of cue-reactivity were not correlated (r = ?.08, p = .66). However, analysis indicated that the alcohol PIT effect was correlated with the self-reported belief that alcohol cues signalled greater effectiveness of the alcohol-seeking response (r = .44, p = .008).

Conclusions: These findings suggest that different measures of cue-reactivity might tap into different responses within an individual. Future research is necessary to consider whether this variance is due to which aspect of cue reactivity is being assessed and whether different types of cue-reactivity are differentially influenced by variables such as outcome expectancy.     

Transition to Independent Living and Substance Involvement of Treated and High Risk Youth

ABSTRACT

National studies indicate that alcohol and drug involvement increases during transition from adolescence to young adulthood. The present study evaluated change in alcohol and drug use as youth move from living with their family of origin to independent living environments. Two samples of youth, those who had previously been treated for alcohol and drug problems (n = 102), and a sample of non-abusing youth (n = 70) with comparable socioeconomic backgrounds and family history of alcohol dependence, were compared as they transitioned into their first independent living environment. There was a 35% increase in the number of monthly drinking episodes across this transition to independent living, and a 46% increase in number of drinks per week. Drug involvement was less affected by this developmental transition, however a larger proportion of teens with a history of substance problems reported use of drugs (31% vs. 48%) following transition to independent living. Both level of exposure to substances in the new environment and peer substance use were significant predictors of post-transition substance involvement. Findings highlight significant changes in alcohol involvement in relation to this critical developmental transition of late adolescence and young adulthood.     

The revised four-factor motivational thought frequency and state motivation scales for alcohol control

IntroductionElaborated Intrusion (EI) Theory holds that both functional and dysfunctional motivational cognitions are characterized by their intensity, cognitive availability and involvement of imagery, and can be assessed in terms of their frequency and cross-sectional nature. Recently published data on the Motivational Thought Frequency (MTF-A) and State Motivation (SM-A) scales for alcohol control, which were based on EI theory, have shown acceptable fit for a three-subscale structure (Intensity, Imagery, Availability). However, subsequent analyses on the MTF's adaptation to diabetic regimen adherence suggested superior fit from a four-factor model, splitting Imagery into Incentives and Self-Efficacy Imagery. The current paper reanalyzed data on the MTF-A and SM-A, including an additional item on each and using a more robust statistical approach.MethodsParticipants (n = 504) reporting recent high-risk drinking or were currently trying to control alcohol consumption volunteered to complete an online survey that included the MTF-A, SM-A, Alcohol Use Disorders Identification Test and Readiness to Change Questionnaire. Confirmatory factor analyses employed robust maximum likelihood (MLR) with Yuan-Bentler χ² adjustment, and presented internal consistencies using omega.ResultsAfter omission of multivariate outliers, SM-A data were available from 399 participants, and MTF-A data from 351. Better fit was found for the four-factor model on both measures, and high internal consistencies were obtained for all subscales. Incentives Imagery and Self-Efficacy Imagery were both associated with greater alcohol problems and readiness to change.ConclusionsThe four-factor structures are statistically superior and more theoretically coherent, and allow a focused assessment of key targets of motivational interventions.     

Contingency Management for Patients With Dual Disorders in Intensive Outpatient Treatment for Addiction

Objective: This quality improvement program evaluation investigated the effectiveness of contingency management for improving retention in treatment and positive outcomes among patients with dual disorders in intensive outpatient treatment for addiction.

Methods: The effect of contingency management was explored among a group of 160 patients exposed to contingency management (n = 88) and not exposed to contingency management (no contingency management, n = 72) in a six-week partial hospitalization program. Patients referred to the partial hospitalization program for treatment of substance use and comorbid psychiatric disorders received diagnoses from psychiatrists and specialist clinicians according to the Diagnostic and Statistical Manual of the American Psychiatric Association. A unique application of the contingency management “fishbowl” method was used to improve the consistency of attendance at treatment sessions, which patients attended 5 days a week. Days attending treatment and drug-free days were the main outcome variables. Other outcomes of interest were depression, anxiety and psychological stress, coping ability, and intensity of drug cravings.

Results: Patients in the contingency management group attended more treatment days compared to patients in the no contingency management group; M = 16.2 days (SD = 10.0) versus M = 9.9 days (SD = 8.5), respectively; t = 4.2, df = 158, p <.001. No difference was found between the treatment groups on number of drug-free days. Psychological stress and drug craving were inversely associated with drug-free days in bivariate testing (r = ?.18, p <.02; r = ?.31, p <.001, respectively). Treatment days attended and drug craving were associated with drug-free days in multivariate testing (B =.05, SE =.01, β =.39, t = 4.9, p <.001; B = ?.47; SE =.12, β = ?.30, t = ?3.9, p <.001, respectively; Adj. R² =.21). Days attending treatment partially mediated the relationship between exposure to contingency management and self-reported drug-free days.

Conclusions: Contingency management is a valuable adjunct for increasing retention in treatment among patients with dual disorders in partial hospitalization treatment. Exposure to contingency management increases retention in treatment, which in turn contributes to increased drug-free days. Interventions for coping with psychological stress and drug cravings should be emphasized in intensive dual diagnosis group therapy.     

Substance Use,Mental Disorders,Abuse, and Crime: Gender Comparisons Among a National Sample of Adolescent Drug Treatment Clients

ABSTRACT

This paper describes important gender comparisons in drug and alcohol use, illegal activity, physical and sexual abuse, and mental health problems among a large sample of adolescents (N = 3,382) who were treated from 1993 to 1995 in adolescent-oriented drug programs that participated in the Drug Abuse Treatment Outcome Study of Adolescents. Most of the adolescents reported regular use of marijuana and alcohol; males had higher rates of illegal activity and involvement with the juvenile justice system; females reported more sexual abuse, while males reported more physical abuse; and males and females had equal rates of conduct disorder and attention deficit hyperactivity disorder.     

Suicide and fatal alcohol poisoning in Russia, 1956–2005

Background: The association between alcohol and suicide is well documented. The role of binge drinking patterns in the alcohol–suicide relationship is a very important issue today. The solid body of research and empirical evidence suggests that hazardous patterns of alcohol consumption (binge drinking) lead to a quicker and deeper intoxication, increasing the propensity for alcohol-related suicide.

Purpose: To estimate the aggregate level effect of binge drinking on the suicide rate in the ‘wet’ Russian drinking culture.

Method: Trends in age-adjusted, sex-specific suicide and fatal alcohol-poisoning rate (as a proxy for binge drinking) from 1956 to 2005 in Russia were analysed employing an ARIMA analysis in order to assess bivariate relationship between the two time series.

Results: The results of the time-series analysis indicates the presence of a statistically significant association between the two time series at zero lag for male (r = 0.79; SE = 0.14), and for female (r = 0.58; SE = 0.14).

Conclusion: The present study replicates previous findings from other settings that suggest positive association between alcohol and suicide at aggregate level. Support is thus provided for the hypothesis that suicide and alcohol are closely connected in cultures where intoxication-oriented drinking patterns prevail and these results add to the growing body of evidence that alcohol played a crucial role in the fluctuation in suicide mortality rate in Russia during the last decades.     

FOLFOX与XELOX方案治疗晚期结直肠癌毒性表现的系统评价

目的 系统评价氟尿嘧啶/亚叶酸钙联合奥沙利铂（FOLFOX方案）与卡培他滨联合奥沙利铂（XELOX方案）治疗晚期结直肠癌毒性差异,为晚期结直肠癌＂个体化＂药物治疗方案选择提供依据。方法 检索PubMed、Embase、Cochrane、CNKI等数据库和ASCO会议文献,采用系统评价的方法进行系统评价。结果共10个研究4084例患者纳入毒性的系统评价,结果 表明XELOX方案在手足综合症（RR=3.60,95%CI：2.27~5.72,P〈0.0001）、血小板减少（RR=1.83,95%CI：1.36~2.48,P〈0.0001）发生率高于FOLFOX方案,在中性粒细胞减少（RR=0.24,95%CI：0.14~0.41,P〈0.0001）发生率低于FOLFOX方案;恶心、呕吐、腹泻以及神经毒性发生率两方案无统计学差异。结论 在晚期结直肠癌治疗中,FOLFOX方案与XELOX方案在毒性反应方面各有特点,应结合患者具体情况,选择最宜治疗方案。     

LETTERS TO THE EDITORS

ABSTRACT

Alcohol and marijuana are the most commonly used substances for college-attending young adults. This study evaluated differences in substance-specific consequence attribution by alcohol-marijuana use patterns (concurrent alcohol and marijuana [CAM; use of both substances, not at same time] and simultaneous [SAM; use of both, at same time]) as well as alcohol-only (AO). First-year college students with prior alcohol use (N = 610, 50.9% women, 71% White, M_age = 18) completed an online assessment of past-three-month substance use, including SAM, and related consequences. Results indicated that polydrug (SAM and CAM) users reported greater alcohol involvement and earlier alcohol initiation than AO, and polydrug use was associated with more alcohol-related problems, including sexual risk taking and alcohol-related blackouts. When restricted to SAM/CAM users, logistic regressions indicated that SAM users reported an increased incidence in two marijuana-related problems relative to CAM (driving after using and academic difficulties), but lower rates of social problems. SAM users were also less likely to attribute substance-related social problems to alcohol. Overall, findings highlight variations that exist within alcohol-marijuana polydrug users and show areas to consider for intervention development and future research.     

中国老年胃食管反流病患者心理健康状况的Meta分析

目的 探讨国内老年胃食管反流病患者的心理健康状况。方法 在PubMed、CNKI、CBM、VIP和万方数据库中获得关于中国老年胃食管反流病患者的心理健康状况的病例对照研究文献,采用RevMan 5.20软件进行meta分析,并采用Stata 11.0统计软件通过Egger''s test检验发表偏倚。结果 经筛选最终纳入6项病例对照研究,其中老年胃食管反流病组712例,对照组464例,均采用焦虑自评量表和抑郁自评量表进行测评。通过meta分析对焦虑、抑郁自评量表进行合并,结果显示：加权均数差（WMD）及95%置信区间CI分别为[WMD=15.32,95% CI（10.15,20.49）;P<0.05]、[WMD=15.57,95% CI（10.42,20.71）;P<0.05]。通过Egger''s test检测发表偏倚显示,无发表偏倚（P>0.05）。结论 中国老年人胃食管反流病患者伴有明显的精神心理异常,且易处于焦虑和抑郁状态。     

Association Between Intimate Partner Violence and Help Seeking for Alcohol Problems

Abstract

Objectives: The primary aim of this study is to determine the association between intimate partner violence, alcohol problems, and help seeking behaviors for alcohol problems. In addition, the study was conducted to examine ethnic differences in the reporting of intimate partner violence, alcohol problems and treatment or help seeking for alcohol problems.

Methods: A probability sample (n = 1468) of White, Black and Hispanic couples 18 years of age or older in the U.S. household population was interviewed in 1995 with a response rate of 85%. Help seeking was defined as talking to someone or seeking treatment for an alcohol problem; therefore, the bivariate and multivariate analyses exclude lifetime abstainers.

Results: Multivariate analysis controlling for ethnicity, gender, age, education, and income indicated that those with alcohol problems and intimate partner violence together were 1.5 (95% CI = 0.8-2.6) times more likely to seek help than those reporting alcohol problems alone.

Conclusions: The coexistence of intimate partner violence and alcohol problems may prompt individuals to seek help for alcohol problems. However, a majority of people who report intimate partner violence and alcohol problems or alcohol problems alone do not seek help.     

乳酸菌阴道胶囊联合抗真菌栓剂序贯给药治疗妊娠期外阴阴道假丝酵母菌病疗效及安全性的Meta分析

目的 用meta分析评价乳酸菌阴道胶囊联合抗真菌栓剂序贯给药治疗妊娠期外阴阴道假丝酵母菌病疗效及安全性。方法 计算机检索PubMed、EMbase、Cochrane Libraries、CNKI、万方和维普数据库（各数据库检索时间均从创建至2016年12月）,收集相关文献。根据纳入和排除标准筛选并提取资料,采用RevMan 5.2软件进行meta分析。结果 共纳入15项研究,2 522例患者。Meta分析结果显示：乳酸菌阴道胶囊联合抗真菌栓剂试验组的治愈率高于单用抗真菌栓剂对照组,2组相比总治愈率具有统计学差异（P<0.000 01）;乳酸菌阴道胶囊联合抗真菌栓剂试验组的复发率低于单用抗真菌栓对照组,2组相比总复发率具有统计学差异（P<0.000 01）;乳酸菌阴道胶囊联合抗真菌栓试验组的不良反应发生率和单用抗真菌栓剂对照组接近,2组相比总不良反应发生率不具有统计学差异（P=0.68）。结论 基于现有临床证据,乳酸菌阴道胶囊联合抗真菌栓剂治疗妊娠期外阴阴道假丝酵母菌病比单用抗真菌栓剂的疗效好,且复发率低,安全性好。     

The Effects of Marijuana Use on Transitions through Stages of Alcohol Involvement for Men and Women in the NESARC I and II

Background: With the changing context of marijuana use, it is critical to identify effects of use. We extend previous work by examining whether marijuana use influences progression and remission through alcohol involvement stages for men and women. Methods: Data come from Waves I and II of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n?=?34,432). We assess the potential influence of marijuana use at Wave 1 on transitions across three latent statuses of alcohol involvement between waves. We apply propensity score weighting to account for shared risk factors. Results: Marijuana use was associated cross-sectionally and longitudinally with alcohol involvement statuses for both sexes. After propensity score adjustment, men with marijuana histories were 3.50 times as likely as men without such histories to transition from no to severe problems across waves relative to staying in the same status (p < .001). Women with marijuana histories were 1.74 times as likely as women without such histories to transition from no problems at Wave 1 to moderate problems at Wave 2 (p = .030) and 0.13 times as likely as women without such histories to transition from severe problems to no problems (p = .006). Conclusions: Results suggest that marijuana use impacts progression to more serious stages of alcohol involvement for both men and women, as well as hinders remission among women. Findings point to the importance of screening those with marijuana histories for alcohol problems, as well as the need to understand the mechanism of why marijuana use may increase the risk of alcohol problems.     

Young adults report increased pleasure from smoking cigarettes when drinking alcohol but not when using marijuana

Background: Among young adults, cigarette smoking is strongly associated with alcohol and marijuana use. The present study compared self-reported co-use of cigarettes and alcohol versus cigarettes and marijuana among young adults using cross-sectional survey data.

Methods: Participants were young adult cigarette smokers (age 18 to 25) who also reported past month alcohol or marijuana use enrolled in a randomized trial testing a smoking cessation intervention on Facebook. Participants self-reported extent of cigarette smoking under the influence of alcohol or marijuana and differences in perceived pleasure from cigarette smoking when drinking alcohol compared to using marijuana.

Results: Among cigarette smokers who drank alcohol and used marijuana in the past month (n?=?200), a similar percentage of cigarettes were smoked under the influence of alcohol (42.4%?±?31.2%) and marijuana (43.1% ±?30.0%). Among alcohol?+?marijuana users, perceived pleasure from smoking cigarettes was significantly greater when drinking alcohol versus when using marijuana (t₍₁₉₉₎?=?7.05, p?n?=?158) or only used marijuana (n?=?54).

Conclusion: Findings highlight greater perceived reward from smoking cigarettes when drinking alcohol compared to when using marijuana, informing smoking cessation interventions that target users of multiple substances.     

The course of stage III melanoma in accordance with the severity of node involvement

Objectives: Pathological stage III melanoma patients have variable clinical presentation and outcome when divided by substages, and the number of metastatic lymph nodes is the most significant independent factor. We aimed to determine the clinical features and natural course of node positive melanoma, such as first relapse and final outcome, and other factors influencing them.

Methods: A total of 362 node positive melanoma patients were included in the study and reviewed retrospectively.

Results: Cases were as follows: N1 (56.6%); N2 (27.1%); and N3 (16.3%). Lymphovascular invasion was found significant among node positive subtypes; it was predominant in patients with involvement of two or more nodes (p?<?.05). The majority of the relapses were locoregional alone (43.4%) and distant alone (31.3%). The lung/pleura was the most frequently metastasized site (32.1%). Time to relapse was the longest for N1 (20.8?months) (p?<?.05). Five and 10?year relapse-free survival (RFS) rates were 40% and 38%, respectively. Nodular histopathology, ulcerated lesion and higher mitotic rates carried worse RFS for all patients and also for N1. Five- and 10?year overall survival (OS) rates were 49% and 40%, respectively. Older age, nodular histopathology, higher mitotic rates and relapse of disease (p?=?.001) were the independent variables that were inversely correlated with OS for all patients.

Conclusion: Comparative analyses of node positive melanoma suggested that there was not only a remarkable heterogeneity in the recurrence and survival rates but also a distinctive pattern among independent prognostic indicators in accordance with the severity of nodal involvement.     

多糖铁复合物治疗肾性贫血的有效性和安全性的meta分析

目的 系统评价多糖铁复合物（polysaccharide iron complex,PIC）治疗肾性贫血的有效性及安全性,为临床提供循证参考。方法 计算机检索PubMed、Embase、Cochrane Library、CNKI、WanFang Data和CBM等数据库,查找PIC对比其他口服铁剂治疗肾性贫血的随机对照试验文献,检索时限均为建库至2018年5月。由2位研究员按纳入与排除标准独立进行文献筛选、资料提取和偏倚风险评价,后采用ReMan5.3软件进行meta分析。结果 共纳入7项研究,包括642例患者（试验组354例,对照组288例）。Meta分析结果显示：与硫酸亚铁/琥珀酸亚铁相比,PIC治疗肾性贫血的临床有效性（P=0.02）、显效性（P<0.000 01）更好;PIC能明显改善患者的血红蛋白（P=0.02）、血清铁蛋白（P=0.009）、转铁蛋白饱和度（P<0.000 01）、红细胞压积（P=0.002）和红细胞（P=0.04）各项实验室指标;PIC的不良事件更少：恶心/呕吐（P<0.000 01）、腹痛/烧灼感（P=0.000 1）、便秘/腹泻（P=0.000 2）。结论 与硫酸亚铁/琥珀酸亚铁相比,PIC治疗肾性贫血具有更好的临床疗效及安全性。     

Time Trends and Policy Gaps: The Case of Alcohol Misuse Among Adolescents in Lebanon

Background: Monitoring studies are crucial for informing and reforming local policies. Objectives: Using the Lebanon 2005 and 2011 Global School-based Student Health Surveys (GSHS), alcohol time trends were described, policy gaps were identified, and harm reduction policy recommendations were made. Methods: In 2005 and 2011, 100 (n = 5109 students) and 44 (n = 2784 students) middle schools were surveyed, respectively. Self-reported cross-sectional data on alcohol use among 7–9th graders in private and public schools was collected including 30-day prevalence, lifetime drunkenness, alcohol-related problems, and sources of alcohol. Results: In 2011, the majority (87%) had alcohol before turning 14. Between 2005 and 2011, past 30-day alcohol use had increased by 40% and lifetime drunkenness by 50% in the total sample (122% among females with a narrowing in the gender gap). Drinking was regular for more than a third of the past 30-day drinkers (drank two or more drinks on the days they drank). Male adolescents were more likely to obtain alcohol from “stores” or “through their friends” whereas females’ main source was their “family.” One in twenty reported experiencing alcohol-related problems (e.g., getting into fights with family/friends and skipping school). Conclusion/Importance: Evidence-informed policy implications include enforcing a minimum legal drinking age, regulating alcohol advertising, and marketing particularly those targeting youth and women, and ensuring the availability of youth-friendly services. Public messages to increase awareness among all stakeholders including youth, their parents, and larger community are also needed.     

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.     

肿瘤并发病原菌感染患者NLR的临床意义

目的 探讨肿瘤患者外周血象中性粒细胞与淋巴细胞数比值（NLR）对肿瘤并发病原菌感染的诊断价值。方法 回顾分析中科院合肥物质研究院肿瘤医院2014年4月至2016年1月收治的43例伴病原菌感染肿瘤患者（感染组）和43例无病原菌感染患者（非感染组）资料,统计学分析两组与健康对照组患者白细胞数（WBC）、中性粒细胞数（NEUT）、淋巴细胞数（LYMPH）、NLR、血红蛋白（Hb）及血清白蛋白（ALB）指标差异及其相关性;采用logistic二分类回归分析肿瘤并发病原菌感染危险因素;ROC曲线分析NLR对肿瘤并发病原菌感染诊断价值。结果 感染组患者的NLR高于非感染组及对照组且非感染组高于对照组,差异均有统计学意义（P=0.000）;感染组WBC及NEUT数均高于非感染组及对照组（P=0.000、P=0.001）但非感染组与对照组比较,差异无统计学意义（P=0.240、P=0.666）;感染组LYMPH、ALB及Hb均低于非感染组及对照组（P=0.000、P=0.000、P=0.003）且非感染组低于对照组（P=0.000、P=0.000、P=0.000）;肿瘤组NLR与其ALB、Hb、淋巴细胞呈负相关（r=-0.530、r=-0.216、r=-0.740,P=0.000、P=0.046、P=0.000）,与中性粒细胞正相关（r=0.604,P=0.000）;logistic回归显示,NLR升高及ALB降低是肿瘤患者合并病原菌感染独立危险因素（P=0.001、P=0.023）。ROC曲线显示,NLR的曲线下面积（AUC）为0.864（P=0.000）,当NLR取值为4.19、4.62时,NLR诊断感染敏感性为88.39%,83.7%,特异性为69.77%、74.4%,诊断价值最大;NEUT的AUC为0.647（P=0.018）;WBC对感染无诊断价值（P=0.237）。结论 NLR对肿瘤患者发生病原菌感染具有较好诊断效能;NLR与ALB、Hb有相关性。     

Substance abuse relapse in Oxford House recovery homes: A survival analysis evaluation

ABSTRACT

Background: This study used survival analysis to examine risk factors for substance abuse relapse among residents in Oxford Houses (OH), a national network of self-run, self-financed aftercare homes for individuals recovering from substance use disorders. Methods: Participants who entered OH within 60 days of a 1-year longitudinal study (N = 268) were selected from of a nationally representative US sample. Discrete-time survival analysis compared baseline risk of relapse with 4 hypothesized survival models that included time-invariant and time-varying factors across 3 subsequent time periods. Results: The model predicting higher risk for more severe substance use disorders and psychiatric problems was supported. The hypothesized model that predicted time-varying increases in alcohol (but not drug) abstinence self-efficacy significantly affected risk of relapse. Hypothesized demographic and employment variables did not significantly predict relapse risk. Conclusions: Results suggested that OH recovery homes may reduce relapse by providing closer monitoring and referring additional services to new residents with more severe prior addiction severity. Risk for relapse may also be reduced by enhancing abstinence self-efficacy for alcohol regardless of drug of choice.