Alcohol Use Disorder, Behavior, Addictive, Couples
Conditions
Brief summary
This project will develop and pilot test a new smartphone-based system for AUD patients, their partners, and clinicians called PartnerCHESS. PartnerCHESS will integrate key features of ABCT and A-CHESS. PartnerCHESS will also include a Clinician Report to automatically alert clinicians of patients at risk of relapse and offer other information on how recovery is proceeding. The project has three specific aims: 1. Integrate A-CHESS with key features of ABCT to create PartnerCHESS to serve patients, partners, and clinicians. 2. Conduct a pilot test (a small randomized clinical trial) of PartnerCHESS to estimate effect size and refine the protocol, procedures, recruitment strategy, measurements, and operations for use in a large RCT. 3a. Decide whether to pursue an R01 application, and if so, 3b. plan for the R01.
Detailed description
Alcohol use disorder (AUD) is one of the most common substance use disorders. Yet only a small fraction of people who need treatment receive it, and most of them get only short-term support even though continuing care has been shown to be much more effective. Partner support can be critical to recovery, but many partners do not know how to support their partners' recovery or manage their own responses to it. Clinicians also lack evidence of the efforts patients are making toward recovery. Treating couples in which one member is recovering from AUD has been shown to be efficacious; in particular, Alcohol Behavioral Couples Therapy (ABCT) has shown positive outcomes. Still, ABCT has not been widely adopted, in part because of practical problems such as the stigma that goes with the partner needing to go to an addiction treatment agency to participate. A-CHESS is a smartphone-based system proven to substantially reduce relapse rates, but A-CHESS serves only the patient. This project will develop and pilot test a new smartphone-based system for AUD patients, their partners, and clinicians called PartnerCHESS. PartnerCHESS will integrate key features of ABCT and A-CHESS. PartnerCHESS will also include a Clinician Report to automatically alert clinicians of patients at risk of relapse and offer other information on how recovery is proceeding. The project has three specific aims: 1. Integrate A-CHESS with key features of ABCT to create PartnerCHESS to serve patients, partners, and clinicians. 2. Conduct a pilot test (a small randomized clinical trial) of PartnerCHESS to estimate effect size and refine the protocol, procedures, recruitment strategy, measurements, and operations for use in a large RCT. 3a. Decide whether to pursue an R01 application, and if so, 3b. plan for the R01. The project would engage 6 couples to help design PartnerCHESS, test its usability and give feedback on its utility. Once ready, the system would be tested by 34 other couples randomized to receive either PartnerCHESS + treatment as usual (TAU) or A-CHESS + TAU for a 6-month trial. The investigators will collect survey data at baseline, 2, 4, and 6 months and analyze it to see if a large clinical trial holds promise and, if so, produce an application to support a full-scale trial based on the technology developed and the research procedures employed in the pilot test. The study is important to public health because of the scope of the alcohol abuse and the potential of technology to improve the lives of both patients and partners. If successful, such technology could greatly broaden the reach and impact of AUD treatment in general and couples therapy in particular.
Interventions
Patients randomized to the PartnerCHESS group will receive all A-CHESS services plus the following services from ABCT: Urge discussion. Daily EMAs will track preconditions for relapse (urges), review urge reduction options on PartnerCHESS, and encourage discussions between partners on the causes of and ways to reduce urges. Homework checklist. Tracks which interventions the couple is using/practicing, along with resources to help. Relapse plan. Monitoring and reminders of steps planned for relapse prevention. Reminders. Reminders to notice something positive in partner, of reasons to stay sober, to take meds, etc. Trigger identification and removal. During set-up, patient and partner enter triggers. PartnerCHESS will quiz couples on upcoming trigger events and remind them of ways to address each.
A-CHESS control group
Sponsors
Study design
Eligibility
Inclusion criteria
A total of 34 dyads were recruited. Patients and partners: * Must be 18 or older * Not have a mental or physical condition that limits smartphone use * Cannot have experienced serious Interpersonal Violence Intimate Partner Violence (IPV) in the index (therapy) relationship in the past year * Not have a history of schizophrenia Patients: * Must have a DSM-5 diagnosis of alcohol use disorder or meet NIAAA guidelines for risky drinking. * Have had at least one alcoholic drink in the last 6 months Partners: * Must be a spouse, or in a 6-month or longer committed romantic relationship * Willing to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With no Heavy Drinking | baseline, 2, 4, and 6 months | At each time of measurement, a timeline follow-back interview was conducted for the past 60 days. Risky drinking day was be defined as greater than 4 drinks for men and greater than 3 drinks for women in 2 hours. |
| Percentage of Days With Heavy Drinking | baseline, 2, 4, and 6 months | At each time of measurement, a timeline follow-back interview was conducted for the past 60 days. |
| Percentage of Days With Any Drinking | Baseline, 2, 4, 6 months | At each time of measurement, a timeline follow-back interview was conducted for the past 60 days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceptions of Family Environment - Conflict | Baseline, 2, 4, 6 months | Drinkers and partners both completed the 9-item Cohesion and 9-item Conflict scales from the Family Environment Scale. Responses were true/false statements, with higher scores indicating more cohesion or conflict. Possible scores range from 33 to 80. |
| Psychological Distress | baseline, 2, 4, and 6 months | Drinkers' and partners' psychological distress was assessed by the OQ-45 scale. Response options range from 0-4, with items 1, 12, 13, 20, 21, 24, 31, 37, and 43 reversed; items are summed (i.e., a possible range of 0-180). High scores suggest distress (anxiety, depression, somatic problems, stress), difficulties in interpersonal relationships and social roles (e.g., work), and low quality of life, with scores of 63 or more indicating symptoms of clinical significance, and changes of 14 points or more considered reliable. |
| Peer Support | Baseline, 2, 4, 6 months | Partners reported on the availability of peer support using the 5-item McTavish Bonding Scale. Response options ranged 1-5 for a total possible range of scores from 5-25; with higher scores suggesting more support. |
| Commitment to Sobriety | Baseline, 2, 4, 6 months | Drinkers completed the 5-item Commitment to Sobriety Scale. Response options ranged 1-5 for a total possible range of scores from 5-25; with higher scores suggesting more commitment. |
| Relationship Satisfaction | baseline, 2, 4, and 6 months | Drinkers' and partners' relationship satisfaction was assessed by the Dyadic Adjustment Scale-Brief (DAS-7) plus item 32 from the DAS-32. Response options ranged 0-5 on most items and 0-6 on item 7 of the DAS-7 (possible scores range from 0 to 41). Consistent with scoring instructions for the DAS-7, items were summed, with higher scores indicating more satisfaction. |
| Perceptions of Family Environment - Cohesion | Baseline, 2, 4, 6 months | Drinkers and partners both completed the 9-item Cohesion and 9-item Conflict scales from the Family Environment Scale. Responses were true/false statements, with higher scores indicating more cohesion or conflict. Possible scores range from 4 to 65. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| A-CHESS Drinker Patients randomized to the A-CHESS group will receive the A-CHESS app on a smartphone.
A-CHESS: A-CHESS control group | 15 |
| PartnerCHESS Drinker Patients randomized to the PartnerCHESS group will receive all A-CHESS services listed above, plus learning modules and resources from Alcohol-based Couple Therapy.
PartnerCHESS: Patients randomized to the PartnerCHESS group will receive all A-CHESS services plus the following services from ABCT:
Urge discussion. Daily EMAs will track preconditions for relapse (urges), review urge reduction options on PartnerCHESS, and encourage discussions between partners on the causes of and ways to reduce urges.
Homework checklist. Tracks which interventions the couple is using/practicing, along with resources to help.
Relapse plan. Monitoring and reminders of steps planned for relapse prevention. Reminders. Reminders to notice something positive in partner, of reasons to stay sober, to take meds, etc.
Trigger identification and removal. During set-up, patient and partner enter triggers. PartnerCHESS will quiz couples on upcoming trigger events and remind them of ways to address each. | 18 |
| A-CHESS Partner Participants randomized to the A-CHESS group will receive the A-CHESS app on a smartphone.
A-CHESS: A-CHESS control group | 15 |
| PartnerCHESS Partner Participants randomized to the PartnerCHESS group will receive all A-CHESS services listed above, plus learning modules and resources from Alcohol-based Couple Therapy.
PartnerCHESS: Patients randomized to the PartnerCHESS group will receive all A-CHESS services plus the following services from ABCT:
Urge discussion. Daily EMAs will track preconditions for relapse (urges), review urge reduction options on PartnerCHESS, and encourage discussions between partners on the causes of and ways to reduce urges.
Homework checklist. Tracks which interventions the couple is using/practicing, along with resources to help.
Relapse plan. Monitoring and reminders of steps planned for relapse prevention. Reminders. Reminders to notice something positive in partner, of reasons to stay sober, to take meds, etc.
Trigger identification and removal. During set-up, patient and partner enter triggers. PartnerCHESS will quiz couples on upcoming trigger events and remind them of ways to address each. | 18 |
| Total | 66 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Withdrawal by Subject | 2 | 0 |
Baseline characteristics
| Characteristic | Total | A-CHESS Drinker | PartnerCHESS Drinker | A-CHESS Partner | PartnerCHESS Partner |
|---|---|---|---|---|---|
| Age, Continuous | 39.97 years STANDARD_DEVIATION 11.3 | 43.33 years STANDARD_DEVIATION 12.43 | 37.83 years STANDARD_DEVIATION 10.53 | 40.93 years STANDARD_DEVIATION 12.4 | 38.50 years STANDARD_DEVIATION 10.27 |
| Alcohol use disorder severity (DSM-5) Mild 2-3 | 1 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants |
| Alcohol use disorder severity (DSM-5) Moderate 4-5 | 2 Participants | 2 Participants | 0 Participants | 0 Participants | 0 Participants |
| Alcohol use disorder severity (DSM-5) Severe 6+ | 30 Participants | 12 Participants | 18 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 2 Participants | 1 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 63 Participants | 13 Participants | 17 Participants | 15 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Living with partner | 55 Participants | 12 Participants | 15 Participants | 12 Participants | 16 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 6 Participants | 1 Participants | 2 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 6 Participants | 2 Participants | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 53 Participants | 12 Participants | 14 Participants | 12 Participants | 15 Participants |
| Sex/Gender, Customized Female | 33 Participants | 3 Participants | 4 Participants | 13 Participants | 13 Participants |
| Sex/Gender, Customized Male | 32 Participants | 12 Participants | 13 Participants | 2 Participants | 5 Participants |
| Sex/Gender, Customized Prefer not to say | 1 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 30 | 0 / 36 |
| other Total, other adverse events | 0 / 30 | 0 / 36 |
| serious Total, serious adverse events | 0 / 30 | 0 / 36 |
Outcome results
Number of Participants With no Heavy Drinking
At each time of measurement, a timeline follow-back interview was conducted for the past 60 days. Risky drinking day was be defined as greater than 4 drinks for men and greater than 3 drinks for women in 2 hours.
Time frame: baseline, 2, 4, and 6 months
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| A-CHESS Drinker | Number of Participants With no Heavy Drinking | Baseline | 1 Participants |
| A-CHESS Drinker | Number of Participants With no Heavy Drinking | 2 months | 1 Participants |
| A-CHESS Drinker | Number of Participants With no Heavy Drinking | 4 months | 5 Participants |
| A-CHESS Drinker | Number of Participants With no Heavy Drinking | 6 months | 6 Participants |
| PartnerCHESS Drinker | Number of Participants With no Heavy Drinking | 6 months | 13 Participants |
| PartnerCHESS Drinker | Number of Participants With no Heavy Drinking | Baseline | 2 Participants |
| PartnerCHESS Drinker | Number of Participants With no Heavy Drinking | 4 months | 10 Participants |
| PartnerCHESS Drinker | Number of Participants With no Heavy Drinking | 2 months | 5 Participants |
Percentage of Days With Any Drinking
At each time of measurement, a timeline follow-back interview was conducted for the past 60 days.
Time frame: Baseline, 2, 4, 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Percentage of Days With Any Drinking | Baseline | 72.8 percentage of days | Standard Deviation 33.5 |
| A-CHESS Drinker | Percentage of Days With Any Drinking | 2 months | 58.3 percentage of days | Standard Deviation 38.9 |
| A-CHESS Drinker | Percentage of Days With Any Drinking | 4 months | 48.3 percentage of days | Standard Deviation 42.3 |
| A-CHESS Drinker | Percentage of Days With Any Drinking | 6 months | 52.7 percentage of days | Standard Deviation 43.5 |
| PartnerCHESS Drinker | Percentage of Days With Any Drinking | 6 months | 48.4 percentage of days | Standard Deviation 44.5 |
| PartnerCHESS Drinker | Percentage of Days With Any Drinking | Baseline | 73.6 percentage of days | Standard Deviation 30 |
| PartnerCHESS Drinker | Percentage of Days With Any Drinking | 4 months | 46.6 percentage of days | Standard Deviation 44.7 |
| PartnerCHESS Drinker | Percentage of Days With Any Drinking | 2 months | 59.6 percentage of days | Standard Deviation 36.2 |
Percentage of Days With Heavy Drinking
At each time of measurement, a timeline follow-back interview was conducted for the past 60 days.
Time frame: baseline, 2, 4, and 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Percentage of Days With Heavy Drinking | Baseline | 51.7 percentage of days | Standard Deviation 38.4 |
| A-CHESS Drinker | Percentage of Days With Heavy Drinking | 4 months | 34.9 percentage of days | Standard Deviation 40.5 |
| A-CHESS Drinker | Percentage of Days With Heavy Drinking | 2 months | 46.7 percentage of days | Standard Deviation 39.4 |
| A-CHESS Drinker | Percentage of Days With Heavy Drinking | 6 months | 37.4 percentage of days | Standard Deviation 44.6 |
| PartnerCHESS Drinker | Percentage of Days With Heavy Drinking | 2 months | 28.6 percentage of days | Standard Deviation 28 |
| PartnerCHESS Drinker | Percentage of Days With Heavy Drinking | Baseline | 50.3 percentage of days | Standard Deviation 34.7 |
| PartnerCHESS Drinker | Percentage of Days With Heavy Drinking | 6 months | 17.7 percentage of days | Standard Deviation 31.7 |
| PartnerCHESS Drinker | Percentage of Days With Heavy Drinking | 4 months | 18.2 percentage of days | Standard Deviation 29.2 |
Commitment to Sobriety
Drinkers completed the 5-item Commitment to Sobriety Scale. Response options ranged 1-5 for a total possible range of scores from 5-25; with higher scores suggesting more commitment.
Time frame: Baseline, 2, 4, 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Commitment to Sobriety | Baseline | 16.2 score on a scale | Standard Deviation 6.4 |
| A-CHESS Drinker | Commitment to Sobriety | 2 months | 15.2 score on a scale | Standard Deviation 4.6 |
| A-CHESS Drinker | Commitment to Sobriety | 4 months | 15.7 score on a scale | Standard Deviation 6.1 |
| A-CHESS Drinker | Commitment to Sobriety | 6 months | 15.9 score on a scale | Standard Deviation 6.9 |
| PartnerCHESS Drinker | Commitment to Sobriety | 6 months | 17.4 score on a scale | Standard Deviation 5.7 |
| PartnerCHESS Drinker | Commitment to Sobriety | Baseline | 15.9 score on a scale | Standard Deviation 4.7 |
| PartnerCHESS Drinker | Commitment to Sobriety | 4 months | 17.8 score on a scale | Standard Deviation 4.7 |
| PartnerCHESS Drinker | Commitment to Sobriety | 2 months | 15.1 score on a scale | Standard Deviation 6.2 |
Peer Support
Partners reported on the availability of peer support using the 5-item McTavish Bonding Scale. Response options ranged 1-5 for a total possible range of scores from 5-25; with higher scores suggesting more support.
Time frame: Baseline, 2, 4, 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Peer Support | Baseline | 13.4 score on a scale | Standard Deviation 6.4 |
| A-CHESS Drinker | Peer Support | 4 months | 11.5 score on a scale | Standard Deviation 4.8 |
| A-CHESS Drinker | Peer Support | 2 months | 13.1 score on a scale | Standard Deviation 7.5 |
| A-CHESS Drinker | Peer Support | 6 months | 12.9 score on a scale | Standard Deviation 5.7 |
| PartnerCHESS Drinker | Peer Support | 6 months | 15.6 score on a scale | Standard Deviation 5.2 |
| PartnerCHESS Drinker | Peer Support | 2 months | 16.1 score on a scale | Standard Deviation 3.8 |
| PartnerCHESS Drinker | Peer Support | 4 months | 14.8 score on a scale | Standard Deviation 3.9 |
| PartnerCHESS Drinker | Peer Support | Baseline | 10.8 score on a scale | Standard Deviation 4.2 |
Perceptions of Family Environment - Cohesion
Drinkers and partners both completed the 9-item Cohesion and 9-item Conflict scales from the Family Environment Scale. Responses were true/false statements, with higher scores indicating more cohesion or conflict. Possible scores range from 4 to 65.
Time frame: Baseline, 2, 4, 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Perceptions of Family Environment - Cohesion | 6 months | 57.3 score on a scale | Standard Deviation 8.6 |
| A-CHESS Drinker | Perceptions of Family Environment - Cohesion | 4 months | 58.6 score on a scale | Standard Deviation 8 |
| A-CHESS Drinker | Perceptions of Family Environment - Cohesion | 2 months | 53.2 score on a scale | Standard Deviation 10.4 |
| A-CHESS Drinker | Perceptions of Family Environment - Cohesion | Baseline | 54.9 score on a scale | Standard Deviation 11.8 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Cohesion | 2 months | 50.4 score on a scale | Standard Deviation 13.5 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Cohesion | 6 months | 54.8 score on a scale | Standard Deviation 15.9 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Cohesion | Baseline | 52.6 score on a scale | Standard Deviation 9.9 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Cohesion | 4 months | 54.8 score on a scale | Standard Deviation 14.6 |
| A-CHESS Partner | Perceptions of Family Environment - Cohesion | Baseline | 52.6 score on a scale | Standard Deviation 10.5 |
| A-CHESS Partner | Perceptions of Family Environment - Cohesion | 6 months | 57.2 score on a scale | Standard Deviation 12.8 |
| A-CHESS Partner | Perceptions of Family Environment - Cohesion | 4 months | 56.4 score on a scale | Standard Deviation 11.8 |
| A-CHESS Partner | Perceptions of Family Environment - Cohesion | 2 months | 52.3 score on a scale | Standard Deviation 12.6 |
| PartnerCHESS Partner | Perceptions of Family Environment - Cohesion | 6 months | 50.7 score on a scale | Standard Deviation 17.4 |
| PartnerCHESS Partner | Perceptions of Family Environment - Cohesion | 2 months | 50.7 score on a scale | Standard Deviation 13.4 |
| PartnerCHESS Partner | Perceptions of Family Environment - Cohesion | 4 months | 55.2 score on a scale | Standard Deviation 9.9 |
| PartnerCHESS Partner | Perceptions of Family Environment - Cohesion | Baseline | 47.4 score on a scale | Standard Deviation 15.8 |
Perceptions of Family Environment - Conflict
Drinkers and partners both completed the 9-item Cohesion and 9-item Conflict scales from the Family Environment Scale. Responses were true/false statements, with higher scores indicating more cohesion or conflict. Possible scores range from 33 to 80.
Time frame: Baseline, 2, 4, 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Perceptions of Family Environment - Conflict | Baseline | 46.2 score on a scale | Standard Deviation 14.2 |
| A-CHESS Drinker | Perceptions of Family Environment - Conflict | 2 months | 40.6 score on a scale | Standard Deviation 12.3 |
| A-CHESS Drinker | Perceptions of Family Environment - Conflict | 4 months | 40.6 score on a scale | Standard Deviation 9.8 |
| A-CHESS Drinker | Perceptions of Family Environment - Conflict | 6 months | 42.3 score on a scale | Standard Deviation 13.2 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Conflict | 2 months | 45.3 score on a scale | Standard Deviation 11.3 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Conflict | 4 months | 43.4 score on a scale | Standard Deviation 11.7 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Conflict | 6 months | 43.6 score on a scale | Standard Deviation 10.5 |
| PartnerCHESS Drinker | Perceptions of Family Environment - Conflict | Baseline | 48.6 score on a scale | Standard Deviation 12.7 |
| A-CHESS Partner | Perceptions of Family Environment - Conflict | 4 months | 43.8 score on a scale | Standard Deviation 10.6 |
| A-CHESS Partner | Perceptions of Family Environment - Conflict | 2 months | 45.7 score on a scale | Standard Deviation 11 |
| A-CHESS Partner | Perceptions of Family Environment - Conflict | 6 months | 43.1 score on a scale | Standard Deviation 8.7 |
| A-CHESS Partner | Perceptions of Family Environment - Conflict | Baseline | 47.1 score on a scale | Standard Deviation 12.4 |
| PartnerCHESS Partner | Perceptions of Family Environment - Conflict | 6 months | 46.7 score on a scale | Standard Deviation 12.7 |
| PartnerCHESS Partner | Perceptions of Family Environment - Conflict | 2 months | 45.4 score on a scale | Standard Deviation 11.3 |
| PartnerCHESS Partner | Perceptions of Family Environment - Conflict | Baseline | 52.8 score on a scale | Standard Deviation 13.1 |
| PartnerCHESS Partner | Perceptions of Family Environment - Conflict | 4 months | 43.2 score on a scale | Standard Deviation 10.5 |
Psychological Distress
Drinkers' and partners' psychological distress was assessed by the OQ-45 scale. Response options range from 0-4, with items 1, 12, 13, 20, 21, 24, 31, 37, and 43 reversed; items are summed (i.e., a possible range of 0-180). High scores suggest distress (anxiety, depression, somatic problems, stress), difficulties in interpersonal relationships and social roles (e.g., work), and low quality of life, with scores of 63 or more indicating symptoms of clinical significance, and changes of 14 points or more considered reliable.
Time frame: baseline, 2, 4, and 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Psychological Distress | Baseline | 54.5 score on a scale | Standard Deviation 31.1 |
| A-CHESS Drinker | Psychological Distress | 2 months | 51.7 score on a scale | Standard Deviation 29.5 |
| A-CHESS Drinker | Psychological Distress | 4 months | 40.3 score on a scale | Standard Deviation 25 |
| A-CHESS Drinker | Psychological Distress | 6 months | 48.8 score on a scale | Standard Deviation 25.3 |
| PartnerCHESS Drinker | Psychological Distress | 2 months | 65.7 score on a scale | Standard Deviation 28.2 |
| PartnerCHESS Drinker | Psychological Distress | 4 months | 59.7 score on a scale | Standard Deviation 27.4 |
| PartnerCHESS Drinker | Psychological Distress | 6 months | 52.1 score on a scale | Standard Deviation 25.8 |
| PartnerCHESS Drinker | Psychological Distress | Baseline | 66.3 score on a scale | Standard Deviation 27.4 |
| A-CHESS Partner | Psychological Distress | 4 months | 41.5 score on a scale | Standard Deviation 16.1 |
| A-CHESS Partner | Psychological Distress | 2 months | 46.8 score on a scale | Standard Deviation 24.1 |
| A-CHESS Partner | Psychological Distress | 6 months | 43.2 score on a scale | Standard Deviation 25.4 |
| A-CHESS Partner | Psychological Distress | Baseline | 44.5 score on a scale | Standard Deviation 23.4 |
| PartnerCHESS Partner | Psychological Distress | 6 months | 54.8 score on a scale | Standard Deviation 29.1 |
| PartnerCHESS Partner | Psychological Distress | 2 months | 53.0 score on a scale | Standard Deviation 20.8 |
| PartnerCHESS Partner | Psychological Distress | Baseline | 53.6 score on a scale | Standard Deviation 21.8 |
| PartnerCHESS Partner | Psychological Distress | 4 months | 52.9 score on a scale | Standard Deviation 27.3 |
Relationship Satisfaction
Drinkers' and partners' relationship satisfaction was assessed by the Dyadic Adjustment Scale-Brief (DAS-7) plus item 32 from the DAS-32. Response options ranged 0-5 on most items and 0-6 on item 7 of the DAS-7 (possible scores range from 0 to 41). Consistent with scoring instructions for the DAS-7, items were summed, with higher scores indicating more satisfaction.
Time frame: baseline, 2, 4, and 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| A-CHESS Drinker | Relationship Satisfaction | Baseline | 28.4 score on a scale | Standard Deviation 4.1 |
| A-CHESS Drinker | Relationship Satisfaction | 2 months | 27.9 score on a scale | Standard Deviation 4.3 |
| A-CHESS Drinker | Relationship Satisfaction | 4 months | 30.0 score on a scale | Standard Deviation 4.4 |
| A-CHESS Drinker | Relationship Satisfaction | 6 months | 29.4 score on a scale | Standard Deviation 5.9 |
| PartnerCHESS Drinker | Relationship Satisfaction | 2 months | 27.0 score on a scale | Standard Deviation 8.1 |
| PartnerCHESS Drinker | Relationship Satisfaction | 4 months | 28.1 score on a scale | Standard Deviation 7.7 |
| PartnerCHESS Drinker | Relationship Satisfaction | 6 months | 27.4 score on a scale | Standard Deviation 7.9 |
| PartnerCHESS Drinker | Relationship Satisfaction | Baseline | 27.5 score on a scale | Standard Deviation 7.3 |
| A-CHESS Partner | Relationship Satisfaction | 4 months | 27.1 score on a scale | Standard Deviation 6.2 |
| A-CHESS Partner | Relationship Satisfaction | 2 months | 26.9 score on a scale | Standard Deviation 6.5 |
| A-CHESS Partner | Relationship Satisfaction | 6 months | 27.5 score on a scale | Standard Deviation 6.6 |
| A-CHESS Partner | Relationship Satisfaction | Baseline | 27.4 score on a scale | Standard Deviation 6.8 |
| PartnerCHESS Partner | Relationship Satisfaction | 6 months | 24.3 score on a scale | Standard Deviation 7.3 |
| PartnerCHESS Partner | Relationship Satisfaction | 2 months | 26.5 score on a scale | Standard Deviation 7.7 |
| PartnerCHESS Partner | Relationship Satisfaction | Baseline | 27.6 score on a scale | Standard Deviation 6.4 |
| PartnerCHESS Partner | Relationship Satisfaction | 4 months | 25.4 score on a scale | Standard Deviation 6.7 |