Single-focussed Versus Integrated Cognitive Behaviour Therapy For Co-occurring Depression And Alcohol Use Problems
Funder
National Health and Medical Research Council
Funding Amount
$777,500.00
Summary
This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our c ....This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our community, it is still not clear how best to manage and treat this group of people. Typically, people will often receive treatment for one part of their presentation, for example their depression or alcohol use problem. However, it is uncommon for the two conditions to be treated in an integrated way. This is certainly true for psychological treatments. Research programs to date have explored effective treatments for depression and alcohol use in the absence of the co-occurring condition. Currently it is not known how well people with co-occurring alcohol use problems and depression respond to treatments with a singular focus. Furthermore, it is not known whether integrating both alcohol use and depressive treatment approaches provides any additional benefit. This study is therefore significant, as it is one of the first to explore effective treatment approaches among people with co-occurring depressive and alcohol use problems. Resolution of these issues will better inform the treatment choices of clinicians practicing in both mental health and alcohol-other drug settings. Importantly, this will potentially improve the match between treatment and people with depression and substance use problems, a clinically prevalent population encountered in community settings.Read moreRead less
Genetic And Environmental Determinants Of Tobacco And Alcohol Use Trajectories Into Adulthood:a Prospective Twin Study.
Funder
National Health and Medical Research Council
Funding Amount
$172,875.00
Summary
Problems associated with the long-term use of tobacco and the abuse of alcohol permeate society. The development of effective programs for both the prevention and cessation of tobacco use and alcohol abuse requires an understanding of the natural history of the use of these substances. Most studies of the natural history of tobacco and alcohol use have followed individuals through secondary school and into the early 20s. These studies tell us about the psychosocial influences on these behaviours ....Problems associated with the long-term use of tobacco and the abuse of alcohol permeate society. The development of effective programs for both the prevention and cessation of tobacco use and alcohol abuse requires an understanding of the natural history of the use of these substances. Most studies of the natural history of tobacco and alcohol use have followed individuals through secondary school and into the early 20s. These studies tell us about the psychosocial influences on these behaviours but not about the role of genes on initiation and escalation of substance use. Yet recent advances in the neurophysiology of nicotine and alcohol receptivity and molecular genetics research suggest that genes play at least some role in determining the use of alcohol and tobacco. This proposal is for funding to continue a study designed to investigate the natural histories of alcohol and tobacco use among a sample of 1400 young Australian twins from adolescence to adulthood (early 30s). The study involves a telephone survey of these twins about their smoking and drinking behaviours, and among other things, their attitudes about smoking and drinking, the use of tobacco and alcohol by family and friends and presence of smoking bans at home and work. Because this study explicitly examines the influence of social and psychological factors on tobacco and alcohol use we will be able to determine the relative contribution of genes and psychosocial factors in tobacco and alcohol use. The proposed study is unique in its use of twins, its longitudinal design and its integration of genetics into psychosocial models of behaviour. The results of this study will help to clarify the role of genes in the development of tobacco use and alcohol abuse. Importantly the results of this study will help to identify those social and psychological factors that increase the likelihood of a genetically susceptible individual becoming dependent on nicotine and-or abusing alcohol.Read moreRead less
An Econometric Investigation Of Harmful Drinking And Price Response By Alcoholic Types To Inform Alcohol Tax Policies
Funder
National Health and Medical Research Council
Funding Amount
$449,157.00
Summary
This study will quantify the price responsiveness of alcohol consumption by types of alcoholic drinks and patterns of use, and the association of harmful drinking with physical and mental health. These estimates will then be used to analyse the impacts of a range of alcohol tax policies and education programs, and potential flow-on effects on health and other drug use, providing a guide to future alcohol policy.
Long Term Follow-up Of Two Randomised Controlled Trials Of Treatment For Depression And Alcohol-other Drug Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$252,925.00
Summary
This study proposes the long term follow-up of participants in two of the first and largest studies of psychological treatment for people with co-occurring depression and alcohol-other drug use problems ever conducted. This is a crucial next step in research on the effectiveness of psychological treatment among this highly prevalent yet often neglected section of the community.
Preclinical Validation Of Oxytocin As A Novel Treatment For Alcohol Dependence
Funder
National Health and Medical Research Council
Funding Amount
$517,624.00
Summary
Alcohol dependence is a major cause of mental and physical illness in Australia. Current medications for treating this condition are of limited effectiveness. This project will investigate the ability of the hormone oxytocin to reduce alcohol abuse and alcohol craving and to reverse the brain damage that alcohol causes. The project will also develop new medications, based on oxytocin, but with more powerful and longer lasting effects. These medications may provide a breakthrough in the fight aga ....Alcohol dependence is a major cause of mental and physical illness in Australia. Current medications for treating this condition are of limited effectiveness. This project will investigate the ability of the hormone oxytocin to reduce alcohol abuse and alcohol craving and to reverse the brain damage that alcohol causes. The project will also develop new medications, based on oxytocin, but with more powerful and longer lasting effects. These medications may provide a breakthrough in the fight against alcoholism.Read moreRead less
Longitudinal Study Of Modifiable Influences For The Development Of Harmful Young Adult Alcohol Use And Related-problems.
Funder
National Health and Medical Research Council
Funding Amount
$1,484,496.00
Summary
Young adulthood is a time of high vulnerability for alcohol use problems that are the major preventable contributor to death and injury in this age period. This 5-year project will identify modifiable influences in adolescence and young adulthood that contribute to harmful alcohol use. A cohort of almost 3,000 young people initially recruited in Victoria in 2002 (aged 11 to 15) will be followed for two further waves of data collection in 2010-11 (age 19 to 23) and 2012-13 (age 21 to 25).
Randomised Controlled Trial Of A New Intervention For Alcohol Craving
Funder
National Health and Medical Research Council
Funding Amount
$780,673.00
Summary
Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and lo ....Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.Read moreRead less
A Controlled Trial Of An Opportunistic Intervention To Reduce Suicide Risk Among Alcohol And Other Substance Misusers
Funder
National Health and Medical Research Council
Funding Amount
$361,000.00
Summary
Hopelessness, depression and suicidal ideation are common among people who misuse alcohol and other substances. A general relationship between alcohol-substance abuse and self-harming - suicidal behaviour has been recognised for decades. From the point of view of diagnosed substance abusers there is a correspondingly high incidence of suicide and self-harm. The lifetime risk for suicide in alcohol dependence is higher than for schizophrenia or affective disorder. Despite the public health and pe ....Hopelessness, depression and suicidal ideation are common among people who misuse alcohol and other substances. A general relationship between alcohol-substance abuse and self-harming - suicidal behaviour has been recognised for decades. From the point of view of diagnosed substance abusers there is a correspondingly high incidence of suicide and self-harm. The lifetime risk for suicide in alcohol dependence is higher than for schizophrenia or affective disorder. Despite the public health and personal burden associated with suicidality, the general lack of skills and focus on management of self-harm in specialised drug and alcohol services is of great concern. In this study, all patients attending drug and alcohol services will be screened for suicide risk, and offered a comprehensive psychological treatment to reduce suicide risk and the use of alcohol and other substances.Read moreRead less
Reducing Alcohol-related Harm In Rural Communities
Funder
National Health and Medical Research Council
Funding Amount
$265,000.00
Summary
In 1992 in Australia, there were an estimated 3,660 alcohol-related deaths and 71,593 alcohol-related hospital episodes, resulting in a total economic cost of $4,031.9 million, 84% of which was avoidable. In 1998, about half of all males and a third of all females drank at least once a month at levels that placed them at risk of harm. In NSW, alcohol was estimated as being a causal factor in about one-quarter of all road traffic deaths in 1995 and was associated with a 58% increase in hospital u ....In 1992 in Australia, there were an estimated 3,660 alcohol-related deaths and 71,593 alcohol-related hospital episodes, resulting in a total economic cost of $4,031.9 million, 84% of which was avoidable. In 1998, about half of all males and a third of all females drank at least once a month at levels that placed them at risk of harm. In NSW, alcohol was estimated as being a causal factor in about one-quarter of all road traffic deaths in 1995 and was associated with a 58% increase in hospital utilistion rates between 1988-89 and 1990-91. The burden of suffering appears disproportionately higher in rural areas of NSW: per capita rate of convictions associated with a prescribed alcohol concentration in rural towns was approximately double that in metropolitan areas in 2000. The rate of attendances at hospital accident and emergency departments was also higher in rural areas. These data suggest a need for additional effort to reduce alcohol-related harm in rural, relative to metropolitan, areas. In Australia, there have been no well-controlled, community-based, attempts to reduce alcohol-related harm by simultaneously implementing a range of interventions. The conduct of a large-scale randomised controlled trial (RCT) to investigate the effectiveness of this approach is difficult to justify, due to the substantial costs associated with such a rigorous design. However, a less rigorus, though equally valid, design, such as a stepped wedged approach, would likely provide good evidence to justify the subsequent conduct of an RCT. If the expected outcomes are not achieved, the conduct of an RCT can be postponed until reasonable preliminary evidence regarding the types of community-based interventions most likely to be effective is obtained. In either case, this study will provide valuable information as to which community-based interventions, and in what combination, are most likely to reduce the occurrence of alcohol-related harm in rural communities in Australia.Read moreRead less
The Relationship Between Cannabis Use And Symptoms And Relapse In Psychosis
Funder
National Health and Medical Research Council
Funding Amount
$169,604.00
Summary
Cannabis is increasingly widely used and abused by young people. Use in young people with schizophrenia is even more extensive. There is some suggestion that this drug use is a result of their illness, ie to reduce unpleasant symptoms or feelings. Equally the drug may contribute to their psychosis. This study aims to assess the degree to which psychosis may be caused by cannabis use in vulnerable young people.