This project is designed to determine if a computer-delivered cognitive-behavioral treatment can improve the otherwise poor alcohol use disorder treatment outcomes for individuals with a co-occurring anxiety disorder. In the past, the investigators showed that this treatment does improve outcomes for these individuals when delivered by a therapist. If the present work shows that the computer-delivered version is also effective, it would provide an inexpensive program with virtually unlimited scalability to enable access to the treatment by many more individuals than is currently the case.
current (past 30 days) Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis of panic disorder with or without agoraphobia (PD/Ag), generalized anxiety disorder (GAD) or social anxiety disorder (SAD)
receiving treatment primarily for alcohol (vs. drug) dependence
ability to provide informed consent
a minimum of an eighth grade English reading level
cognitive or medical impairments that prohibit study participation as determined by study PI
serious suicide risk determined by study PI
court-ordered treatment. (The exclusion is based on its classification as a "vulnerable" population.)
Self-reported past participation in a Kushner intervention study while in Lodging Plus
Parallel
Negative Emotions and Addiction Tools Program (NEAT)- Cognitive Behavioral Therapy
BehavioralThe program provides simplified clinical, learning and neuroscience-based education about the vicious cycle in which negative affect serves to motivate drinking, which, in turn, worsens negative affect. Participants also learn how each of three skills (breathing control, cognitive restructuring, problem solving) was designed to disrupt a specific element of the vicious cycle that includes physiological, psychological and behavioral processes.
Progressive Muscle Relaxation Training (PMRT)
BehavioralPMRT is a standard stress management coping skill that entails tensing and releasing specified muscle groups to obtain deep muscle relaxation.
Percent heavy ("binge") days drinking
a ratio expressed as a percent of the days the individual drank 5 (for men) or 4 (for women) or more drinks to the total number of days over the follow-up period in which drinking was possible.
Days to first use
Determined for the entirety of the post treatment time for which the investigators have data up to the 8-month assessment.
Any use of alcohol
Any use of alcohol will be binary (yes/no) indicator of whether any alcohol was consumed.
Percent days drinking
a ratio of the days that alcohol was consumed to the total number of possible drinking days.
Days to first binge
Determined for the entirety of the post treatment time for which the investigators have data up to the 8-month assessment.
Days to first 3 consecutive days of drinking
Determined for the entirety of the post treatment time for which the investigators have data up to the 8-month assessment.
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