Prevention and Treatment of Alcohol Problems: Research Opportunities -- Copyright -- PREFACE -- REFERENCES -- Contents -- SUMMARY -- RESEARCH OPPORTUNITIES IN THE PREVENTION OF ALCOHOL PROBLEMS: A PUBLIC HEALTH PERSPECTIVE -- The Epidemiology of Alcohol-Related Problems -- Individual-Environment Interactions: Focus on the Individual -- The Life-Course Developmental Perspective -- Social Learning Models -- Genetic Determinants of Risk -- Individual-Environment Interactions: Focus on the Environment -- Community Approaches and Perspectives from Other Health Fields -- Methodological Issues in Alcohol Prevention Research: Conclusions and Recommendations -- RESEARCH OPPORTUNITIES IN THE TREATMENT OF ALCOHOL PROBLEMS -- Historical Factors in Treatment Research -- Conceptual and Technical Advances in Assessment -- Effectiveness of Treatment Modalities: Studies of Process and Outcome -- Early Identification and Treatment -- Patient-Treatment Matching and Outcome Improvement in Alcohol Rehabilitation -- Advances in the Treatment of Other Psychoactive Substance-Use Disorders: Implications for Alcohol Treatment Research -- Health Consequences of Alcohol Abuse -- Treatment Costs, Benefits, and Cost Offsets: Public Policy Considerations -- FUNDING MECHANISMS AND THE NECESSARY INFRASTRUCTURE FOR TREATMENT AND PREVENTION RESEARCH -- Supporting the Scientific Infrastructure for Prevention Research -- Supporting the Scientific Infrastructure for Treatment Research -- I RESEARCH OPPORTUNITIES IN THE PREVENTION OF ALCOHOL-RELATED PROBLEMS -- References -- 1 A Public Health Perspective on the Prevention of Alcohol Problems -- A PUBLIC HEALTH MODEL OF ALCOHOL-RELATED PROBLEMS -- PREVENTION RESEARCH FROM A PUBLIC HEALTH PERSPECTIVE -- A SYSTEMS APPROACH -- References -- 2 Epidemiology of Alcohol-Related Problems -- INJURIES.

Methodological Problems in Studying Alcohol-Related Injuries -- Vehicular Injuries -- Falls -- Drownings -- Fires and Burns -- CRIME -- SUICIDE -- CHILD ABUSE -- SEXUALLY TRANSMITTED DISEASES -- EARLY SEXUAL ACTIVITY AND ADOLESCENT PREGNANCY -- FETAL ALCOHOL SYNDROME AND FETAL ALCOHOL EFFECTS -- References -- 3 Individual-Environment Interactions: Focus on the Individual -- LIFE-COURSE DEVELOPMENT, VULNERABILITY, AND PREVENTION RESEARCH -- The Developmental Approach: Rationale and Definitions -- The Life-Course Events Approach -- Social Fields -- Risk Factors: Intraindividual and Environmental Domains -- Individual-Environment Interaction -- The Prospective Study: Characteristics and Advantages -- Findings from Prospective Risk-Factor Research -- Limitations in Existing Prospective Research -- Research on Preventive Trials: Implications from Prospective Research -- Importance of Longitudinal Data Bases -- SOCIAL LEARNING MODELS -- Implications of Social Learning Theory for Research on Prevention -- The Coping Skills Training Approach -- Self-Management Techniques -- Cognitive Restructuring -- Motivation and Readiness to Change Behavior -- Life-Style Change -- GENETIC DETERMINANTS OF RISK -- CONCLUSION -- References -- 4 Individual Environment Interactions: Focus on the Environment -- ENVIRONMENTAL CONTROLS ON THE AVAILABILITY OF ALCOHOLIC BEVERAGES -- Studies That Measure the Effect of Multiple Influences on Consumption -- Studies That Measure the Effects of Specific Factors upon Consumption Alcohol Prices and Taxation -- Minimum Age of Purchase -- Zoning and Conditional-Use Permits -- ENVIRONMENTAL INFLUENCES ON INDIVIDUAL DRINKING BEHAVIOR -- The Normative Environment and the Mass Media -- Public Information Campaigns -- Commercial Alcohol Advertising -- Fictional Media Content -- The Legal Environment -- Alcohol-Impaired Driving.

Dram Shop or Server Liability -- Context and Setting as Environmental Influences -- Server Intervention -- Drinking Establishments -- The Workplace as a Drinking Setting -- FACTORS THAT AFFECT THE RISK OR SEVERITY OF THE NEGATIVE CONSEQUENCES OF DRINKING -- References -- 5 Community Approaches and Perspectives from Other Health Fields -- LIMITATIONS OF ALCOHOL PREVENTION RESEARCH -- COMMUNITY-BASED CARDIOVASCULAR DISEASE PREVENTION STUDIES -- Lessons from the Three-Community-Study and the Five-City Project -- Results from Other Comprehensive CVD Prevention Programs -- RESULTS FROM PRIMARY PREVENTION PROGRAMS IN OTHER HEALTH FIELDS -- Promoting Seat Belt Use -- Cancer Prevention through Mass Media Advertising -- Smoking Prevention and Cessation -- Preventing Adolescent Pregnancy through School-Based Clinics -- SUMMARY OF LESSONS LEARNED FROM OTHER FIELDS -- IMPLICATIONS FOR ALCOHOL PROBLEM PREVENTION -- References -- 6 Methodological Issues in Alcohol Prevention Research: Conclusions and Recommendations -- RESEARCH DESIGN FOR FUTURE ALCOHOL PREVENTION RESEARCH PROGRAMS -- The Importance of Theory -- Need for Both Laboratory and Field Prevention Research -- The Practical Significance of Prevention Research -- DIRECTION AND DESIGN OF FUTURE ALCOHOL PREVENTION RESEARCH PROGRAMS: CONCLUSIONS AND RECOMMENDATIONS -- References -- II RESEARCH OPPORTUNITIES IN THE TREATMENT OF ALCOHOL-RELATED PROBLEMS -- Introduction -- 7 The Social and Historical Context of Alcohol Treatment Research -- FEDERAL INVOLVEMENT IN ALCOHOL TREATMENT -- EMERGING TRENDS IN TREATMENT SERVICES -- DEMOGRAPHY, EPIDEMIOLOGY, AND THE DELIVERY OF TREATMENT SERVICES -- POPULAR TRENDS IN TREATMENT AND REFERRAL -- POLICY-ORIENTED SERVICES RESEARCH -- References -- 8 Issues of Assessment, Methodology, and Research Design -- RECENT DEVELOPMENTS IN CONCEPTUALIZATION.

ADVANCES IN ASSESSMENT TECHNOLOGY -- Diagnosis -- Differential Assessment -- Research on the Reliability and Validity of Assessments -- Research on Verbal Report Methods -- Use of Biological Markers -- Automation of Data Collection -- ASSESSMENT OF TREATMENT PROCESS, QUALITY, AND OUTCOME -- Treatment Variables -- Outcome Variables -- GROWING SOPHISTICATION IN METHODOLOGICAL APPROACHES -- Experimental Approaches -- Quasi-Experimental Approaches -- Aggregate-Level Descriptive Studies -- References -- 9 Treatment Modalities: Process and Outcome -- OUTCOME RESEARCH ON SPECIFIC TREATMENT APPROACHES -- Pharmacotherapies -- Antidipsotropics -- Effect-Altering Medications -- Psychotropics -- Aversion Therapies -- Psychotherapy and Counseling -- Didactic Approaches -- Mutual Help Groups -- Behavioral Self-Control Training -- Conjoint Therapies -- Broad-Spectrum Treatment Strategies -- Relapse Prevention -- RESEARCH ON TRADITIONAL TREATMENT PROGRAMS -- RESEARCH ON THE INTENSITY AND DURATION OF TREATMENT -- RESEARCH ON AFTERCARE -- TREATMENT PROCESS RESEARCH -- Mechanisms of Treatment Efficacy -- Therapist Variables -- Motivation -- Compliance -- Mandated Treatment -- CONCLUSIONS -- Does Treatment Work? -- Specific Conclusions -- References -- 10 Early Identification and Treatment -- CONTROLLED TRIALS AND PROGRAM EVALUATIONS -- BRIEF INTERVENTIONS AND TREATMENT RESEARCH -- RESEARCH ON INTERVENTIONS WITH PREGNANT WOMEN -- RESEARCH ON NONABSTINENCE OUTCOMES AND GOALS -- SCREENING, RECRUITMENT, AND IMPLEMENTATION -- Screening -- Recruitment -- Implementation -- References -- 11 Patient-Treatment Matching and Outcome Improvement in Alcohol Rehabilitation -- ADVANCES IN PATIENT-TREATMENT MATCHING RESEARCH, 1978-1988 -- Advances in Research Methodology -- Advances in Patient Measurement -- ADVANCES IN TREATMENT MEASUREMENT.

RESEARCH ON PATIENT-TREATMENT MATCHING: PERSPECTIVES AND OPPORTUNITIES -- Matching before Treatment Starts: Special Populations and Self-Selection -- Matching at the Initiation of Treatment: Levels of Treatment Intensity -- Matching during the Treatment Process: Role of Treatment Components -- Matching following the Rehabilitation Intervention: Role of the Posttreatment Environment -- PATIENT-TREATMENT MATCHING: SOME CONCLUSIONS AND RESEARCH RECOMMENDATIONS -- References -- 12 Advances in the Treatment of Other Psychoactive Substance-Use Disorders: Implications for Research on Treatment of… -- SMOKING -- Treatment Process Research -- Processes and Stages of Change -- Cognitive Predictors of Smoking Cessation -- Antecedents to Relapse and Coping Skills -- Social Support -- Motivational Factors -- Treatment Studies on Smoking Cessation -- Unique and Programmatic Approaches to Smoking Cessation -- Physician Counseling -- Special Populations -- OTHER DRUG DEPENDENCIES -- Use of Psychotherapy in the Treatment of Drug-Dependent Patients -- Conditioned Factors in Substance Abuse Treatment -- Psychopharmacological Treatments for Drug Dependence -- Medications That Treat the Associated Psychiatric Symptoms of Drug-Dependent Individuals -- CONCLUSIONS -- References -- 13 Health Consequences of Alcohol Abuse: Opportunities for Treatment Research -- INTOXICATION -- ALCOHOL WITHDRAWAL -- Pharmacotherapies for Alcohol Withdrawal -- Nonpharmacological Detoxification -- Withdrawal Scale -- Treatment Settings -- Special Patient Populations -- Treatment of Seizures -- Treatment of Delirium Tremens -- Engagement in Follow-up Treatment -- Detoxification of Alcoholics Addicted to Other Substances -- Alcoholic Hallucinosis and Paranoia -- Treatment of Post withdrawal Symptoms -- Insomnia in Alcoholics -- Effects of Alcohol on Sleep -- Sleep during Acute Alcohol Withdrawal.

Improvement with Abstinence.