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Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Juan, Puerto Rico, June 14-19, 2008.
Steven J. Ondersma, PhD (Wayne State University), Theresa M. Winhusen, PhD (University of Cincinnati/CinARC, OV Node), Yun Wang, MD (Wayne State University).
Although originally developed to help persons who are reluctant to change, evidence of the efficacy of Motivational Interviewing (MI) has led to its use with a range of individuals. Some investigations of this practice suggest that MI may be less efficacious, or even counter-productive, with persons who report adequate pre-treatment motivation. The present analysis examined whether a crossover interaction of baseline motivation and condition (disordinal moderation) could partially explain negative findings in protocol CTN-0013 (Winhusen et al, 2008). Participants in this analysis were 200 substance abusing pregnant women presenting for substance abuse treatment at 1 of 4 sites. Women were randomly assigned to either a 3-session Motivational Enhancement Therapy (MET) condition or treatment as usual (TAU). Two primary measures of baseline motivation were utilized: (a) the University of Rhode Island Change Assessment Questionnaire (URICA), and (b) a single question regarding the participant's drug use goal.
The primary outcome for this analysis was any positive urinalysis for drug use at either the 4- or 12-week follow-up. Effect size analyses revealed small nonsignificant trends in the expected direction, such that MET was more efficacious than TAU with those not seeking to quit permanently (logit d = .15), with the reverse being true for participants who indicated a desire to quit permanently (logit d = -.10). However, this effect was not significant in logistic regression analyses controlling for drug use at baseline. Further, this effect was not present (and was even reversed) in some analyses of specific drugs and/or follow-up points. In conclusion, these findings highlight the often-neglected truth that moderation effects are unstable and should be interpreted with caution. Disordinal moderation of MET efficacy by baseline motivation does not appear to have contributed to the negative results of CTN-0013. (Poster, PDF, English, 2008)
 Keywords: Behavior therapy | CTN platform/ancillary study | Gender-specific interventions | Motivational Enhancement Therapy (MET) | Motivational interviewing (MI) | Pregnant women | University of Rhode Island Change Assessment (URICA) | Women | College on Problems of Drug Dependence (CPDD) annual meeting, 2008
Document No: 304
Submitted by Steven Ondersma, PhD, Wayne State University, 9/2008. |
