Citation

Moxley-Kelly N, Ouimet MC, Dongier M, Chanut F, Tremblay J, Marcantoni W, Brown TG. Alcohol Clin. Exp. Res. 2019; 43(2): 324-333.

Affiliation

McGill University.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/acer.13935

PMID

30536575

Abstract

AIMS: Heterogeneity in the driving while impaired (DWI) offender population and modest outcomes from remedial programs are fueling interest in clarifying clinically significant DWI subtypes to better assess recidivism risk and target interventions. Previously, Brown et al. (2016) identified two putative behavioral phenotypes of DWI offenders with distinct behavioural, personality, cognitive and neurobiological profiles: 1) offenders primarily engaging in DWI (pDWI); and 2) offenders engaging in DWI and other traffic violations (MIXED). Here we evaluate these phenotypes' clinical significance for prediction of recidivism and intervention targeting.

METHOD: DWI recidivists participating in a previous randomized controlled trial (N = 184; Brown et al., 2010; Ouimet et al., 2013) comparing brief Motivational Interviewing (BMI) and an information and advice control condition (IA) were retrospectively classified as either pDWI (n = 97) or MIXED (n = 87). Secondary analyses then evaluated the effect of this phenotypic classification on self-reported 6- and 12-month alcohol misuse outcomes and documented 5-year DWI recidivism violations, and in response to either BMI or IA (i.e., pDWI-BMI, n = 46; MIXED-BMI, n = 45; pDWI-IA, n = 51; MIXED-IA, n = 42). Two hypotheses were tested: 1) MIXED classification was associated with poorer alcohol misuse outcomes and recidivism outcomes than pDWI classification; and 2) pDWI paired with BMI was associated with better outcomes compared to MIXED paired with BMI.

RESULTS: MIXED classification was associated with significantly greater risk of recidivism over the 5-year follow-up compared to pDWI classification. Moreover, the pDWI-BMI pairing was associated with significantly decreased recidivism risk compared to the MIXED-BMI pairing. Analyses of 6- and 12-month alcohol use outcomes produced null findings.

CONCLUSIONS: The clinical significance of phenotypic classification for risk assessment and targeting intervention was partially supported with respect to recidivism risk. Prospective investigation of this and other behavioural phenotypes is indicated. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

alcohol; brief intervention; driving while impaired; motivational interviewing; phenotype; treatment responsivity; typology