Citation

Cheng B, Coates JM, Gullo MJ, Chan G, Kavanagh DJ, Feeney GFX, Young RMD, Clark PJ, Connor JP. Alcohol Clin. Exp. Res. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1111/acer.14938

PMID

36098356

Abstract

BACKGROUND AND AIMS: For most treatment-seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non-specific about treatment consumption goals, which limit effectiveness. Desires and mental imagery are relevant in motivation for AUD treatment engagement. The Motivational Thought Frequency Scale modified for an abstinence goal (MTF-A) was adapted from MTF for controlled drinking (MTF-CD). This study psychometrically evaluated the MTF-A in an alcohol dependent sample engaged in treatment with an abstinence goal. To enhance clinical use of the scale, a secondary aim was to consider application of a psychometrically equivalent short version of the MTF-A.

METHOD: A sample (N = 329) of treatment-seeking AUD patients (mean age of 44.44 years, SD = 11.89 years, 72% male) undertaking a Cognitive Behavioural Treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF-A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF-A measured motivation for abstinence through four factors: intensity, self-efficacy imagery, incentives imagery, and availability. Confirmatory Factor Analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first-session treatment non-attendance and alcohol consumption between baseline assessment and treatment, controlling for potential confounds.

RESULTS: A four-factor structure provided best fit for the MTF-A, compared with one- and three-factor models. A shortened 9-item MTF-A scale (S-MTF-A) provided better fit than the 13-item MTF-A scale. Both MTF-A and S-MTF-A displayed good internal consistency. Both MTF-A and S-MTF-A successfully predicted first-session treatment non-attendance, but neither predicted alcohol consumption between baseline assessment and treatment.

CONCLUSIONS: The four-factor S-MTF-A displayed superior model fit compared to the original 13-item MTF-A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation.

Language: en

Keywords

alcohol; Alcohol use disorder; treatment motivation