SPONTANEOUS REMISSION AMONG UNTREATED PROBLEM DRINKERS (FROM LONGITUDINAL RESEARCH ON DRUG USE - EMPIRICAL FINDINGS AND METHODOLOGICAL ISSUES, 1978, BY DENISE B KANDEL - SEE NCJ-50219)

• NCJ Number: 50627
• Author(s): R ROLZEN; D CAHALAN; P SHANKS
• Date Published: 1978
• Length: 25 pages
• Grant Number(s): AA00275-6
• Sponsoring Agency: US Dept of Agriculture
• Corporate Author: Hemisphere Publishing Corp
• Publication Format: Document
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

METHODOLOGICAL ISSUES IN LONGITUDINAL RESEARCH ON SPONTANEOUS REMISSION FROM ALCOHOL-RELATED PROBLEMS ARE EXAMINED, WITH REFERENCE TO DATA FROM A STUDY OF REMISSIONS AMONG A SAMPLE OF WHITE ADULT MALES.

Abstract

THE FOLLOWING TWO ISSUES ARE CONSIDERED: (1) THE IMPACT THAT VARYING THE CRITERIA OF ALCOHOLISM AND THE DEFINITION OF REMISSION CAN HAVE ON ESTIMATES OF CERTAIN BACKGROUND FEATURES OF SPONTANEOUS REMISSION RESEARCH DESIGN, SUCH AS WHETHER REMISSION IS SCORED ONLY IN THE DIRECTION OF IMPROVEMENT OR AS A TWO-WAY CHANGE VARIABLE, CAN INFLUENCE FINDINGS. STUDY DATA WERE DRAWN FROM A SAMPLE OF WHITE, NONINSTITUTIONALIZED MALES AGED 29 TO 59 LIVING IN SAN FRANCISCO, CALIF. THE SUBJECTS WERE ASKED ABOUT THEIR DRINKING PATTERNS AND PROBLEMS, PSYCHOLOGICAL ADJUSTMENT, LIFE CIRCUMSTANCES, AND DEMOGRAPHIC CHARACTERISTICS IN TWO STUDIES CONDUCTED 4 YEARS APART. A TOTAL OF 615 RESPONDENTS COMPLETED BOTH STUDIES. IN THIS SAMPLE, VARIATIONS IN OUTCOME CRITERIA AND CRITERIA FOR DEFINING PROBLEM DRINKING PRODUCED IMPROVEMENT RATES VARYING FROM 11 TO 71 PERCENT. ALTHOUGH REMISSION LEVELS ARE HIGHLY RESPONSIVE TO MEASUREMENT CRITERIA, THE GENERAL TREND IS CLEAR: BY MOST CRITERIA, THERE WAS A SUBSTANTIAL AMOUNT OF SPONTANEOUS REMISSION OF DRINKING PROBLEMS IN A POPULATION IN WHICH THE OVERALL TREND WAS STABLE OR EVEN INCREASING. THE IMPLICATION IS THAT THE CONVENTIONAL CLINICAL PICTURE OF DRINKING PROBLEMS AS RELATIVELY STABLE, LASTING PHENOMENA MAY NEED CHANGING TO ACCOUNT FOR A SIGNIFICANT AMOUNT OF EPISODIC AND SITUATIONAL FLUX IN A LARGE SEGMENT OF THE DRINKING POPULATION. IN MEDICAL CONCEPTUALIZATIONS OF ALCOHOL-RELATED PROBLEMS, REMISSION IS HANDLED AS A PROGNOSTIC MATTER. STUDIES FOLLOW PREVIOUSLY DIAGNOSED CASES OVER TIME, EXPLORING FACTORS ASSOCIATED WITH IMPROVEMENT AND NONIMPROVEMENT. HOWEVER, REMISSION CAN BE VIEWED AS A DIAGNOSTIC MATTER, REQUIRING MODIFICATIONS IN THE LOGIC AND PRACTICE OF PROGNOSTIC STUDIES. A DIAGNOSTIC APPROACH TO REMISSION MIGHT BE ORIENTED AROUND SAMPLES THAT INCLUDE BOTH REPUTEDLY POSITIVE AND NEGATIVE CASES, AROUND MEASURES OF CHANGE THAT MOVE IN BOTH DIRECTIONS, AND AROUND INDEPENDENT VARIABLES DRAWN FROM DIAGNOSTIC PROTOCOLS. BY SEPARATING OUT AND SYSTEMATICALLY VARYING THE DIMENSIONS OF ALTERNATIVE RESEARCH STRATEGIES, IT IS SHOWN THAT THE SUBSTANTIVE RESULTS OF REMISSION STUDIES ARE IN PART BYPRODUCTS OF THE WAY THE RESEARCH PROBLEM HAS BEEN DEFINED AND THE RESEARCH DESIGN IMPLIED BY EACH PROBLEM DEFINITION. SUPPORTING DATA AND LIST OF REFERENCES ARE INCLUDED. (LKM)