Alcohol use disorder in socially stable women receiving outpatient treatment : Individual characteristics of importance for onset age and treatment outcome

Abstract: Socially stable women with alcohol use disorder (AUD) are seldom studied separately and are often marginalized in treatment of substance abuse. The overall aim of this thesis was to examine variables of importance in relation to age at onset of AUD and treatment outcome.Study I, which included 338 men and women being treated for AUD, showed that women had a significantly later onset and shorter duration in excessive alcohol use as well as less weekly pure alcohol intake than men. Participants with earlier onset of excessive alcohol use reported significantly more psychiatric symptoms and more immature personality traits than those with later onset. Study II-IV included 75 women with AUD receiving outpatient treatment. Of the participants, 68% reported a history of childhood maltreatment. Emotional abuse and their mother’s alcohol and/or substance problems were independent predictors of earlier age at onset of AUD. In Study III treatment outcome was measured as a change in alcohol consumption. A more positive change, especially with regard to abstinence, was found in women who did not report childhood abuse. Study IV showed that, at 12month follow up, most of the participants had reached their end-oftreatment goal either abstinence or low-risk drinking. However, those with a goal of abstinence at the end of treatment showed significantly less risk drinking than those with low-risk drinking as a goal. The most important predictor of abstinence at the 12-month follow up was having abstinence as an end –of –treatment goal. These results indicate the importance of identifying and addressing childhood trauma in treating socially stable women with AUD. Focusing on motivational changes during treatment may also be of importance, especially in patients with relapses, as abstinence still is the most stable treatment option.