%0 Journal Article
%T Using a randomized controlled trial to test whether modifications to contingency management improve outcomes for heavy drinkers with serious mental illness
%J Contemporary clinical trials
%D 2018
%A Oluwoye, Oladunni
%A Skalisky, Jordan
%A Burduli, Ekaterina
%A Chaytor, Naomi S.
%A McPherson, Sterling
%A Murphy, Sean
%A Herron, Jalene
%A Hirchak, Katherine
%A Burley, Mason
%A Ries, Richard K.
%A Roll, John M.
%A McDonell, Michael G.
%V 69
%N 
%P 92-98
%X BACKGROUND: In contingency management (CM), individuals receive rewards for alcohol abstinence. CM is associated with reduced alcohol use in adults with co-occurring serious mental illnesses (SMI). Pre-treatment urine ethyl glucuronide (uEtG) levels equivalent to daily heavy drinking (uEtG > 349 ng/mL) are associated with poor response to CM. Modifications to CM are needed to improve outcomes for non-responders. AIMS: To determine if pre-treatment heavy drinkers, defined by uEtG, with SMI achieve higher levels of alcohol abstinence when they receive an increased magnitude of reinforcement for abstinence (High-Magnitude CM) or reinforcers for reduced drinking, prior to receiving reinforcers for abstinence (Shaping CM), relative to those who receive typical low-magnitude abstinence based CM (Usual CM). Additionally, variables in the Addictions Neuroclinical Assessment model will be examined as treatment response moderators. <br><br>METHODS: Participants (N = 400) will be recruited from two urban mental health organizations and complete a 4-week induction periodwhere they will be reinforced for submitting samples for uEtG testing. Participants who attain a mean uEtG > 349 mg/mL will be randomized to receive either Usual CM, High-Magnitude CM, or Shaping CM for 16 weeks. Differences in abstinence, assessed by uEtG, will be examined during treatment and during a 12-month follow-up. Measures of negative emotionality, alcohol reinforcer salience, and executive functioning will be gathered at study intake and used to predict treatment outcomes. <br><br>DISCUSSION: This novel approach to CM will use an alcohol biomarker to identify those at risk for treatment non-response and determine if adaptations to CM might improve outcomes for this group.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 1551-7144
%U http://dx.doi.org/10.1016/j.cct.2018.04.010