Mike Anestis commented on 'Not all emotions are created equal: The difference between positive and negative urgency'

2009-06-01T18:19:10Z

This was a great comment and I've spent a lot of time thinking about my response over the past few days. In fact, my next article will be on Project Match, a study that examined the relative effectiveness of AA, cognitive therapy, and motivational enhancement theapy in the treatment of alcohol use disorders. In this study, the authors concluded that all three treatments were equally effective (with folks in AA showing better results on a selection of secondary variables not directly related to alcohol use) and that matching clients based on particular characteristics to certain treatments is not effective.

In that Project Match study, there were a number of problems that I'll highlight in detail in the coming article, but one of the central problems is that a variety of potentially important variables were not measured. Drinking motives, which had been the subject of research prior to the onset of the study, were not included. As such, there is no data indicating whether drinking to cope should be treated differently than drinking to enhance positive affect or drinking for social reasons.

Positive and negative urgency were not yet being researched when Project Match happened, so the authors can not be faulted for not measuring them; however, their absense leaves a gaping hole in our understanding of the degree to which patient characteristics might necessitate particular treatment approaches.

It seems reasonable to me that different drinking motives will result in differential treatment response. Yes, the behavior is the same regardless of motive - alcohol is being consumed excessively and physiological dependence has developed - but the motivation for drinking and the context within which the behavior occurs is different. Perhaps the data will show that neither motives nor variables like positive and negative urgency make a difference, but until we see that data, I'll remain highly skeptical of that possibility.

Thanks for the comment! It's given me a lot to think about.

Jan commented on 'Not all emotions are created equal: The difference between positive and negative urgency'

2009-05-29T20:54:31Z

As a non-professional I must admit that I did not sail through this post. This happened because the article is, as you pointed out, rather scientific and esoteric. However when the articles are more technical, I’ve discovered that if I can plod through a first read, a second read is much more interesting.

After reading your post a second time, and taking much more from it, I remembered that I also skimmed the article on drinking motives, more so for a not relevant to my personal or professional experience (as a teacher for children and adolescents in a residential psychiatric setting) than for the scientific and esoteric barrier. So I reread that post as well, and here is the question I come away with:

If I were asked about treatment for alcohol abuse, I would answer that some people need treatment in a residential setting in order to “dry out” but that for some people AA is enough and for those who need residential placement, AA is still a pretty strong part of their recovery. I have no idea if that is correct, as my opinion is largely based upon movies (Sandra Bullock’s 28 Days for example) and television, like the youngest brother in Brothers and Sisters.

Has this been studied? Does AA work as successfully as fictional media portrays? And if it does work, is the success similar for individuals high in positive urgency and for those high in negative urgency? I would think this an important distinction for lay people to be exposed to, because if AA does not work for both drinking motivations, it would be unfair to impart onto the person who fails in AA a lack of effort, when perhaps the 12 step program simply does not address the reason that person abuses alcohol.

Comments on Not all emotions are created equal: The difference between positive and negative urgency

Mike Anestis commented on 'Not all emotions are created equal: The difference between positive and negative urgency'

Jan commented on 'Not all emotions are created equal: The difference between positive and negative urgency'