Difficulties In Emotion Regulation During Rehabilitation For Alcohol Addiction: Correlations With Metacognitive Beliefs About Alcohol Use And Relapse Risk

Figures & data

Figure 1 Study flow chart with exclusion criteria.

Table 1 Sociodemographic And Clinical Characteristics Of The Total Sample (n=65)

Variable	N (%)
Sex
Male	46 (70.7)
Female	19 (29.3)
Education
Low	35 (53.85)
Middle-high	30 (46.15)
Work status
Employed	19 (29.23)
Not employed	46 (70.77)
Comorbidity
Yes	40 (61.54)
No	25 (38.46)
Intervention
Pharmaco- & Psychotherapy	35 (53.85)
Psychotherapy only	30 (46.15)
Alcohol dependence
≤10 years	33 (50.77)
>10 years	32 (49.23)
Substance dependence
Pure Alcoholics	52 (80)
Polyabusers	13 (20)
Previous admissions
Yes	42 (64.61)
No	23 (35.39)
Age
Mean±SD	51.03±8.71
Audit
Mean ±SD	27.16±7.78

Abbreviation: SD, standard deviation.

Table 2 Changes In Median Scores Of Cognitive And Metacognitive Scales Pre (T0) And Post (T1) Rehabilitation

	Admission (T0)	Discharge (T1)	z	P	Cohen’s d
		Median (IQR)	Median (IQR)
Difficulties in emotion regulation scale (DERS)
Non-acceptance	14 (8–21)	10 (6–16)	4.39	<0.0001	0.54
Goals	13 (10–19)	10 (7–15)	3.35	<0.008	0.41
Strategies	21 (16–26)	16 (11–23)	3.17	<0.005	0.40
Impulse	11 (8–17)	8 (6–12)	3.65	<0.0002	0.45
Clarity	11 (8–15)	9 (6–14)	2.63	<0.008	0.32
Awareness	6 (4–10)	6 (3–8)	1.50	0.13	–
DERS Total	88 (64–150)	72 (52–145)	4.36	<0.0001	0.54
Positive alcohol metacognitions (PAMS)
Emotional Self Regulation	18 (10–22)	11 (0–18)	4.23	<0.0001	0.52
Cognitive Self Regulation	7 (4–9)	4 (0–6)	3.71	<0.0002	0.46
PAMS Total	26 (14–31)	15 (0–25)	4.14	<0.0001	0.51
Negative alcohol metacognitions (NAMS)
Beliefs about Uncontrollability	6 (3–9)	4 (0–7)	4.5	<0.0001	0.55
Cognitive Harm	9 (4–11)	9 (0–11)	0.85	0.39	–
NAMS Total	16 (7–19)	12 (0–17)	3.47	<0.0005	0.43
Penn Alcohol Craving Scale (PACS)
Craving	18 (15–21)	11 (5–16)	4.63	<0.0001	0.57
N, patients=65

Table 3 Changes In Mean Scores Of Psychological Scales Pre (T0) And Post (T1) Rehabilitation

	Admission (T0)	Discharge (T1)	t	P	Cohen’s d
		Mean (SD)	Mean (SD)
CBA-OE Subscales
Anxiety	24.70 (12.94)	12.75 (8.32)	7.773	<0.0001	1.09
Well-being	21.37 (11.07)	36.18 (10.63)	10.460	<0.0001	1.36
Perception of positive change	20.09 (7.21)	29.37 (6.15)	10.298	<0.0001	1.38
Depression	33.07 (15.28)	14.05 (9.97)	9.757	<0.0001	1.47
Psychological distress	30.53 (15.53)	11.87 (10.07)	8.982	<0.0001	1.42
N, patients=65

Table 4 Correlations Of DERS Total Score And Subscales With Psychological, Cognitive And Metacognitive Factors At Admission

	DERS Total	Non-acceptance	Goals	Strategies	Impulse	Clarity	Awareness
2. Anxiety	0.27*	0.13	0.21	0.34*	0.26*	0.18	0.05
3. Well-being	−0.31*	−0.14	−0.13	−0.39*	−0.17	−0.43*	−0.23
4. Perception of positive change	−0.28*	−0.16	−0.14	−0.33*	−0.18	−0.37*	−0.18
5. Depression	0.29*	0.13	0.24	0.36*	0.25*	0.29*	0.09
6. Psychological distress	0.24	0.05	0.15	0.27*	0.31*	0.24*	0.19
7. Positive alcohol metacognitions	0.36*	0.30*	0.38*	0.25	0.33*	0.36*	0.34*
8. Negative alcohol metacognitions	0.41*	0.31*	0.44*	0.40*	0.47*	0.20	0.09
9. Craving	0.21	0.15	0.33*	0.22	0.20	0.04	−0.05

Note: Values presented are Spearman correlation coefficient (r). *P value <0.05.

Figure 2 Box-plot of difficulties in “Emotional clarity” between abstinent or not subject at one month from discharge.

Figure 3 Box-plot of difficulties in “Emotional clarity” between subjects with low (PACS score ≤15) and high craving (PACS score >15) at discharge.

Figure 4 Clinical profile of psychological variables: T0 (admission); T1 (discharge).