Predicting Post-Treatment-Initiation Alcohol Use Among Patients With Severe Mental Illness and Alcohol Use Disorders

Clara M. Bradizza, Stephen A Maisto, Paula C. Vincent, Paul R. Stasiewicz, Gerard J. Connors, Nicole D. Mercer

Research output: Contribution to journalArticle

13 Scopus citations


Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD). At 6-months follow-up, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment, with participants who lived in supervised settings (41%) reporting significantly more days of treatment (β = .34, p < .001). In addition, participants with more psychiatric symptoms, as assessed with the Brief Symptom Inventory and Structured Clinical Interview for the Positive and Negative Syndrome Scale, reported significantly fewer treatment days (β = -.20, p < .001). Number of days that participants attended treatment was indirectly associated with alcohol use outcomes and was mediated by use of alcohol-specific coping skills, such that more frequent use of such skills was associated with less post-treatment-initiation alcohol use (β = -.34, p < .001). This study emphasizes the favorable prognosis for alcohol outcomes among treated individuals with SMI and AUD and the importance of psychosocial interventions, particularly those that result in better alcohol-specific coping skills.

Original languageEnglish (US)
Pages (from-to)1147-1158
Number of pages12
JournalJournal of Consulting and Clinical Psychology
Issue number6
StatePublished - Dec 2009



  • alcohol outcome
  • bipolar disorder
  • dual diagnosis
  • schizophrenia
  • severe mental illness

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this