The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders

The effects of the antidepressant venlafaxine (VEN-225 mg daily) and transdiagnostic cognitive behavioral treatment (CBT) alone and in combination on alcohol intake in subjects with co-morbid alcohol use disorders (AUDs) and anxiety disorders were compared. Drinking outcomes and anxiety were assessed for 81 subjects treated for 11 weeks with one of 4 conditions: 1) VEN–CBT, 2) VEN-Progressive Muscle Relaxation therapy (PMR), 3) Placebo (PLC)-CBT and 4) a comparison group of PLC-PMR. For subjects who reported taking at least one dose of study medication, the Time × Group interaction was significant for percent days of heavy drinking and drinks consumed per day. For the measure of percent days heavy drinking, the paired comparison of PLC-CBT versus PLC-PMR group indicated that the PLC-CBT group had greater drinking reductions, whereas other groups were not superior to the comparison group. In Week 11, the proportion of subjects in the PLC-CBT group that had a 50% reduction from baseline in percent days heavy drinking was significantly greater than those in the comparison group. Of the 3 “active treatment” groups only the PLC-CBT group had significantly decreased heavy drinking when contrasted to the comparison group. This finding suggests that the transdiagnostic CBT approach of Barlow and colleagues may have value in the management of heavy drinking in individuals with co-morbid alcoholism and anxiety.     

Parental Communication of Responsiveness and Control as Predictors of Adolescents' Emotional and Behavioral Resilience in Families with Alcoholic Versus Nonalcoholic Parents

Interactions between parents and children establish norms for managing emotions and behavior, which are markers of resilience. This study examines how features of interpersonal communication between parents and children facilitate the resilience of children of alcoholic parents versus nonalcoholic parents. Parent–adolescent dyads (30 families of alcoholics, 30 families of nonalcoholics) were invited to participate in two videotaped interactions, which were then rated for parental responsiveness and control and adolescent emotion regulation and behavioral impulsivity. Parental responsiveness was positively associated with emotion regulation, and parental control was negatively associated with emotion regulation and positively associated with impulsivity. Moderation analyses point to several notable differences in the effects for alcoholic versus nonalcoholic families.