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BRIEF RESEARCH REPORT article

Front. Psychiatry
Sec. Addictive Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1486278
This article is part of the Research Topic Addictive Disorders and Digital Medicine: Technology-based solutions for Addictive Disorders View all 7 articles

Is Internet-Based Cognitive Behavioral Therapy for alcohol use disorder equally effective for men and women? Implications of a secondary analysis of a clinical trial

Provisionally accepted
Greta Schettini Greta Schettini 1,2*Magnus Johansson Magnus Johansson 1,2Sam Andersson Sam Andersson 1Danilo Romero Danilo Romero 1,2Anne H Berman Anne H Berman 3Philip Lindner Philip Lindner 1,2
  • 1 Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
  • 2 Stockholm Health Care Services, Stockholm, Stockholm, Sweden
  • 3 Department of Psychology, Faculty of Social Sciences, Uppsala University, Uppsala, Uppsala, Sweden

The final, formatted version of the article will be published soon.

    INTRODUCTION Excessive alcohol use is a major public health concern, for which internet interventions have shown to be effective. Group-average effects may however mask substantial inter-individual variations in changes; identifying predictors of this variation remains an important research question. Biological sex is associated with pharmacokinetic differences in alcohol tolerance, which is reflected in many national guidelines recommending sex-specific thresholds for excessive drinking. Whether effects of internet interventions are moderated by sex, and whether any moderation is due to confounders, remains largely unexplored.AIM To examine sex-differences in outcomes (both response and remission) after an internet intervention for alcohol use disorder, and to identify any confounders.METHOD The current study is a secondary analysis of a randomized controlled trial. After identifying factors in which men and women differed at baseline, mixed effects models were re-run using a subsampling matching strategy.Men and women differed in baseline sum of drinks and self-rated anxiety. Sex was found to moderate (absolute) response but not remission, neither when using sex-specific or common thresholds for risky drinking. However, after controlling for baseline drinking through subsampling, the difference in response was no longer significant.CONCLUSION Our findings suggests that the apparent sex-difference in treatment response was confounded by intercept-slope correlationi.e. since men on average drank more at baseline, this offered larger room for decreasing. When conducting studies on internet interventions for addictive disorders, it is crucial to consider which outcomes to use, and how these are operationalized.

    Keywords: Addiction, Gender-difference, Sex-difference, alcohol, Digital interaction, cofounders

    Received: 25 Aug 2024; Accepted: 26 Nov 2024.

    Copyright: © 2024 Schettini, Johansson, Andersson, Romero, Berman and Lindner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Greta Schettini, Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm, 171 77, Stockholm, Sweden

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.