Within Sex Differences from a Clinical Trial of Digital Cognitive Behavioral Therapy for Alcohol Use Disorder Among a Nontreatment Sample.

BACKGROUND

While rates of alcohol use disorder (AUD) have been rising faster among women than among men, women remain less likely than men to receive any treatment. The present study examined acceptability and usability of digital cognitive behavioral therapy computer based training for cognitive behavioral therapy (CBT4CBT) by sex and explored within-sex associations between study condition and AUD outcomes in a nontreatment-seeking sample.

METHODS

Exploratory analyses used data from a clinical trial of CBT4CBT for AUD among an online sample of people with lifetime AUD who were not receiving AUD treatment (N = 160 total; females: n = 83 cognitive behavioral therapy [CBT], n = 26 contro [Co]; males: n = 39 CBT, n = 12 Co). Study assessments were administered at baseline, postintervention, and 1-month follow-up and included self-reported alcohol use, recovery, and acceptability measures. Sex differences and within-sex comparisons were assessed using t-tests, chi-square tests, Fisher exact tests, and sex-stratified random-effects regressions.

RESULTS

Female participants were 44.3 (standard deviation [SD] = 15.8) years of age, and the majority were White (73.4%). Male participants were 38.8 (SD = 15.1) years of age and were primarily White (47.1%) or Black (43.1%). The percentage of participants with heavy drinking days was lower in the CBT4CBT group among female participants at postintervention and among male participants at the 1-month follow-up. Random-effects regressions indicated a significant intervention effect on the percentage of drinking days among female participants. CBT4CBT acceptability and usability were high across sexes, barring a few exceptions specifically among female participants.

CONCLUSIONS

Both male and female participants experienced significant intervention effects. Acceptability data and within-sex associations between study condition and outcomes identified potential areas for improving online alcohol interventions for women.