OBJECTIVE In a randomized trial for women with alcohol use disorders (AUD), the efficacy of Female-Specific Cognitive Behavioral Therapy (FS-CBT) was compared with Gender-Neutral CBT (GN-CBT; Epstein et al., 2018). The current study examined whether putative mechanisms of change differed between treatment conditions, using a novel statistical approach. Both treatments were hypothesized to work by increasing use of alcohol-related coping skills (coping) and confidence to abstain from drinking (confidence), but FS-CBT additionally targeted female-salient mechanisms: anxiety, depression, sociotropy (i.e., overinvestment in others' opinion of oneself), autonomy, and social networks supportive of abstinence. METHOD Ninety-nine women with AUD (55 in GN-CBT, 44 in FS-CBT) completed self-report assessments at baseline and 0, 6, and 12 months posttreatment. Multilevel vector autoregression estimation was used to analyze associations between putative mechanisms of change, and network models of those associations were generated using network analysis. RESULTS Across conditions, higher confidence and coping were directly associated with less drinking; autonomy was directly and indirectly associated with drinking. Additionally, network analysis indicated that although variation in depression was associated with change in other variables specifically for GN-CBT, sociotropy was associated with change specifically in FS-CBT. CONCLUSIONS Women receiving CBT-AUD changed their drinking through increased confidence to abstain and greater use of coping skills. Autonomy played a central role in behavior change across treatment conditions. Participants receiving treatment tailored to women also changed through decreases in sociotropy and increases in social support for abstinence. For women who received standard CBT, changes in depression were important to clinical improvement. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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酒精使用障碍女性的女性特异性和中性认知行为疗法的变化机制。

目的在一项针对酒精中毒症（AUD）的女性的随机试验中，将女性特定认知行为疗法（FS-CBT）与性别中性CBT（GN-CBT; Epstein等人，2018）的疗效进行了比较。当前的研究使用一种新颖的统计方法检查了治疗条件之间的假定变化机制是否不同。假设这两种疗法都可以通过增加使用酒精相关的应对技巧（应付）和戒酒的信心（信心）来起作用，但是FS-CBT还针对女性显着机制：焦虑，抑郁，社交性（即对其他方面的过度投资） （对自己的看法），自主权和支持禁欲的社交网络。方法九十九名患有AUD的妇女（GN-CBT中为55，FS-CBT中为44）在基线时完成了自我报告评估，而0、6，和治疗后12个月。多级向量自回归估计用于分析假定的变化机制之间的关联，并使用网络分析生成这些关联的网络模型。结果在各种情况下，较高的自信心和应对与减少饮酒直接相关。自主与饮酒直接或间接相关。此外，网络分析表明，尽管抑郁症的变化与其他专门针对GN-CBT的变量的变化有关，但社会适应力却与FS-CBT的变化特别相关。结论接受CBT-AUD疗法的女性通过增加戒酒信心和更多地使用应对技巧来改变饮酒习惯。自主性在不同治疗条件下的行为改变中起着核心作用。接受针对妇女的治疗的参与者还因社会适应力的下降和禁欲的社会支持的增加而发生了变化。对于接受标准CBT的女性来说，抑郁的变化对于临床改善很重要。（PsycINFO数据库记录（c）2020 APA，保留所有权利）。