Abstract Background: This study aimed to investigate the feasibility of a 3-month Dialectical Behavior Therapy Skills Training stand-alone outpatient program (DBT-ST-OP) for alcohol use disorder (AUD) by comparing primary and secondary outcomes with the same intervention provided in a mixed format (inpatient + outpatient). The study also assessed experiential avoidance (EA) changes during treatment and its early predictive role in treatment retention. Ultimately, the mediating role of difficulties with emotion regulation (DER), EA changes, and the functional relationships between them were explored in relation to abstinence maintenance (AM).Methods: A voluntary sample of 171 treatment-seeking individuals with AUD was consecutively admitted. AM was indicated by random weekly urine toxicological screening. DER and EA were assessed at the beginning, after 1 month, and at the end of treatment. Two serial multiple mediational models were estimated.Results: DBT-ST-OP showed more beneficial primary (i.e., AM, attrition rate, treatment attendance) and secondary (i.e., DER levels) outcomes compared with the same treatment provided in a mixed format. EA significantly decreased during the treatment, independently of baseline levels. Further, it did not represent an early predictive factor for drop-out. DER changes were a full mediator of AM and explained EA changes during the treatment.Conclusion: DBT-ST is a feasible stand-alone outpatient program for AUD. DER represents a relevant therapeutic process in explaining AM and EA changes. Future controlled and follow-up studies should focus on the efficacy of DBT-ST in treating AUD and evaluate the role of DER and EA in long-term relapse prevention.

中文翻译：

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辩证行为治疗技能培训作为治疗酒精使用障碍的门诊项目的可行性：情绪调节和经验回避困难的作用

摘要 背景：本研究旨在通过将主要和次要结果与提供的相同干预措施进行比较，调查为期 3 个月的辩证行为治疗技能培训独立门诊计划 (DBT-ST-OP) 用于酒精使用障碍 (AUD) 的可行性。以混合形式（住院+门诊）。该研究还评估了治疗期间的体验回避 (EA) 变化及其在治疗保留中的早期预测作用。最终，探讨了情绪调节困难 (DER)、EA 变化以及它们之间的功能关系与戒断维持 (AM) 之间的中介作用。 方法：连续入院的 171 名寻求治疗的 AUD 个体的自愿样本. AM 由每周随机尿液毒理学筛查指示。DER 和 EA 一开始就进行了评估，1个月后，治疗结束时。估计了两个串行多重中介模型。结果：与以混合格式提供的相同治疗相比，DBT-ST-OP 显示出更有益的主要（即，AM、流失率、治疗出席率）和次要（即，DER 水平）结果。EA 在治疗期间显着降低，与基线水平无关。此外，它并不代表辍学的早期预测因素。DER 变化是 AM 的完整中介并解释了治疗过程中 EA 的变化。结论：DBT-ST 是一种可行的 AUD 独立门诊计划。DER 代表了解释 AM 和 EA 变化的相关治疗过程。未来的对照和随访研究应侧重于 DBT-ST 治疗 AUD 的疗效，并评估 DER 和 EA 在长期预防复发中的作用。