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Title: "Motivational subtypes: Exploring behavior change variables and drinking outcomes among at risk drinkers admitted to a trauma unit." Presented at the Research Society on Alcoholism (RSA) annual meeting, San Diego, CA, June 2009.

Abstract: Alcohol use plays a major role in causing of injury and in emergency medical admissions.  Medical settings provide clinicians with a unique opportunity to intervene with risky alcohol users who are not presenting for substance abuse treatment.  Since these individuals may be more or less motivated for change, examining readiness to change, an important component of the intentional behavior change process, would be important.  The current study attempted to replicate the five group cluster solution of DiClemente and Hughes (1990) using four stage based URICA subscales with a clinical sample and examined readiness to modify risky drinking of patients admitted to a trauma unit and how readiness related to other change variables including: temptation and confidence related to drinking too much, processes of change, and drinking consequences, as well as subsequent drinking behavior.  Five motivational profiles, similar to those previously found, emerged as reasonable clusters in this sample.  However, percentages of individuals classified into each subtype differed somewhat, with fewer individuals in the current sample falling into the Precontemplation cluster (13% in the current sample vs. 28% in the previous sample) and more individuals falling into the Contemplation cluster (31% vs. 24%) and the Ambivalent cluster (20% vs. 13%).  These motivational subtypes differed significantly on levels of: temptation, self-efficacy, processes of change, and drinking consequences with the Precontemplation, Uninvolved, and Contemplation groups reporting less temptation, greater self-efficacy, and fewer drinking related consequences as compared to the Ambivalent and Participation groups. The Precontemplation and Uninvolved groups also used fewer processes of change as compared to the Ambivalent and Participation groups.  Although motivational subtypes did not differ significantly on baseline drinking, they demonstrated significant differences in drinks per drinking day at the six-month follow-up controlling for baseline drinking and intervention assignment.  The Precontemplation and Uninvolved groups reported more drinks per drinking day than the Contemplation and Participation groups.  These relations among the motivational subtypes, the behavior change variables, and the drinking outcomes support the utility of looking at patient attitudes and intentions related to change in clinical settings to inform treatment planning and outcome prediction.