Changes in alcoholic patients' coping responses predict 12-month treatmentoutcomes

Patient subtypes (Types A and B alcoholism), determinants, and outcomes ass ociated with changes in coping responses of 133 alcoholic patients in the y ear following admission to treatment were examined. In general, patients' u se of avoidance coping declined and use of approach coping increased. Type B patients used more avoidance coping than did Type A patients, but the sub types did not differ in rate of change in coping. As a determinant of copin g, cognitive appraisal of threat showed a trend toward predicting avoidance coping at 6- and 12-month follow-ups. Decreased cognitive avoidance coping (e.g., daydreaming) predicted fewer alcohol, psychological, and interperso nal problems. Increased behavioral approach coping (e.g,, taking action) pr edicted lower severity of alcohol problems. Further study of changes in the cognitive aspects of coping (i.e., appraisals and cognitive avoidance copi ng) is needed to determine mechanisms underlying cognitive processes associ ated with treatment outcomes.