Disorders - Alcohol Use
Lindgren, K. P., Wiers, R. W., Teachman, B., Gasser, M. L., Westgate, E. C., Enkema, M., Neighbors, C.
Implicit alcohol associations predict unique variance in alcohol outcomes, and they may represent untapped targets for treatment. Tasks that attempt to modify such associations to be more adaptive have been developed, and there is preliminary evidence that those training tasks can shift these associations and improve treatment outcomes. We sought to replicate and extend those findings in US undergraduates who were social drinkers (Study 1) or at-risk hazardous drinkers (Study 2). In both studies, we tested three adaptations of a previously used training task, the approach avoid task. One adaptation targeted implicit alcohol approach associations - associations that predict hazardous drinking and that have been successfully modified via this task in European college students and in European adults receiving inpatient alcohol treatment. The remaining two adaptations targeted implicit drinking identity associations - associations that have recently been found to the most consistent and robust predictors of drinking in US undergraduates. In study 1, we recruited 300 undergraduates who drank at least 4/5 drinks (for women/men) in the last 30 days. They were randomly assigned to one of three training types and then to either real or sham training conditions. They completed two, weekly training sessions. In study 2, we recruited 288 undergraduates who were at risk for alcohol use disorders. The same training procedures were used, but the two training sessions occurred in a single week. Results were not as expected. Across both studies and all three training types, there were no consistent effects of training on implicit alcohol associations or alcohol outcomes (craving, future drinking intentions, preferences for alcohol-related stimuli, or drinking refusal self-efficacy). Training does not appear to be effective at this dosage in US undergraduates. Findings from these studies are important because such studies are extremely costly and labor-intensive to conduct. Future research may benefit from focusing on more severe populations, increasing training dose, and increased gamification of the training tasks.
Alcoholism: Clinical & Experimental Research, 39 : 30A
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Lammers, J., Goossens, F., Conrod, P., Engels, R., Wiers, R.W., Kleinjan, M.
Aim: The effectiveness of Preventure was tested on drinking behaviour of young adolescents in secondary education in the Netherlands. Design: A cluster randomized controlled trial was carried out, with participants assigned randomly to a two-session coping skills intervention or a control no-intervention condition. Setting: Fifteen secondary schools throughout the Netherlands; seven schools in the intervention and eight schools in the control condition. Participants: A total of 699 adolescents aged 13-15 years participated, 343 allocated to the intervention and 356 to the control condition, with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation-seeking. Intervention and comparator: Preventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control. Measurements: The effects of the intervention on the primary outcome past-month binge drinking, and the secondary outcomes binge drinking frequency, alcohol use, alcohol frequency and problem drinking, were examined. The primary analyses of interest were intervention main effects at 12 months post-intervention. In addition, intervention effects on the linear development of binge drinking using a latent-growth curve approach were examined. Findings: Binge drinking rates were not significantly different between the intervention (42.9%) and control group (49.2%) at 12 months follow-up [odds ratio (OR) = 1.05, confidence interval (CI) = 0.99, 1.11]. Intention-to-treat analyses revealed no significant intervention effects on alcohol use (53.9 versus 61.5%; OR = 0.99, CI = 0.86, 1.14) and problem drinking (37.0 versus 44.7%; OR = 1.03, CI = 0.92, 1.10) at 12 months follow-up. The post-hoc latent-growth analyses revealed significant effects on the development of binge drinking (beta = -0.16, P = 0.05), and binge drinking frequency (beta = -0.14, P = 0.05). Conclusion: The alcohol prevention programme, Preventure, appears to have little or no effect on overall prevalence of binge drinking in adolescents in the Netherlands but may reduce the development of binge drinking over time. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Addiction, 110(7) : 1101-1109
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Skills training, Other Psychological Interventions, Personalised feedback, normative feedback
LaBrie, J. W., Napper, L. E., Grimaldi, E. M., Kenney, S. R., Lac, A.
Students with poor mental health are at increased risk for problematic alcohol use. These students also tend to underutilize alcohol-related protective behavioral strategies (PBS). Cross-sectional studies indicate that PBS use may be particularly useful for students with mental health challenges; however, it is unclear whether training these students to use PBS is an effective approach for reducing alcohol use and consequences. The current study evaluated the efficacy of a standalone PBS skills training and personalized feedback (PBS-STPF) intervention among students accessing mental health services. Participants (N = 251) were randomly assigned to either an individual facilitator-led PBS-STPF intervention or a health-related control condition. Participants completed online follow-up surveys 1 and 6 months post-intervention which included measures of alcohol use, negative consequences, and a composite measure of PBS use. Relative to control participants, students in the PBS-STPF condition reported significantly greater PBS use but no differences in alcohol use or consequences. Participants in both conditions reported decreases in drinking outcomes over time. Tests of mediation indicated that the intervention indirectly led to reduction in drinking outcomes at 6 months through increased PBS use. Although the intervention resulted in changes in PBS use that were maintained for up to 6 months post-intervention, the effects of the intervention on drinking and consequences were limited. A brief standalone PBS training may need augmentation in order to promote effective use of PBS for substantial decreases in alcohol consequences.;
Prevention Science, 16(5) : 663-673
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Skills training, Personalised feedback, normative feedback
Yurasek, A., Fernandez, A., Miller, M. B., Metrik, J., Borsari, B.
Aims: Marijuana use among college students is highly prevalent and associated with poorer academic outcomes. Although brief motivational interventions (BMIs) have been shown to be efficacious with reducing alcohol use in college students, little is known about the utility of alcohol BMIs in reducing other addictive behaviors, such as marijuana use, that often co-occur with drinking. The purpose of the current study was to examine the impact of alcohol-focused BMIs implemented within a stepped care approach in reducing marijuana use. Methods: Participants were 530 college students who violated campus alcohol policy and were mandated to receive an alcoholfocused brief advice (BA) session. Of the 530 participants, 39% (N= 208) reported baseline marijuana use and were included in the current analyses. Participants who reported continued risky alcohol use (4 or more heavy drinking episodes and/or 5 or more alcohol-related problems in the past month) six weeks following the BA session were randomized to BMI (n = 92) or assessment only (n = 90). Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results: Repeated measures ANOVA revealed that students did not reduce their frequency of marijuana use following a BA session, nor did the BMI significantly reduce marijuana use compared to the assessment-only group. Conclusions: Despite reductions in alcohol use, marijuana use did not change following alcohol-focused intervention efforts. This suggests that marijuana users can still benefit from alcohol-related interventions yet may need a more intense and targeted marijuana focused intervention to induce changes in marijuana use.
Drug & Alcohol Dependence, 156 : e243-e244
- Year: 2015
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
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Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Samson, J. E., Tanner-Smith, E. E.
OBJECTIVE: The purpose of this study was to conduct a meta-analysis summarizing the effectiveness of brief, single-session interventions to reduce alcohol use among heavy drinking college students.
METHOD: A comprehensive literature search identified 73 studies comparing the effects of single-session brief alcohol intervention with treatment-as-usual or no-treatment control conditions on alcohol use among heavy drinking college students. Random-effects meta-analyses with robust variance estimates were used to synthesize 662 effect sizes, estimating the average overall effect of the interventions and the variability in effects across a range of moderators.
RESULTS: An overall mean effect size of ḡ = 0.18, 95% CI [0.12, 0.24] indicated that, on average, single-session brief alcohol interventions significantly reduced alcohol use among heavy drinking college students relative to comparison conditions. There was minimal variability in effects associated with study method and quality, general study characteristics, participant demographics, or outcome measure type. However, studies using motivational enhancement therapy/motivational interviewing (MET/MI) modalities reported larger effects than those using psychoeducational therapy (PET) interventions. Further investigation revealed that studies using MET/ MI and feedback-only interventions, but not those using cognitive-behavioral therapy or PET modalities, reported average effect sizes that differed significantly from zero. There was also evidence that long-term effects were weaker than short-term effects.
CONCLUSIONS: Single-session brief alcohol interventions show modest effects for reducing alcohol consumption among heavy drinking college students and may be particularly effective when they incorporate MET/MI principles. More research is needed to directly compare intervention modalities, to develop more potent interventions, and to explore the persistence of long-term effects.
Journal of Studies on Alcohol & Drugs, 76(4) : 530-543
- Year: 2015
- Problem: Alcohol Use
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Personalised feedback, normative feedback
Schuckit, M. A., Smith, T. L., Kalmijn, J., Skidmore, J., Clausen, P., Shafir, A., Saunders, G., Bystritsky, H., Fromme, K.
Background: Heavy drinking is common during transitions from high school to college. Optimal programs for diminishing risks for high alcohol consumption often tailor the approach to the specific needs of students. This study describes the results of an Internet-based prevention protocol that tailors the information to the risk associated with a pre-existing phenotype, the Low level of Response (Low LR) to alcohol. Methods: Using stratified random assignment, 454 freshmen with Low and High LR values were assigned to 2 education groups (LR-based where all examples were given the context of the Low LR model of heavy drinking or a State Of The Art (SOTA) Group where the same lessons were taught but without an emphasis on LR) or a no-intervention Control Group. Individuals in the 2 education groups viewed 50-minute online videos once per week for 4 weeks. Changes in drinking patterns were assessed at Baseline, 4 weeks, and 8 weeks using a 2 (LR status) by 3 (education group) by 3 (time points) analysis of variance, with additional tests for ethnicity and sex. Results: Low LR participants tended to decrease their usual (p < 0.06) and maximum (p < 0.05) drinks per occasion most prominently when assigned to the LR-based protocol, while those with High LRs improved more in the SOTA Group. The most robust differences were seen when controlling for ethnicity. The effect sizes were small to medium. Conclusions: These results support the advantages of carrying out prevention via the Internet and in tailoring the approach to a pre-existing phenotype.
Alcoholism: Clinical & Experimental Research, 39(2) : 308-316
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Walton, M. A., Chermack, S. T., Ehrlich, P., Carter, P., Booth, B. M., Blow, F., Barry, K., Cunningham, R. M.
Few underage drinkers who might benefit from alcohol brief interventions (BI) are identified and receive interventions in the emergency department (ED). This study examined the efficacy of motivational interviewing based BIs, delivered by a computer or a therapist in the ED on alcohol use and consequences at 3 months. Patients (ages 14-20) in the ED were approached to complete a screening survey; participants screening positive for risky drinking (AUDIT-C score: ≥3 ages 14-17; ≥4, ages 18-20) completed a baseline assessment and were randomized to: a stand-alone computer BI, a therapist BI (assisted by a computer), or a control brochure condition. The computer BI was as an offline, Facebook styled program, delivered on touch-screen tablets with audio. The therapist BI was facilitated by a computerized workbook. Among 4389 patients screened, 24.0% (n = 1054) reported risky drinking; 836 participants (79.3%) were enrolled in the randomized controlled trial (mean age = 18.6, 51.6% male, 79.4% Caucasian). Follow-up rates were 87% at 3 months. Regression analyses (controlling for gender, age group, and baseline values) were conducted to examine main effects of the BIs on alcohol consumption and alcohol-related consequences at 3 months. The computer BI reduced consumption (p < 0.05, Cohen's d = 0.10) and consequences (p < 0.05; Cohen's d = 0.11) as compared to the control. Similarly, the therapist BI reduced consumption (p < 0.05, Cohen's d = 0.09) and consequences (p < 0.05, Cohen's d = 0.14) as compared to the control. A single session BI delivered solely by a computer, or by a therapist, reduced alcohol use and consequences among underage drinkers in the short term; however, effect sizes were modest. Findings for the stand-alone, single session computer BI are particularly appealing given ease of implementation in real world ED settings. Future papers will examine efficacy at 6 and 12 months.
Alcoholism: Clinical & Experimental Research, 39 : 22A
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Wiener, C., Herring, D., Dotson, K., Schreiner, A., Bowers, C., Dunn, S., Dunn, M.
College students represent a unique group at risk for heavy drinking and alcohol-related harms. Drinking patterns have been shown to be related to expectations that individuals have regarding the effects of alcohol, and changing these alcohol expectancies has been shown to reduce risky drinking and underage alcohol use. Based on this premise, the Expectancy Challenge Alcohol Literacy Curriculum (ECALC) was created to reduce alcohol use by facilitating change of alcohol expectancies that correspond with early and problematic drinking. The ECALC is a 45-minute program that has been administered in group and individual format. In a series of development and validation studies, the ECALC has been successfully administered to elementary, high school and college students, mandated college students, and higher risk individuals involved in university fraternities and sororities. To increase the efficiency of the ECALC, a digital version was created for automated delivery of program content. The present study was conducted to validate the automated ECALC by delivering the program to first-year college students (n = 991) across three semesters (summer, fall, and spring). Participating Psychology classes (n = 48) were randomly assigned to experimental or assessment only control conditions. Expectancies were assessed using the Comprehensive Effects of Alcohol Scale (CEOA), and alcohol use data was collected using a drinking calendar that included the number of standard drinks consumed and duration for each drinking episode over the previous 30 days. Analyses comparing experimental and control group participants indicated that students who received the automated ECALC reported significantly lower CEOA scores at post-test on Sociability, Liquid Courage, Risk and Aggression, Sexuality, and Tension Reduction. ECALC participants reported significantly higher scores on the Cognitive/Behavioral Impairment subscale. Significant reductions in alcohol use were found for participants in Summer and Fall Semesters. Only 9% of the total sample participated during Spring Semester, and no significant changes in alcohol use were found for these students. Overall, the automated ECALC was found to be effective in changing key alcohol expectancies, and reducing alcohol use among participants who received the program in a Summer or Fall Semester.
Alcoholism: Clinical & Experimental Research, 39 : 206A
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Young, C. M., Neighbors, C., Rodriguez, L. M., Campbell, M. T., Lu, Q.
Expressive writing interventions have shown positive physical and psychological health benefits over time; however, work utilizing expressive writing to change behavior has been minimal. The current research applied the expressive writing paradigm to reduce drinking intentions among college students, and evaluated the roles of shame and guilt in intervention effects. College student (N = 495) who reported consuming at least one drink a month completed a baseline survey and were randomly assigned to one of three expressive writing conditions: Negative (write about a heavy drinking event that was negative); Positive (write about a heavy drinking event that was positive); or Neutral (write about their first day of college). After the expressive writing session, readiness to change drinking behaviors and future drinking intentions were assessed. Results revealed significant intervention effects on readiness to change, intended drinks per week, and intended numbers of drinks during a future peak drinking occasion. Participants in the negative condition displayed higher levels of event related guilt and shame. Only the reparative behavior subscale of guilt mediated intervention effects on readiness to change, which also mediated the association between guilt-reparative behavior and drinking intentions. Results provide initial support for an expressive writing intervention to reduce drinking intentions among college students. Results also underscore the importance of eliciting emotions associated with positive chance and reparative behavior when considering negative past experiences and future behavior change.
Alcoholism: Clinical & Experimental Research, 39 : 269A
- Year: 2015
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Steinka-Fry, K. T., Tanner-Smith, E. E., Grant, S.
Introduction: College students' 21st birthday celebrations often involve consumption of extreme amounts of alcohol as well as alcohol-related risks. This systematic review aims to determine whether birthday-focused, individually-targeted, no-contact (email or letter-based) brief alcohol interventions (BAIs) reduce college students' 21st birthday celebratory drinking.; Methods: A systematic search identified 9 randomized evaluations with 10 interventions to reduce 21st birthday drinking. Quantity of alcohol consumed and estimated blood alcohol concentration (BAC) were measured. Random-effects meta-analysis was used to summarize the effects of the interventions.; Results: There was no evidence that birthday-focused BAIs reduce quantities of alcohol consumed during birthday celebrations (g = 0.05, 95% CI [-0.03 to 0.13]). The interventions were associated with significant reductions in estimated BAC levels (g = 0.20, 95% CI [0.07 to 0.33]), but this effect was small in absolute terms. The quality of this body of evidence was very low, as evaluated using the GRADE approach. In particular, it was limited by substantial participant attrition post-randomization due to included studies' recruitment and randomization procedures.; Conclusions: There is no evidence that birthday-focused, individually-targeted BAIs reduce the quantity of alcohol consumed by students during 21st birthday celebrations, although these interventions may yield small beneficial effects on estimated BAC. Many methodological concerns were identified in included studies. This area of research would benefit from theory-based RCTs that are well-designed and executed. Future research should also investigate strategies other than birthday-focused, individually-targeted, brief interventions to curb 21st birthday celebratory drinking.; Copyright © 2015 Elsevier Ltd. All rights reserved.
Addictive Behaviors, 50 : 13-21
- Year: 2015
- Problem: Alcohol Use
- Type: Systematic reviews
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
Tait, R. J., Lenton, S.
Background: Sexual and intimate partner violence (IPV) is a leading cause of disease burden, with alcohol use strongly related to these behaviors. Online interventions have been shown to be effective in reducing both alcohol use and some alcohol-related problems. These programs are widely available especially to university students, a particularly high-risk group for sexual or IPV. Aim: We aimed to systematically review the evidence for the effectiveness of online alcohol interventions in reducing sexual violence or IPV. Methods: We searched electronic databases (PsycInfo, Embase, Global Health, Medline, CINAHI, Pubmed, and ProQuest) and hand searched key reviews. Results: From 569 titles, 23 were assessed in detail: five articles (four studies) fulfilled the inclusion criteria. All these studies were undertaken in the USA, with three recruiting college students (n. = 17,332), and one using an emergency department (n. = 262) sample of adolescents. We summarized the characteristics of the samples, the interventions and outcomes for alcohol use and sexual violence or IPV. Most interventions were unguided, with only one group receiving a guided intervention. Effect sizes, where they could be calculated, were small (Cohen's d<. 0.2) or not significantly different to zero for alcohol, sexual violence or IPV outcomes. Conclusions: Currently, there are insufficient data to evaluate the effectiveness of online alcohol interventions in reducing sexual or IPV. Given the prevalence of these behaviors and their association with alcohol use, this deficit requires urgent attention.
Internet Interventions, 2(2) : 152-160
- Year: 2015
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Tanner-Smith, E. E., Lipsey, M. W.
This study reports findings from a meta-analysis summarizing the effectiveness of brief alcohol interventions for adolescents (age 11-18) and young adults (age 19-30). We identified 185 eligible study samples using a comprehensive literature search and synthesized findings using random-effects meta-analyses with robust standard errors. Overall, brief alcohol interventions led to significant reductions in alcohol consumption and alcohol-related problems among adolescents (g = 0.27 and g = 0.19) and young adults (g = 0.17 and g = 0.11). These effects persisted for up to 1. year after intervention and did not vary across participant demographics, intervention length, or intervention format. However, certain intervention modalities (e.g., motivational interviewing) and components (e.g., decisional balance, goal-setting exercises) were associated with larger effects. We conclude that brief alcohol interventions yield beneficial effects on alcohol-related outcomes for adolescents and young adults that are modest but potentially worthwhile given their brevity and low cost.
Journal of Substance Abuse Treatment, 51 : 1-18
- Year: 2015
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)