Disorders - Alcohol Use
Neighbors, C., Fossos, N., Rodriguez, L., Tidwell, J., Foster, D., Chen, C.
Considerable research has demonstrated the potential clinical utility of expressive writing in multiple domains. Brief alcohol interventions often include discussions of the pros and cons of drinking, during which specific drinking experiences are sometimes recalled and verbally described. Similarly, brief interventions often include reviews of negative alcohol-related consequences experienced in the past. The present research was designed to evaluate the potential impact of writing about a specific past drinking experience on future drinking intentions. Participants included 200 undergraduate college students who were randomly assigned to one of three conditions. Participants were instructed to either write about (i) a time when they had a lot to drink that was a good time; (ii) a time when they had a lot to drink that was a bad time; or (iii) their first day of college (control). Participants were subsequently asked to report their intentions to drink over the next three months. Dependent variables included intended number of drinks per week, drinking frequency, and intended number of heavy drinking occasions (5/4 drinks for men/women). Analyses evaluated differences among conditions and evaluated gender as a moderator of condition effects. Social desirability was included as a covariate. Overall, participants who wrote about a negative drinking experience reported intending to drink significantly fewer drinks per week (M = 6.74) relative to control participants (M = 9.42), t(191) = 2.60, p = 0.01. Additionally, a significant interaction indicated that writing about a negative drinking experience had a differential impact on intended heavy drinking among men and women, t(191) = 2.60, p < 0.05. Tests of simple slopes suggested that writing about a negative drinking experience, relative to control, was associated with significantly fewer intended heavy drinking occasions among men (p < 0.01) but not women (p = 0.53). No differences were found for frequency intentions, nor were any differences found between participants who wrote about a positive drinking experience relative to those who wrote about their first day of college. Results provide preliminary support for writing about negative drinking experiences as a potentially fruitful intervention strategy and, at the same time, reducing potential concerns regarding iatrogenic effects of writing about positive drinking experiences.
Alcoholism: Clinical & Experimental Research, 35 : 214A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Paschall, M. J., Antin, T., Ringwalt, C. L., Saltz, R. F.
Objective: AlcoholEdu for College is a 2- to 3-hour online course for incoming college freshmen. This study was the first multicampus trial to examine effects of AlcoholEdu for College on alcohol-related problems among freshmen. Method: Thirty universities participated in the study. Fifteen were randomly assigned to receive AlcoholEdu, and the other 15 were assigned to the control condition. AlcoholEdu was implemented by intervention schools during the summer and/or fall semester. Cross-sectional surveys of freshmen were conducted at each university beginning before the intervention in spring 2008/2009; post-intervention surveys were administered in fall 2008/2009 and spring 2009/2010. The surveys included questions about the past-30-day frequency of 28 alcohol-related problems, from which we created indices for the total number of problems and problems in seven domains: physiological, academic, social, driving under the influence/riding with drinking drivers, aggression, sexual risk taking, and victimization. Multilevel Poisson regression analyses were conducted to examine intent-to-treat and dosage effects of AlcoholEdu for College on these outcomes. Results: Multilevel intent-to-treat analyses indicated significant reductions in the risk for past-30-day alcohol problems in general and problems in the physiological, social, and victimization domains during the fall semester immediately after completion of the course. However, these effects did not persist in the spring semester. Additional analyses suggested stronger AlcoholEdu effects on these outcomes at colleges with higher rates of student course completion. No AlcoholEdu effects were observed for alcohol-related problems in the other four domains. Conclusions: AlcoholEdu for College appears to have benefi cial short-term effects on victimization and the most common types of alcohol-related problems among freshmen. Universities may benefi t the most by mandating AlcoholEdu for College for all incoming freshmen and by implementing this online course along with environmental prevention strategies.
Journal of Studies on Alcohol & Drugs, 72(4) : 642-650
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Paschall, M. J., Antin, T., Ringwalt, C. L., Saltz, R. F.
Background: Internet-based alcohol misuse prevention programs are now used by many universities. One popular 2- to 3-hour online course known as AlcoholEdu for College is typically required for all incoming freshmen and thus constitutes a campus-level strategy to reduce student alcohol misuse. Purpose: Multi-campus study to evaluate the effectiveness of an Internet-based alcohol misuse prevention course. Design: RCT with 30 universities: 21 entered the study in Fall 2007, nine in Fall 2008. Fifteen were randomly assigned to receive the online course and the other 15 were assigned to the control condition. The course was implemented by intervention schools during the late summer and/or fall semester. Cross-sectional surveys of freshmen were conducted at each university, beginning prior to the intervention in Spring 20082009; post-intervention surveys were administered in Fall 20082009 and Spring 20092010. Setting/participants: Public and private universities of varying sizes across the U.S. Random samples of 200 freshmen per campus were invited to participate in online surveys for the evaluation. Overall survey response rates ranged from 44% to 48% (M (almost equal to) 90 participants per campus). Intervention: The online course includes five modules; the first four (Part I) are typically offered in the late summer before matriculation, and the fifth (Part II) in early fall. Course content includes defining a standard drink, physiologic effects of alcohol, the need to monitor blood alcohol level, social influences on alcohol use, alcohol laws, personalized normative feedback, and alcohol harm-reduction strategies. Students must pass an exam after Part I to advance to Part II. Main outcome measures: Past-30-day alcohol use, average number of drinks per occasion, and binge drinking. Results: Multilevel intent-to-treat analyses indicated significant reductions in the frequency of past-30-day alcohol use (beta = 0.64, p<0.05) and binge drinking (beta = 0.26, p<0.05) during the fall semester immediately after completion of the course. However, these effects did not persist when assessed in the spring semester. Post hoc comparisons suggested stronger course effects on these outcomes at colleges with higher rates of student course completion. No course effects were observed for average number of drinks per occasion or prevalence of binge drinking, regardless of the campus course completion rate. Conclusions: This study provides initial evidence that the Internet-based alcohol misuse prevention course has beneficial short-term effects on hazardous drinking behavior among first-year college students, which should be reinforced through effective environmental prevention strategies. Trial registration number: This trial is registered in Clinicaltrials.gov (NCT 01382979). (copyright) 2011 American Journal of Preventive Medicine.
American Journal of Preventive Medicine, 41(3) : 300-308
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Palfai, Tibor P., Zisserson, Rebecca, Saitz, Richard
Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention. Methods: One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored ≥ 8 on the AUDIT participated in this randomized controlled trial for course credit. Participants were assigned to 1 of 4 conditions in this 2 Intervention (Alcohol Feedback vs. Control) × 2 Assessment (Motivational Assessment vs. No Motivational Assessment) between-subjects design. Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables. Results: Controlling for corresponding baseline alcohol measures, hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences. For those who reported more alcohol consequences at baseline, the alcohol intervention resulted in significantly less alcohol use and fewer heavy drinking episodes at follow-up, while no difference was observed between intervention conditions for those with few baseline consequences. Assessment did not moderate intervention effects. Discussion: These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Addictive Behaviors, 36(5) : 539-542
- Year: 2011
- 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)
O'Leary-Barrett, M., Topper, L., MacKie, C. J., Castellanos-Ryan, N., Al-Khudhairy, N., Conrod, P. J.
Context: Personality-targeted interventions have significant preventative effects on onset and growth of drinking, binge-drinking and drinking problems (Conrod et al., 2006, 2008), and concurrently reduce emotional and behavioral problems specific to each personality profile (Castellanos and Conrod, 2008). Objective: This paper will examine whether these results can be replicated in a randomized controlled trial of teacher-delivered personality-targeted interventions. In addition, broader outcomes of the program on cigarette smoking, school attendance and attainment will be examined. Participants: 2499 adolescents (mean age 13.7 years) in 18 schools across London, U.K. Schools were randomly assigned to control or intervention condition, and students in intervention schools who met the criteria for any of the 4 personality risk subscales of the Substance Use Risk Profile Scale (Negative Thinking, Anxiety Sensitivity, Sensation Seeking and Impulsivity) were invited to participate in a personality-targeted intervention by trained members of staff from their schools. One thousand one hundred fifty-seven students met the criteria for personality risk for substance abuse, 694 of which were invited to take part in interventions. Main Outcome Measures: Drinking status, binge- drinking status and drinking problems at 6, 12, 18 and 24 months postbaseline in students meeting the personality risk criteria for substance use. Secondary measures include mental health symptoms, risky behavior, school attainment and attendance. This paper will present 6-month outcomes on these measures. Results: At 6-months follow-up, the intervention group were 53% less likely to report alcohol use than the control group (OR = 0.57, CI = 0.37-0.88), and drinkers at baseline were 52% less likely to be binge-drinking than controls (OR = 0.48, CI = 0.28-0.83). Receiving an intervention predicted significantly reduced drinking problem scores ((beta) = -0.11, SD = 0.04) and frequency of drinking ((beta) = -0.14, SD = 0.66). The intervention group reported smoking significantly fewer cigarettes ((beta) = -0.13, SD = 0.06), and fewer depression ((beta) = -0.12, SD = 0.04) and anxiety ((beta) = -0.13, SD = 0.05) symptoms. Findings on school attainment and attendance will also be presented. Conclusions: These findings provide evidence demonstrating that educational professionals can be successfully trained in the delivery of a brief personality-targeted substance misuse prevention program, and have wider implications for the delivery and sustained use of such programmes in schools.
Alcoholism: Clinical & Experimental Research, 35 : 316A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Reynolds, E. K., MacPherson, L., Tull, M. T., Baruch, D. E., Lejuez, C. W.
College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time null Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions. (copyright) 2011 American Psychological Association.
Journal of Counseling Psychology, 58(4) : 555-564
- Year: 2011
- Problem: Depressive Disorders, Alcohol Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Murphy, J. G., Skidmore, J. R., Dennhardt, A. A., Martens, M. P., Barnett, N. P., Borsari, B., Colby, S. M.
Brief Motivational Interventions (BMIs) have demonstrated efficacy in decreasing college student drinking but they typically yield only small to moderate effect sizes and further research is needed to increase their efficacy. Behavioral economic research has demonstrated that (i) substance abusers show a strong preference for immediate rewards and steeply discount the value of delayed rewards, (ii) substance abusers generally report lower levels of reinforcement from substance-free activities, and (iii) reductions in substance abuse are facilitated by increased engagement in constructive substance-free activities. Basic research with humans and animals suggests that increasing the salience of delayed substance-free rewards can increase individuals' capacity for delaying gratification. A recent clinical trial (Murphy et al., 2005) indicated that low levels of substance-free reinforcement predicted poor BMI response, and that participants who successfully reduced their drinking increased their participation in academic activities. This presentation will describe the results of a controlled clinical trial evaluating the incremental efficacy of a novel behavioral economic intervention (Substance-Free Activity Session, SFAS) above and beyond a standard alcohol MI session for heavy drinking college students (n = 82; 50% female). The SFAS uses MI and personalized feedback to increase the salience of delayed academic, career, and other substance-free rewards. The SFAS includes feedback on recent time allocation to substance use vs. studying and other substance-free activities, the relation between time spent studying and GPA, and the relation between GPA and income. Participants also establish short-term goals that would support their long-term goals. One-month outcomes (99% follow-up rate) indicated that the combination of MI plus a 50-minute SFAS was associated with greater reductions in peak blood alcohol levels (p = 0.07) and alcohol related problems (p < .001) than MI plus a 50-minute relaxation control session. Students may make subtle changes in drinking or protective behaviors that are motivated by a desire to minimize the impact of drinking on college and career goals. Additional analysis will examine whether these treatment effects persist during the next academic semester and whether they are mediated by increased engagement in substance free activities, greater commitment to academic and career goals, and increased valuation of delayed rewards.
Alcoholism: Clinical & Experimental Research, 35 : 297A
- Year: 2011
- Problem: Alcohol Use
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Relaxation
Labbe, A. K., Maisto, S. A.
Heavy alcohol use among college students has become a substantial health concern. With national survey data indicating that 40% of college students report consuming five or more alcoholic drinks at least monthly (Johnston, O'Malley, Bachman, & Schulenberg, 2009), prevention and intervention programs are needed to address this problem. The Task Force on College Drinking, commissioned by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), designated alcohol expectancy challenges (ECs) as a recommended treatment strategy to reduce alcohol use among college students (NIAAA, 2002). This paper is a systematic critical review of the studies that have been conducted to assess for the efficacy of ECs among college students with a focus on changes in expectancies and alcohol consumption, and possible differences in efficacy for men and women. The review revealed that ECs were most efficacious when administered to male-only groups of participants; while ECs for female-only and mixed-gender groups demonstrated less consistent results. The implications of the findings of this critical review for the direction of future research are discussed. (copyright) 2011 Elsevier Ltd.
Clinical Psychology Review, 31(4) : 673-683
- Year: 2011
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Martens, M. P., Smith, A. E., Murphy, J. G.
Problems associated with excessive drinking among college students are well-known. One commonly used strategy for intervening with at-risk college drinkers involves the use of a single session Motivational Interviewing (MI)-based, one-on-one intervention that also incorporates personalized feedback about one's drinking habits. One limitation of research in this area is that the interventions typically include several components or domains, and little is known about the degree to which any individual component is associated with changes in drinking behaviors The purpose of the present study was to begin to address this limitation by examining the efficacy of nullvery briefnull (i.e., 15 to 20 minute) in-person interventions that focused on only a single behavior change component. Subjects are college students who reported at least one heavy drinking episode in the previous month (63% women; 89% white; M age = 20.10 years). Subjects were randomized to one of three conditions: (i) Protective Behavioral Strategies Feedback (PBSF), where subjects received personalized feedback on their use or nonuse of different protective behaviors, (ii) Personalized Normative Feedback (PNF), where subjects received personalized feedback on their own quantity and frequency of drinking, their perceptions of drinking among other students, and actual drinking rates among other students, and (iii) Education-Only (EO), where subjects received general educational information about the effects of alcohol. The PBSF and PNF interventions were delivered in a MI-based format, whereas EO was delivered in a didactic format. Preliminary one-month outcomes are available on 157 subjects; by the time of the RSA convention we anticipate having baseline, one-month, and six-month data on approximately 300 subjects. After controlling for the effects of baseline values, results indicate statistically significant betweengroup differences on average number of drinks per week (p < 0.01, n2 = 0.078), peak number of drinks over the past 30 days (p = 0.05, n2 = 0.039), and alcohol-related problems (p = 0.05, g2 = 0.045) at the one-month follow-up. Subjects in the PNF condition reported less alcohol use than those in the EO condition, while those in both the PBSF and PNF condition reported fewer alcohol-related problems than those in the EO condition. These findings provide promising evidence for the effects of in-person interventions focusing only on perceived normative drinking or protective behavioral strategies.
Alcoholism: Clinical & Experimental Research, 35 : 298A
- Year: 2011
- 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, Psychoeducation, Other service delivery and improvement interventions
Larimer, M. E., LaBrie, J., Atkins, D. C., Lee, C. M., Lewis, M. A., Neighbors, C., Kilmer, J. R., et-al
Personalized Normative Feedback (PNF) is designed to correct normative misperceptions by presenting feedback comparing students' own drinking and perceptions of others' drinking (perceived descriptive norms) to the actual reported drinking of others (actual descriptive norms). PNF generally provides norms for a nulltypical student,null yet questions remain regarding how efficacy of PNF is influenced by similarity of the participant to the normative reference group. In theory, norms for more proximal or similar referents should have greater impact. However, misperceptions are generally smaller for more similar referents compared to the nulltypical student.null The current RCT compared 'typical student' PNF to PNF for reference groups at increasing levels of similarity to the respondent (same-sex, same-ethnicity, same- Greek status, and all combinations of these attributes). The resulting 8 PNF reference groups were also compared to web-BASICS feedback and assessment controls. Participants (n = 1,831 Caucasian and Asian undergraduates) reported heavy episodic drinking (5/4 drink cut-off) at least once in the past month, and were stratified based on drinks per week (DPW;10 or fewer; 11+) and demographics prior to randomization. Poison Hierarchical Generalized Linear Modeling suggest both web-BASICS and PNF (combined across conditions) were associated with reduced DPW among heavy-drinking students (14.5% & 12% improvement, respectively) at 6 months, though all conditions including controls reported decreases x2(5) = 76.5, p < 0.01). Surprisingly, among heavy drinkers, typical student PNF resulted in significantly lower DPW than PNF for more specific reference groups combined (p = 0.05), and gender- and Greek-specific PNF in particular. Results were mediated by changes in perceived norms for the typical student. Further, magnitude of discrepancy between respondents' drinking and the norm provided in PNF was related to outcomes, where those who received a norm more discrepant from (and lower than) their own drinking showed greater change. Because the typical student norm was most discrepant from the drinking of the majority of heavy drinkers, this finding also helps explain the advantage of typical student PNF. Preliminary results at 12 months suggest similar patterns, though in some cases not statistically significant. Additional analyses will explore moderators of PNF and web-BASICS efficacy, and impact on other drinking outcomes.
Alcoholism: Clinical & Experimental Research, 35 : 298A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
, 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)
Leffingwell, T., Weaver, C., Wagener, T., Mignogna, J.
This presentation will report on the progress of a program of research on the efficacy of a computerized brief intervention for heavy drinking college students. The intervention, called the Drinking Assessment and Feedback Tool for College Students (DrAFT-CS), is designed to incorporate many of the principles of the well-known gold-standard BASICS intervention. It relies upon personalized feedback regarding alcohol use, including quantity and frequency, normative comparisons, and reframing consumption in terms of monetary and caloric costs, to encourage changes toward more moderate consumption. The intervention has been subject to four different small randomized trials to date that have guided the development of the intervention. These trials have compared the intervention to no treatment and minimal assessment controls and comparison conditions that have included personalized feedback with a live interviewer and conditions that receive a brief moderation skills training module. After the intervention was found to have no observable impact on drinking in an initial small trial, modifications were made to the program. In the second trial, at-risk students exposed to the DrAFT-CS reduced their weekly alcohol consumption relative to minimal-assessment controls (p < 0.05, n2 = 0.12). In the third trial, the DrAFT-CS failed to produce significant changes in weekly consumption (p = 0.09, g2 = 0.02), but live, in-person feedback with an interviewer trained in motivational interviewing did so (p < 0.01, n2 = 0.08). In this trial, participants exposed to the DrAFT-CS did demonstrate significant reductions in estimated BACs achieved on average (p < 0.01, n2 = 0.05) and peak drinking occasions (p < 0.01, n2= 0.05). Given the inconsistent findings from prior trials, a fourth trial is underway to further examine the efficacy of the DrAFT-CS and test the potential additive effects of brief training in moderation skills is currently in progress and results will be available by date of the conference. Taken together, these trials lend some support for the efficacy of brief, computerized feedback-based interventions for eliciting reductions in risky drinking behavior among at-risk college student populations. Computerized interventions, with their strong treatment fidelity and low costs of dissemination enabling broader reach, may be promising approaches for dealing with this public health problem even if overall effect sizes are small.
Alcoholism: Clinical & Experimental Research, 35 : 298A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Seigers, D. K. L., Carey, K. B.
Objectives: To provide a critical review of the efficacy of brief interventions for alcohol use in college health centers. Methods: Studies were included if (a) they examined brief intervention trials that were conducted in college- or university-based student health centers or emergency departments, and (b) they provided pre-post data to estimate change. Results: Twelve studies suggested that screening and brief interventions in these settings are acceptable, feasible, and promote risk reduction. Conclusions: Findings support continued use of time-limited, single-session interventions with motivational interviewing and feedback components. (copyright) 2010 Taylor & Francis Group, LLC.
Journal of American College Health, 59(3) : 151-158
- Year: 2011
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions