Disorders - Alcohol Use
Foxcroft, D. R., Tsertsvadze, A.
Alcohol misuse in young people is a cause of concern for health services, policy makers, prevention workers, and criminal justice system, youth workers, teachers, and parents. To systematically review evidence on the effectiveness of universal multi-component prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. To update a part of a previously published Cochrane systematic review. Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO. Randomized trials evaluating universal multi-component prevention programs (intervention delivered in more than one setting) and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records. Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed. 20 parallel-group trials were included. The reporting quality of trials was poor, only 25% and 5% of them reporting adequate method of randomisation and program allocation concealment, respectively. Incomplete data was adequately addressed in about half of the trials and this information was unclear for about 20% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively.12 of the 20 trials showed some evidence of effectiveness compared to a control or other intervention group, with persistence of effects ranging from 3 months to 3 years. Of the remaining 8 trials, one trial reported significant effects using one-tailed tests and 7 trials reported no significant effects of the multi-component interventions for reducing alcohol misuse.Assessment of the additional benefit of multiple versus single component interventions was possible in 7 trials with multiple arms. Only one of the 7 trials clearly showed a benefit of components delivered in more than one setting. There is some evidence that multi-component interventions for alcohol misuse prevention in young people can be effective. However, there is little evidence that interventions with multiple components are more effective than interventions with single components.
Cochrane Database of Systematic Reviews, 9 : CD009307
- Year: 2011
- Problem: Alcohol Use
- Type: Systematic reviews
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
Ekman, Diana Stark, Andersson, Agneta, Nilsen, Per, Stahlbrandt, Henriettae, Johansson, Anne Lie, Bendtsen, Preben
Background: The limited number of electronic screening and brief intervention (e-SBI) projects taking place in young adult student populations has left knowledge gaps about the specific methods needed to motivate reduced drinking. The aim of the present study was to compare differences in alcohol consumption over time after a series of e-SBIs was conducted with two groups of young adult students who were considered risky drinkers. The intervention group (IG) (n = 80) received extensive normative feedback; the control group (CG) (n = 78) received very brief feedback consisting of only three statements. Method: An e-SBI project was conducted in naturalistic settings among young adult students at a Swedish university. This study used a randomized controlled trial design, with respondents having an equal chance of being assigned to either the IG or the CG. The study assessed changes comparing the IG with the CG on four alcohol-related measurements: proportion with risky alcohol consumption, average weekly alcohol consumption, frequency of heavy episodic drinking (HED) and peak blood alcohol concentration (BAC). Follow-up was performed at 3 and 6 months after baseline. Results: The study documented a significant decrease in the average weekly consumption for the IG over time but not for the CG, although the differences between the groups were non-significant. The study also found that there were significant decreases in HED over time within both groups; the differences were about equal in both groups at the 6-month follow-up. The proportion of risky drinkers decreased by about a third in both the CG and IG at the 3- and 6-month follow-ups. Conclusions: As the differences between the groups at 6 months for all alcohol-related outcome variables were not significant, the shorter, generic brief intervention appears to be as effective as the longer one including normative feedback. However, further studies in similar naturalistic settings are warranted with delayed assessment groups as controls in order to increase our understanding of reactivity assessment in email-based interventions among students. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Addictive Behaviors, 36(6) : 654-659
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Doumas, D. M., Workman, C., Smith, D., Navarro, A.
This study evaluated the efficacy of two brief personalized normative feedback interventions aimed at reducing heavy drinking among mandated college students (N = 135). Students were randomly assigned to one of two conditions: Web-based assessment with self-guided personalized normative feedback (SWF) or Web-based assessment with counselor-guided personalized normative feedback (CWF). Results indicated that students in the CWF condition reported significantly greater reductions in weekly drinking quantity and binge drinking frequency than those in the SWF group at follow-up (M = 8 months). Students in the CWF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the SWF group. In addition, changes in estimates of peer drinking partially mediated the effect of the intervention on changes in drinking. Results suggest that counselor-guided feedback may be more effective in reducing drinking among mandated students relative to self-guided feedback in the long term. (copyright) 2010 Elsevier Inc.
Journal of Substance Abuse Treatment, 40(4) : 376-385
- Year: 2011
- 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: Service Delivery & Improvement, Psychological Interventions (any)
, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Conrod, P. J., Castellanos-Ryan, N., Mackie, C.
Objective: To examine the long-term effects of a personality-targeted intervention on drinking quantity and frequency (QF), problem drinking, and personality-specific motivations for alcohol use in early adolescence. Method: A randomized control trial was carried out with 364 adolescents (median age 14) recruited from 13 secondary schools with elevated scores in Hopelessness, Anxiety-Sensitivity (AS), Impulsivity, and Sensation-Seeking. Participants were randomly assigned to a control no-intervention condition or a 2-session group coping skills intervention targeting 1 of 4 personality risk factors. The effects of the intervention on quantity/frequency (QF) of alcohol use, frequency of binge drinking, problem drinking, and motives were examined at 6, 12, 18, and 24 months postintervention. Results: Intent-to-treat repeated measures analyses revealed a significant overall intervention effect in reducing problem drinking symptoms, and a Time × Intervention effect on drinking QF and binge drinking frequency. Relative to the control group, the intervention group showed significantly reduced drinking and binge drinking levels at 6 months postintervention and reduced problem drinking symptoms for the full 24-month follow-up period (Cohen's d = 0.33). A significant Time × Intervention × Personality interaction was demonstrated for coping and enhancement drinking motives. In addition to an overall effect of intervention on coping motives, the AS group who received that intervention reported fewer coping motives compared with the AS control group at 12 and 24 months postintervention. Conclusions: This study provides further evidence showing that personality-targeted interventions reduce drinking behavior in adolescents in the short term. Novel findings were that the interventions were shown to produced long-term effects on drinking problems and personality-specific effects on drinking motives. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Consulting & Clinical Psychology, 79(3) : 296-306
- Year: 2011
- 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)
, Skills training
Conrod, P. J., O'Leary-Barrett, M., Newton, N., Topper, L., Castellanos-Ryan, N., MacKie, C.
Background: Selective school-based alcohol prevention programs targeting youth with personality risk factors for addiction and mental health problems have been shown to be effective in reducing alcohol misuse in those with elevated personality risk profiles. This study examines the indirect effect of this selective program on the broader low risk population of students whose drinking is potentially influenced their high risk peers. Methods: Cluster randomized controlled trial (NCT00344474) in high-schools in London, U.K. Participants were 1210 high and 1433 low-risk students attending schools randomized the Preventure Programme, a selective alcohol prevention programme targeting personality risk factors for substance misuse; or treatment as usual statutory drug education in class. Participants were assessed for drinking, binge drinking and problem drinking status pre-, 6, 12, 18 and 24 months postrandomization. Results: Unconditional hierarchical generalized linear models tested intervention and intervention by risk group differences in postintervention drinking and growth in drinking from 6 months to 24 months. Significant risk-group by intervention interactions at the 6-month intercept for binge-drinking OR = 0.58 (0.35-0.98) and problem-drinking, OR = 0.66 (0.43- 1.03), but significant intervention effects on growth in rates of drinking, OR = 0.87 (0.76-1.00), binge-drinking, OR = 0.78 (0.65-0.95) and problem-drinking, OR = 0.90 (0.83-0.99) within the full sample indicated that high-risk youth targeted in the programme benefitted immediately following interventions and throughout the follow-up; and low-risk students benefited from the programme at later time points. Conclusions: Results suggest indirect, nullherdnull effects, of this targeted intervention on the broader youth population, potentially through being exposed to fewer social influences to binge drink.
Alcoholism: Clinical & Experimental Research, 35 : 316A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Cornelius, J., Douaihy, A., Chung, T., Kelly, T., Daley, D., Hayes, J., Wood, D., Kirisci, L., Clark, D.
The authors recently completed a first long-term (4 year) follow-up study involving subjects who had participated in a double-blind, placebo-controlled acute phase trial of fluoxetine (20 mg) in adolescents with comorbid major depressive disorder (MDD) and an alcohol use disorder (AUD). The subjects in the acute phase trial included 50 teens who had been randomized to fluoxetine or placebo, all of whom also received motivational enhancement therapy (MET) and cognitive behavioral psychotherapy (CBT) during the acute phase trial. During the acute phase trial, subjects in both treatment groups showed significant decreases in alcohol use and depressive symptoms, but no significant between-group differences were noted, suggesting efficacy for CBT-MET therapy but not for fluoxetine (Cornelius, et al., 2009). Most (72%) of the subjects who participated in the acute phase trial also participated in the 4- year follow-up assessment study, consisting of four annual assessments over 4 years. At the four-year follow-up evaluation, ratings of depressive symptoms and of alcohol quantity (but not frequency) were significantly lower than baseline levels, but were not significantly different from end-of-trial levels. These findings suggest longer-term efficacy (4 year) for CBT/MET therapy for treating the depressive and alcohol-related symptoms of MDD-AUD teens.
Alcoholism: Clinical & Experimental Research, 35 : 20A
- Year: 2011
- Problem: Depressive Disorders, Alcohol Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Daeppen, J. B., Bertholet, N., Gaume, J., Fortini, C., Faouzi, M., Gmel, G.
Background: Brief motivational intervention (BMI) is one of the few effective strategies targeting alcohol consumption, but has not been tested in young men in the community. We evaluated the efficacy of BMI in reducing alcohol use and related problems among binge drinkers and in maintaining low-risk drinking among non-bingers. Methods: A random sample of a census of men included during army conscription (which is mandatory for 20-year-old males in Switzerland) was randomized to receive a single face-to-face BMI session (N = 199) or no intervention (N = 219). A six-month follow-up rate was obtained for 88.7% of the subjects. Results: Among binge drinkers, there was 20% less drinking in the BMI group versus the control group (incidence rate ratio = 0.80, confidence interval 0.66-0.98, p = 0.03); the BMI group showed a weekly reduction of 1.5 drinks compared to an increase of 0.8 drinks weekly in the control group. Among subjects who experienced one or more alcohol-related consequences over the last 12 months, there was 19% less drinking in the BMI group compared to the control group (incidence rate ratio = 0.81, confidence interval 0.67-0.97, p = 0.04). Among non-bingers, BMI did not contribute to the maintenance of low-risk drinking. Conclusion: BMI reduced the alcohol use of binge drinkers, particularly among those who experienced certain alcohol-related adverse consequences. No preventive effect of BMI was observed among non-bingers. BMI is a plausible secondary preventive option for young binge drinkers. (copyright) 2010 Elsevier Ireland Ltd.
Drug & Alcohol Dependence, 113(1) : 69-75
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Cunningham, R. M., Chermack, S. T., Shope, J. T., Bingham, C. R., Zimmerman, M. A, Blow, F. C., Walton, M. A.
Introduction: Brief interventions in the urban Emergency Department (ED) visit provide an opportunity to reduce violence and alcohol misuse among teens at-risk for future injury. A prior publication from this study found that a brief intervention in the ED among teens who self report alcohol and aggression reduced the prevalence of aggression and alcohol consequences in the 3 to 6 months post ED visit. Purpose: To determine the 12 month alcohol and violence outcomes of the SafERteen brief ED intervention. Methods: Patients (ages 14 to 18; 12pm to 11pm; 7 days/week) at an urban ED in Flint, MI, completed a computerized screening survey for past year alcohol use and aggression. Adolescents screening positive completed a computerized baseline assessment, were randomized to condition (computer brief intervention, therapist brief intervention, or control) and completed follow-up assessments at 3, 6 and 12 months. The BI for violence and alcohol combined motivational interviewing with skills training. Data were analyzed using generalized estimating equations (GEE) using an intent to treat approach. Outcome variables included: peer aggression and victimization, violence consequences, alcohol use (AUDIT-C), binge drinking, and alcohol consequences (POSIT). The relationship between alcohol use and peer violence over the 12-month follow-up was examined also. Results: Of the 3,338 adolescents (43.5% male; 55.9% African American) who were screened (12% refused), 726 were randomized and twelve month follow up rate was 83%. As compared to the control, participants in the therapist intervention showed sustained reductions in the occurrence of peer aggression at 12 months (therapist )43%, control )26%, computer )26%; p < 0.01). No significant decreases were maintained in peer victimization, violence consequences, and alcohol consequences at 12 months. After controlling for baseline binge drinking, binge drinking during the follow-up (p < 0.05) and therapist condition (p < 0.01) were significantly related to decreased peer aggression at 12-months. Conclusions: Among adolescents identified in the ED with alcohol use and aggression, a brief intervention resulted in a sustained decrease in self-reported aggression at 12 months, and this was associated with a decrease in binge drinking.
Alcoholism: Clinical & Experimental Research, 35 : 213A
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Skills training, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Caria, Maria Paola, Faggiano, Fabrizio, Bellocco, Rino, Galanti, Maria Rosaria
Background: Although social environments may influence alcohol-related behaviours in youth, the relationship between neighbourhood socioeconomic context and effectiveness of school-based prevention against underage drinking has been insufficiently investigated. We study whether the social environment affects the impact of a new school-based prevention programme on alcohol use among European students.; Methods: During the school year 2004-2005, 7079 students 12-14 years of age from 143 schools in nine European centres participated in this cluster randomised controlled trial. Schools were randomly assigned to either control or a 12-session standardised curriculum based on the comprehensive social influence model. Randomisation was blocked within socioeconomic levels of the school environment. Alcohol use and alcohol-related problem behaviours were investigated through a self-completed anonymous questionnaire at baseline and 18 months thereafter. Data were analysed using multilevel models, separately by socioeconomic level.; Results: At baseline, adolescents in schools of low socioeconomic level were more likely to report problem drinking than other students. Participation in the programme was associated in this group with a decreased odds of reporting episodes of drunkenness (OR = 0.60, 95% CI = 0.44-0.83), intention to get drunk (OR = 0.60, 95% CI = 0.45-0.79), and marginally alcohol-related problem behaviours (OR = 0.70, 95% CI = 0.46-1.06). No significant programme's effects emerged for students in schools of medium or high socioeconomic level. Effects on frequency of alcohol consumption were also stronger among students in disadvantaged schools, although the estimates did not attain statistical significance in any subgroup.; Conclusions: It is plausible that comprehensive social influence programmes have a more favourable effect on problematic drinking among students in underprivileged social environments.; Trial Registration: ISRCTN: ISRCTN18092805.;
BMC Public Health, 11 : 312-312
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Carey, Kate B., Carey, Michael P., Henson, James M., Maisto, Stephen A., DeMartini, Kelly S.
Aims: College students who violate alcohol policies are often mandated to participate in alcohol‐related interventions. This study investigated (i) whether such interventions reduced drinking beyond the sanction alone, (ii) whether a brief motivational intervention (BMI) was more efficacious than two computer‐delivered interventions (CDIs) and (iii) whether intervention response differed by gender. Design: Randomized controlled trial with four conditions [brief motivation interventions (BMI), Alcohol 101 Plus™, Alcohol Edu for Sanctions®, delayed control] and four assessments (baseline, 1, 6 and 12 months). Setting: Private residential university in the United States. Participants: Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Measurements: Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems and recidivism. Findings: Piecewise latent growth models characterized short‐term (1‐month) and longer‐term (1 - 12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow‐up year. No differences in recidivism were found. Conclusions: Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Addiction, 106(3) : 528-537
- Year: 2011
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Calabria, B., Shakeshaft, A. P., Havard, A.
This review identified published studies evaluating interventions delivered outside educational settings, designed for young people with existing alcohol use problems, or who participate in behaviour that places them at high risk of alcohol-related harm, critiqued their methodology and identified opportunities for new interventions. A systematic search of the peer-reviewed literature interrogated 10 electronic databases using specific search strings, limited to 2005-09. No additional studies were found by a librarian searching other collections and clearing-houses, or by hand-searching review paper reference lists. The 1697 articles identified were reviewed against criteria from the Dictionary for the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. The methodological quality of existing studies is variable, and needs to be both more rigorous and more consistent. Particular problems include the lack of blinding outcome assessors, a reliance solely on self-report measures, highly variable consent and follow-up rates, infrequent use of intention-to-treat analyses and the absence of any economic or cost analyses. The range of interventions evaluated is currently limited to individually focused approaches, almost exclusively implemented in the United States. There is a great need for more intervention trials for young people at high risk of experiencing alcohol-related harm that are both methodologically rigorous and have a broader community focus, to complement the psychological interventions that currently dominate the relevant literature. Such trials would improve outcomes for high-risk young people themselves and would improve the evidence base, both in their own right and by facilitating future meta-analyses. (copyright) 2011 The Authors, Addiction (copyright) 2011 Society for the Study of Addiction.
Addiction (Abingdon, England), 106(8) : 1406-1418
- Year: 2011
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Medications used to treat substance abuse, Psychological Interventions (any)
Cornelius, J. R., Douaihy, A., Bukstein, O. G., Daley, D. C., Wood, S. D., Kelly, T. M., Salloum, I. M.
Objective: Behavioral therapies developed specifically for co-occurring disorders remain sparse, and such therapies for comorbid adolescents are particularly rare. This was an evaluation of the long-term (2-year) efficacy of an acute phase trial of manualized cognitive behavioral therapy/motivation enhancement therapy (CBT/MET) vs. naturalistic treatment among adolescents who had signed consent for a treatment study involving the SSRI antidepressant medication fluoxetine and CBT/MET therapy for comorbid major depressive disorder (MDD) and an alcohol use disorder (AUD). We hypothesized that improvements in depressive symptoms and alcohol-related symptoms noted among the subjects who had received CBT/MET would exceed that of those in the naturalistic comparison group that had not received CBT/MET therapy. Methods: We evaluated levels of depressive symptoms and alcohol-related symptoms at a two-year follow-up evaluation among comorbid MDD/AUD adolescents who had received an acute phase trial of manual-based CBT/MET (in addition to the SSRI medication fluoxetine or placebo) compared to those who had received naturalistic care. Results: In repeated measures ANOVA, a significant time by enrollment status difference was noted for both depressive symptoms and alcohol-related symptoms across the two-year time period of this study, with those receiving CBT/MET demonstrating superior outcomes compared to those who had not received protocol CBT/MET therapy. No significant difference was noted between those receiving fluoxetine vs. those receiving placebo on any outcome at any time point. Conclusions: These findings suggest long-term efficacy for an acute phase trial of manualized CBT/MET for treating comorbid MDD/AUD adolescents. Large multi-site studies are warranted to further clarify the efficacy of CBT/MET therapy among various adolescent and young adult comorbid populations. (copyright) 2011 Elsevier Ltd.
Addictive Behaviors, 36(8) : 843-848
- Year: 2011
- Problem: Depressive Disorders, Alcohol Use
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy