An Integrated Personalized Feedback Intervention for Hazardous Drinkers with Elevated Anxiety Sensitivity and Subclinical PTSD

项目概要/摘要 危险饮酒和创伤后应激障碍（PTSD）同时发生是极其常见的 与更大的残疾、死亡率和较差的健康结果相关的疾病 单独任一条件。然而，对于这种服务不足的情况，没有经验支持的干预计划可用。 由于保留率低和辍学率高，人口和最有希望的干预措施受到限制。一个 可能导致危险饮酒和创伤后应激障碍共病的跨诊断危险因素是焦虑敏感性（即， 对焦虑相关感觉的负面后果的恐惧）。焦虑敏感性是一种可塑性， 认知情感脆弱性因素与危险饮酒和发展呈正相关 维持创伤后应激障碍（PTSD）。专门针对焦虑敏感性的综合干预措施 危险饮酒和创伤后应激障碍症状尚未开发或测试。个性化反馈 干预措施（PFI）可能有助于弥补这一差距，因为它们已被证明可以有效减少危险 饮酒和酒精相关后果对不同人群的影响是短暂的、具有成本效益的且容易 可传播的。目前 NRSA 博士前奖学金的目的是协助随机 对照试验（RCT），由博士共同领导。 Michael Zvolensky 和 Anka Vujanovic，旨在开发和测试 新型基于计算机的 PFI 对至少患有亚临床 PTSD 的危险饮酒者（即， 支持每个 PTSD 症状群中至少一种症状）和焦虑敏感性升高。第一个目标 该项目的目的是协助评估一次简短的单次会议的可行性和可接受性， 集成的、基于计算机的个性化反馈干预（AP-PFI）。第二个目标是协助 进行随机对照试验来检查治疗后的疗效和干预效果（与对照条件 [C-PFI] 相比） 干预以及一周和一个月的随访。第三个目标是探索变革机制和 主持人。主要假设是随机分配到 AP-PFI（相对于 C-PFI）的参与者将报告更多 减少饮酒的动机/意图，以及测试后较低的焦虑敏感性水平。中学 假设随机分配到 AP-PFI（相对于 C-PFI）的参与者将表现出更大的比率变化 有害饮酒，降低饮酒频率和饮酒量，减少负面影响 饮酒的后果，并降低 PTSD 症状的严重程度。拟议的研究提供了一种创新的 先前研究的延伸，与当前的 NIAAA 举措非常吻合，并且有可能直接 为患有 PTSD 症状和焦虑敏感性升高的危险饮酒者提供护理信息。

PROJECT SUMMARY/ABSTRACT Hazardous drinking and posttraumatic stress disorder (PTSD) are exceedingly common co-occurring conditions that are associated with greater disability, mortality, and poor health outcomes as compared to either condition alone. Yet, no empirically supported intervention programs are available for this underserved population and the most promising interventions are limited due to poor retention and high dropout rates. A transdiagnostic risk factor that may underlie comorbid hazardous drinking and PTSD is anxiety sensitivity (i.e., the fear of the negative consequences of anxiety-related sensations). Anxiety sensitivity is a malleable, cognitive-affective vulnerability factor that is positively related to hazardous drinking and the development and maintenance of PTSD. An integrated intervention to specifically target anxiety sensitivity in the context of hazardous drinking and PTSD symptoms has not been developed or tested. Personalized feedback interventions (PFI) may help to address this gap as they have demonstrated efficacy in reducing hazardous drinking and alcohol-related consequences across various populations and are brief, cost-effective, and easily disseminable. The objective of the present NRSA pre-doctoral fellowship is to assist on a randomized controlled trial (RCT), co-led by Drs. Michael Zvolensky and Anka Vujanovic, aimed at developing and testing the efficacy of a novel computer-based PFI among hazardous drinkers with at least subclinical PTSD (i.e., endorsing at least one symptom in each PTSD symptom cluster) and elevated anxiety sensitivity. The first aim of this project will be to assist on evaluating the feasibility and acceptability of a brief, single-session, integrated, computer-based personalized feedback intervention (AP-PFI). The second aim will be to assist on conducting a RCT to examine efficacy and intervention effects (versus a control condition [C-PFI]) across post- intervention and one-week and one-month follow-ups. A third aim will be to explore mechanisms of change and moderators. Primary hypotheses are that participants randomized to AP-PFI (vs. C-PFI) will report greater motivation/intention to reduce drinking, and lower levels of anxiety sensitivity at post-test. Secondary hypotheses are that participants randomized to AP-PFI (vs. C-PFI) will evince greater change in rates from hazardous to non-hazardous drinking, lower frequency and quantity of alcohol consumption, reduced negative consequences of drinking, and lower PTSD symptom severity. The proposed study provides an innovative extension of previous research, coincides well with current NIAAA initiatives, and has the potential to directly inform care for hazardous drinkers with PTSD symptomatology and elevated anxiety sensitivity.