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

项目摘要/摘要 危险饮酒和创伤后应激障碍(PTSD)是非常常见的并存现象 与以下情况相比，与更大的残疾、死亡率和较差的健康结果相关的条件 任何一种单独的情况。然而，没有经验支持的干预计划可用于这种服务不足的情况 由于保留率差和辍学率高，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同存在的跨诊断风险因素是焦虑敏感性(即， 对与焦虑相关的感觉的负面后果的恐惧)。焦虑敏感是一种可延展性的， 认知-情感易感性因素与危险饮酒和疾病的发展呈正相关 维持创伤后应激障碍。在以下背景下针对焦虑敏感性的综合干预 危险饮酒和创伤后应激障碍症状尚未形成或测试。个性化反馈 干预措施(PFI)可能有助于弥补这一差距，因为它们已证明在减少危险方面有效 在不同人群中与饮酒和酒精相关的后果，而且是短暂的、经济有效的，而且很容易 可传播性。目前NRSA博士前奖学金的目标是帮助一项随机的 由Michael Zvolensky博士和Anka Vujanovic博士共同领导的对照试验(RCT)，旨在开发和测试 一种新的基于计算机的PFI在至少患有亚临床PTSD的危险饮酒者中的有效性(即， 在每个创伤后应激障碍症状群中至少认可一个症状)，并提高焦虑敏感度。第一个目标 该项目的主要任务是协助评估一次简短的、单次会议、 集成的、基于计算机的个性化反馈干预(AP-PFI)。第二个目标将是协助 进行随机对照试验，以检查疗效和干预效果(与对照条件[C-PFI]相比) 干预并进行为期一周和一个月的随访。第三个目标将是探索变化的机制和 版主。基本假设是，被随机分配到AP-PFI(与C-PFI)的参与者将报告更多 减少饮酒的动机/意图，以及考试后较低的焦虑敏感度水平。次要的 假设被随机分配到AP-PFI的参与者(与C-PFI相比)将表现出更大的比率变化 有害于非危险饮酒，降低饮酒频率和饮酒量，减少负面影响 饮酒的后果，以及较低的创伤后应激障碍症状严重程度。拟议的研究提供了一种创新的 对以前研究的扩展，与目前的NIAAA倡议很好地吻合，并有可能直接 告知对有创伤后应激障碍症状和焦虑敏感度升高的危险饮酒者的护理。

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.