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

项目总结/摘要 危险饮酒和创伤后应激障碍（PTSD）是非常常见的共同发生 与以下情况相比，与更大的残疾、死亡率和不良健康结局相关的疾病 任何一种情况下。然而，没有经验支持的干预方案可用于这一服务不足的地区。 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 可能是危险饮酒和PTSD共病的基础的转诊断风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，这是积极相关的危险饮酒和发展， PTSD的维持。一个综合的干预措施，专门针对焦虑敏感性的背景下， 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）可能有助于解决这一差距，因为它们已证明在减少危险 饮酒和酒精相关的后果在不同的人群，是短暂的，具有成本效益， 可传播的目前NRSA博士前奖学金的目的是协助进行随机 由Michael Zvolensky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的危险饮酒者中的疗效（即， 在每个PTSD症状群中认可至少一种症状）和焦虑敏感性升高。第一个目标 该项目的主要目的是协助评估一个简短的单一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，以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， 版主。主要假设是，随机分配至AP-PFI（与C-PFI相比）的受试者报告的 减少饮酒的动机/意图，以及测试后较低的焦虑敏感性水平。二次 假设随机分配至AP-PFI（与C-PFI相比）的受试者将显示从 有害饮酒改为无害饮酒，降低饮酒频率和数量，减少负 饮酒的后果，以及较低的PTSD症状严重程度。这项研究提供了一个创新的 之前研究的扩展，与当前的NIAAA计划非常吻合，并且有可能直接 对患有创伤后应激障碍和焦虑敏感性升高危险饮酒者进行知情护理。

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.