Brief Intervention for Socially Anxious Alcohol Abusers

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DESCRIPTION (provided by applicant): Episodic alcohol abuse is common among college students. Recently, brief interventions focusing on motivational strategies and behavior skills to reduce heavy drinking and alcohol-related problems have shown beneficial small to medium effects in college drinkers who reported heavy drinking and/or alcohol-related problems. However, because diagnostic measures were not used, the effectiveness of such time-efficient interventions for students with DSM-diagnosed alcohol abuse remains unknown. Furthermore, most interventions have not taken into account psychiatric comorbidity, in particular social anxiety, a frequent problem for college students that has been linked to excessive alcohol use. This project will extend knowledge on brief interventions by (a) use of a standardized DSM-IV diagnostic measure to select college alcohol abusers and (b) integration of cognitive-behavioral therapeutic strategies for social anxiety with an existing alcohol intervention designed for college students. Funding through an Exploratory Development Grant for Intervention Research is requested to achieve the study goals detailed here. The efficacy of a new integrated treatment, the Brief Intervention for Socially Anxious Drinkers (BISAD) will be developed and tested. All participants must meet DSM-IV criteria for alcohol abuse and report heavy drinking and high social anxiety on standardized measures. Phase I of the study will focus on the development of the treatment manuals and measures of therapy integrity for BISAD and its control comparator, an extended treatment-as-usual focusing on alcohol skills and psychoeducation. During this phase therapists will be trained to administer the manualized interventions to study participants (N=20). Phase II will include further refinement of the therapy integrity measures and data collection for the pilot study (N=56). Participants will be randomized to either BISAD (n=28) or an extended treatment-as-usual (n=28) condition. The pilot study will provide preliminary data on the efficacy of the proposed intervention in reducing heavy drinking, social anxiety, and their negative consequences at 1-month and 4-month follow-ups after treatment termination. These data will provide estimated effect sizes for future testing of BISAD in a full-scale clinical trial. Furthermore, the study results will contribute to the conceptualization and methodological development of combined interventions for other substance use and psychiatric problems.