Protective behavioral strategies and mental health: Reducing alcohol-related risk

描述（由申请人提供）：大学生中不断上升的心理困扰率为那些对减少酒精相关问题感兴趣的大学工作人员创造了一个新的、迄今尚未得到充分研究的领域。心理健康状况较差的学生（与同龄人相比，焦虑、抑郁、心理困扰程度更高）不仅饮酒量与其他学生相当，而且在控制饮酒时，他们经历的与酒精相关的负面后果也明显更多。然而，很少有针对这一人群的酒精干预措施，尽管事实上，努力发现有效的策略，以降低患有并存精神健康问题和高风险饮酒的学生的风险，具有广泛的意义。此外，我们的初步横断面研究发现，自发采用认知行为保护行为策略(PBS；例如，间隔饮酒，在饮酒时避免危险活动，如玩饮酒游戏或驾驶)旨在减少饮酒（与没有使用PBS的学生相比），心理健康状况较差的学生比心理健康状况较好的学生减少的后果要大得多，即使在饮酒控制之后也是如此。虽然PBS技能培训已成为几种多组分简短干预措施的一部分，但没有关于其作为单独干预措施的有效性的公开数据。因此，本研究将评估单独的PBS认知行为技能训练与个性化反馈（PBS- stpf）干预在增加PBS使用和减少危险饮酒和从大学咨询中心寻求服务的学生的负面后果方面的效果。参与者将是来自大学咨询中心的350名学生客户（60%为女性），他们在过去一个月里至少有过一次严重的偶发性饮酒事件。他们将被随机分配到PBS-STPF干预组或健康信息控制组。这两种情况都需要在计算机上完成基线调查，然后进行一对一的20- 25分钟的讨论。PBS- stf干预使用个人PBS反馈表来加强现有PBS的使用，同时建议参与者将来可能使用的其他保护策略。与会者还将探讨在经常遇到和高风险情况下实施这些战略的方法，并探讨克服实施障碍的方法。在PBS干预或对照讨论之后，参与者将通过在线调查进行两次评估（干预后1个月和6个月）。我们还将评估PBS使用是否介导干预效果，以及饮酒的心理困扰严重程度和应对动机是否调节干预效果。该项目将提供有价值的信息，说明基于认知行为的PBS独立干预在心理健康状况较差的学生中的效果，以及关于不同水平的一般和特定心理健康、酒精使用和酒精相关负面后果之间关系的初步数据。

DESCRIPTION (provided by applicant): Escalating rates of psychological distress among college students create a new and, as yet, understudied area of concern for college personnel interested in reducing alcohol-related problems. Not only do students with poorer mental health (anxiety, depression, greater levels of psychological distress in comparison to peers) drink at levels equivalent to other students, but when controlling for drinking, they experience significantly more alcohol-related negative consequences. However, few alcohol interventions have targeted this population despite that fact that efforts to uncover effective strategies to reduce risk among students with co-morbid mental health issues and high-risk drinking hold wide implications. Further, our preliminary cross-sectional work has found that among students spontaneously employing cognitive behavioral protective behavioral strategies (PBS; e.g., spacing out drinks, avoiding risky activities while drinking such as playing drinking games or driving) aimed at reducing drinking (compared to students not employing PBS), students with poorer mental health experienced significantly greater reductions in consequences than those with better mental health, even after control for drinking. While PBS skills training has been part of several multi-component brief interventions, there is no published data about its efficacy as a stand-alone intervention. Thus, the proposed study will evaluate the efficacy of a stand-alone PBS cognitive-behavioral skills training with personalized feedback (PBS-STPF) intervention at increasing PBS use and reducing risky drinking and negative consequences among students seeking services from a college counseling center. Participants will be 350 student-clients from a college counseling center (60% female) who have had at least one heavy episodic drinking event in the past month. They will be randomized to either the PBS-STPF intervention or health information control condition. Both conditions involve completing a baseline survey on a computer followed by a one-one-one 20- 25 minute discussion. The PBS-STF intervention utilizes a personal PBS feedback sheet to reinforce existing PBS use while suggesting other protective strategies that the participant may use in the future. Participants will also explore ways to implement these strategies in frequently encountered and high-risk situations and explore ways to overcome barriers to implementation. Following either the PBS intervention or control discussion, the participants will be assessed via online surveys twice (1-month and 6-months post-intervention). We will also evaluate whether PBS use mediates intervention efficacy and whether level of severity of psychological distress and coping motives for drinking moderate intervention efficacy. This project will provide valuable information on both the efficacy of a cognitive behavioral based PBS stand-alone intervention among students with poorer mental health and preliminary data on relationships between various levels of general and specific mental health, alcohol use, and negative alcohol-related consequences. PUBLIC HEALTH RELEVANCE: This study evaluates the efficacy of a protective behavioral strategies (PBS) cognitive-behavioral skills training with personalized feedback (PBS-STPF) intervention aimed at increasing PBS use and reducing risky drinking and negative consequences among students seeking services from a college counseling center.