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

描述（由申请人提供）：大学生心理困扰率的不断上升，为有兴趣减少酒精相关问题的大学人员创造了一个新的、尚未得到充分研究的关注领域。不仅心理健康状况较差的学生（焦虑，抑郁，与同龄人相比心理困扰程度更高）饮酒水平与其他学生相当，但当控制饮酒时，他们会经历更多与酒精相关的负面后果。然而，很少有酒精干预措施针对这一人群，尽管事实上，努力发现有效的策略，以减少患有共病心理健康问题和高风险饮酒的学生之间的风险具有广泛的影响。此外，我们初步的横断面研究发现，在自发采用认知行为保护行为策略（PBS;例如，间隔饮料，避免危险活动，而饮酒，如玩饮酒游戏或驾驶），旨在减少饮酒（与学生相比，没有使用PBS），学生心理健康较差的经历了显着更大的减少后果比那些心理健康较好，即使在控制饮酒。虽然PBS技能培训是几个多组成部分的简短干预措施的一部分，但没有关于其作为独立干预措施的有效性的公开数据。因此，拟议的研究将评估一个独立的PBS认知行为技能培训与个性化反馈（PBS-STPF）干预在增加PBS的使用和减少风险饮酒和从大学咨询中心寻求服务的学生的负面后果的有效性。参与者将是来自大学咨询中心的350名学生客户（60%为女性），他们在过去的一个月里至少有一次重度饮酒事件。他们将被随机分配到PBS-STPF干预或健康信息控制条件。这两种情况都涉及在计算机上完成基线调查，然后进行20- 25分钟的一对一讨论。PBS-STF干预利用个人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。与会者还将探讨如何在经常遇到的高风险情况下实施这些战略，并探讨如何克服实施障碍。在PBS干预或对照讨论后，将通过两次在线调查（干预后1个月和6个月）对参与者进行评估。我们还将评估PBS的使用是否介导干预效果，以及心理困扰的严重程度和饮酒的应对动机是否适度干预效果。该项目将提供有关心理健康状况较差的学生中基于认知行为的PBS独立干预的有效性的有价值的信息，以及关于各种水平的一般和特定心理健康，酒精使用和负面酒精相关后果之间关系的初步数据。 公共卫生相关性：本研究评估了保护性行为策略（PBS）认知行为技能训练与个性化反馈（PBS-STPF）干预的有效性，旨在增加PBS的使用，减少危险饮酒和不良后果的学生寻求服务，从大学咨询中心。

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.