Web-Based Treatment of Heavy Drinking Among Women with a History of Sexual Trauma

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DESCRIPTION (provided by applicant): Dr. Cynthia Stappenbeck has a strong foundation in alcohol research with an emphasis on examining the associations among alcohol use, trauma exposure, interpersonal aggression, and emotion regulation. Her long-term career goal is to build upon her previous experience conducting laboratory and experimental research to become an independent clinical scientist able to make a substantive contribution to the field of alcohol research by developing, evaluating, and widely disseminating therapeutic interventions among individuals at risk for problems associated with heavy drinking. Through her 5-year training plan and complementary research plan, the Mentored Clinical Scientist Research Career Development Award provides an opportunity for her to achieve this goal. Aims of the training plan include gaining experience conducting randomized controlled trials, continuing to develop advanced multivariate statistical skills, gaining knowledge on how to leverage technology for the administration and dissemination of therapeutic interventions, and presenting and disseminating data. These more immediate goals will be achieved through an interactive training plan comprised of direct mentorship, formal coursework, seminars, workshops, attendance at national conferences, and manuscript and grant writing. Dr. Stappenbeck's knowledge gained through the activities outlined in the training plan will be augmented by the proposed research. The goal of the research plan is to develop and empirically evaluate a web-based intervention to reduce heavy drinking among college women with a history of sexual assault who display elevated levels of psychological distress. College women with a history of sexual assault often report more heavy drinking and psychological distress than women without a history of assault. Moreover, women with assault histories often have difficulty regulating their emotions and tolerating distress which can lead to a pattern of drinking to cope distress. Trauma exposure, negative mood, and poor coping strategies have been associated with poor treatment outcomes and relapse following alcohol treatment. Incorporating distress tolerance and emotion regulation skills with an alcohol intervention may enhance treatment effects among women with a history of sexual assault by decreasing their motivation to drink to cope with depression or anxiety and by building adaptive coping strategies. Therefore, the web-based intervention will include cognitive behavioral skills for reducing alcohol consumption and incorporate emotion regulation and distress tolerance skills from Dialectical Behavior Therapy. The first phase of this research includes the initial development and continued refinement of the web-based intervention modules using an iterative process in which participant and expert feedback on intervention material is received and then an open trial is conducted to further refine the intervention and website. The second phase consists of a randomized controlled trial in which heavy drinking college women with a history of sexual assault and elevated levels of psychological distress will be recruited and randomized to receive the intervention or an assessment only control. Web-based surveys will be administered at baseline and post-treatment as well as 1- month and 6-months post-treatment in order to provide a more thorough examination of the mechanisms of change associated with the intervention. Drs. Debra Kaysen, Dennis Donovan, Melanie Harned, and David Atkins will serve as mentors on this award and Dr. William George will serve as an advisor. Collectively the mentorship team will provide expertise in the content areas, the conduct of randomized clinical trials, advanced statistical analyses, and use of technology to deliver interventions. Resources at the University of Washington provide an environment conducive to developing a career in alcohol research and gaining the skills necessary to launch a career as an independent scientist. The proposed award will provide pilot data for Dr. Stappenbeck's first R01 submission to NIAAA to more rigorously test this intervention against active controls with a larger sample and is consistent with NIH's goal of increasing and maintaining a strong cohort of investigators to address the Nation's behavioral and clinical research needs.