Guilt and expressive writing for reducing alcohol use in college students

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DESCRIPTION (provided by applicant): The current application proposes to evaluate expressive writing as a novel intervention for problem drinking among college students. College students are at increased risk for alcohol misuse compared to other adults, and development of efficacious intervention approaches is an urgent priority for NIAAA. The vast majority of individually focused brief interventions targeting college drinking have focused on personalized feedback approaches and recent innovations have largely been limited to finer distinctions of these, which require assessment and programming for implementation. The present research proposes expressive writing as a novel alternative, which has been used extensively in other domains but not as an alcohol intervention strategy. We propose a theoretically-based approach, which incorporates expression of the self-conscious emotion of guilt and the written analogue of change talk as proposed mechanisms of intervention efficacy. We will also examine individual differences in propensity for guilt as a moderator of intervention efficacy. Heavy drinking college students (N=600) will be randomly assigned to one of six expressive writing conditions based on the 2 (alcohol vs. distress) x 2 (guilt vs. no guilt) + 1 (neutral control) + 1 (personalized feedback) design. Participation in the study involves completion of a screening assessment, a baseline assessment, the intervention, post-intervention assessment, and follow-up assessments at one-month, three-months, six- months, and twelve-months. There will be three intervention (expressive writing) prompts to take place every week for three weeks, the first of which will occur immediately following the baseline assessment. All baseline assessments, narrative intervention assignments, and immediate post-tests for all conditions will be conducted in-lab. All other assessments including screening and follow-up assessments will be completed remotely by web. Pilot data has provided some support for a single session of expressive writing in reducing drinking intentions, as well as event-related guilt as a mediator of intervention efficacy. The present research builds on these studies by incorporating multiple sessions and multiple follow-up assessments to evaluate actual changes in drinking and psychological well-being, in a complex experimental design and will evaluate theoretically-based mediators and moderator. If effective, this intervention approach will offer a novel intervention which will not require any pre-assessment or programming of personalized feedback, and would serve as an alternative to existing approaches, which is capable of being more easily disseminated.