Guilt and expressive writing for reducing alcohol use in college students

描述（由申请人提供）：目前的申请建议评估表达性写作作为一种新的干预大学生饮酒问题。与其他成年人相比，大学生滥用酒精的风险增加，制定有效的干预方法是NIAAA的当务之急。绝大多数针对大学饮酒的单独集中的简短干预措施都集中在个性化的反馈方法上，最近的创新在很大程度上局限于更精细的区分，这需要评估和规划实施。本研究提出表达性写作作为一种新的替代方案，已被广泛用于其他领域，但不是作为酒精干预策略。我们提出了一个理论为基础的方法，其中包括表达的自我意识的内疚情绪和书面模拟的变化谈话作为建议的干预效果的机制。我们还将研究内疚倾向的个体差异作为干预功效的调节因素。大量饮酒的大学生（N=600）将被随机分配到六种表达性写作条件之一，这些条件基于2（酒精vs.痛苦）x 2（内疚vs.无内疚）+ 1（中性对照）+ 1 （个性化反馈）设计。参与研究涉及完成筛选评估、基线评估、干预、干预后评估以及1个月、3个月、6个月和12个月的随访评估。每周将进行三次干预（表达性写作）提示，持续三周，第一次将在基线评估后立即进行。所有基线评估、叙述性干预分配和所有条件的即时后检查将在实验室内进行。所有其他评估（包括筛选和随访评估）将通过网络远程完成。试验数据提供了一些支持，一个单一的会议表达性写作在减少饮酒的意图，以及事件相关的内疚作为一个中介， 干预效果本研究建立在这些研究的基础上，通过将多个会议和多个后续评估，以评估饮酒和心理健康的实际变化，在一个复杂的实验设计，并将评估基于理论的调解人和调解人。如果有效，这种干预方法将提供一种新的干预方法，不需要任何预先评估或个性化反馈的规划，并将作为现有方法的替代方法，能够更容易地传播。

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.