Guilt and expressive writing for reducing alcohol use in college students

描述（由申请人提供）：本申请旨在评估表达性写作作为一种新的干预大学生饮酒问题的方法。与其他成年人相比，大学生酒精滥用的风险增加，开发有效的干预方法是NIAAA的当务之急。绝大多数针对大学饮酒的个人关注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仅限于这些方法的更细微的区别，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颖的替代方法，已广泛应用于其他领域，但尚未作为酒精干预策略。我们提出了一种基于理论的方法，将内疚的自我意识情绪的表达和改变谈话的书面模拟作为干预效果的提议机制。我们还将研究内疚倾向的个体差异作为干预效果的调节因素。大量饮酒的大学生（N=600）将被随机分配到基于2（酒精vs痛苦）x 2（内疚vs无内疚）+ 1（中性对照）+ 1的六种表达性写作条件中的一种

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.