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现性写作作为一种新的干预措施，在大学生中的问题饮酒。与其他成年人相比，大学生酗酒的风险更高，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重点简短干预措施都集中在个性化反馈方法上，最近的创新在很大程度上局限于对这些方法进行更细微的区分，这需要评估和规划来实施。本研究提出表现性写作作为一种新的替代方案，在其他领域得到了广泛的应用，但还不是一种酒精干预策略。我们提出了一种基于理论的方法，该方法结合了内疚的自我意识情绪的表达和改变谈话的书面模拟，作为提出的干预效果的机制。我们还将考察内疚倾向的个体差异，以此作为干预效果的调节因素。酗酒大学生(N=600)将被随机分配到六种表达写作条件中的一种，基于2(酒精与痛苦)×2(有罪与无罪)+1(中性对照)+1 (个性化反馈)设计。参与研究包括完成筛查评估、基线评估、干预、干预后评估和1个月、3个月、6个月和12个月的随访评估。为期三周，每周进行三次干预(表达写作)提示，第一次将在基线评估后立即进行。所有的基线评估、叙述性干预任务和所有条件的即时后测都将在实验室内进行。所有其他评估，包括筛选和后续评估，都将通过网络远程完成。试点数据为单次表达写作减少饮酒意图提供了一些支持，并为事件相关内疚作为饮酒行为的中介提供了支持 干预效果。本研究以这些研究为基础，采用复杂的实验设计，纳入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，并将评估基于理论的中介和调节因素。如果有效，这种干预方法将提供一种新的干预方法，不需要对个性化反馈进行任何预先评估或规划，并将作为现有方法的替代办法，这种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.