Secondary Prevention of Alcohol Dependence and Depression Among College Students

项目概述：酒精依赖和重度抑郁症是大学生困扰和残疾的两大主要来源。发展这些障碍的风险分别包括危险饮酒和抑郁症状加重，这两种情况在很大一部分大学生中都有经历，并使他们面临各种负面学术和人际关系后果的风险。危险饮酒和抑郁症状加重不仅增加了酒精依赖和重度抑郁症的发展风险，而且在这些疾病的发展、维持和复发中相互影响。最后，亚临床抑郁症状升高的危险饮酒学生表现出明显的认知动机特征，这可能影响他们改变的能力。鉴于抑郁症状升高和危险饮酒经常同时发生，在综合干预中解决这两个问题有许多好处。目前的项目旨在制定一个短期（3期）干预措施来实现这些目标。具体而言，本提案旨在：(1)为有酒精依赖和重度抑郁症风险的大学生开发一种综合的短期二级预防方法，以及(2)进行一项试点试验，以确定干预效果的效应大小估计。在第一阶段（1A阶段），将开发干预措施，并在8名表现出轻度至中度抑郁症状的危险饮酒大学生中进行试点测试。对于试点试验（Stage1B），参与者将被分配到基于系统动机咨询的短期干预（Cox & Klinger, 2004）或仅评估控制条件。将在基线、3个月和6个月时评估酒精结局、抑郁症状和假设的改变过程。这项工作的结果将为一项随机对照试验提供基础，以检验这种新的干预措施在预防酒精依赖和重度抑郁症发展方面的有效性。

DESCRIPTION (provided by applicant): Project Summary: Alcohol dependence and major depression represent two major sources of distress and disability among college students. Risks for the development of these disorders include hazardous drinking and elevated depressive symptoms respectively, both of which are experienced by a large proportion of college students and place them at risk for a variety of negative academic and interpersonal consequences. Hazardous drinking and elevated depressive symptoms not only increase the risk for the development of alcohol dependence and major depression but also have reciprocal influences on one another in the development, maintenance, and recurrence of these disorders. Finally, hazardous drinking students with elevated subclinical depression symptoms exhibit distinct cognitive motivational characteristics that may influence their ability to change. Given the frequent co-occurrence of elevated depressive symptoms and hazardous drinking, there are a number of advantages to addressing both of the issues in an integrated intervention. The current project seeks to develop a short-term (3-session) intervention to address these objectives. Specifically, this proposal seeks to: (1) develop an integrated short-term secondary prevention approach for alcohol dependence and major depression for college students at risk for these disorders, and (2) conduct a pilot trial to determine effect size estimates of the efficacy of the intervention. During the first phase (Stage 1A) the intervention will be developed and pilot tested with 8 hazardous drinking college students who exhibit mild to moderate depressive symptoms. For the pilot trial (Stage1B), participants will be assigned to either a short-term intervention that is based on systematic motivational counseling (Cox & Klinger, 2004) or an Assessment Only control condition. Alcohol outcomes, depressive symptoms, and hypothesized change processes will be assessed at baseline, 3 and 6 months. Results of this work will provide the basis for a randomized controlled trial to examine the efficacy of this new intervention to prevent the development of alcohol dependence and major depression.