Motivational and Cognitive Intervention for Anxious and Depressed Hazardous Drink

描述（由申请人提供）：在过去的一年中，大约30%到60%的美国大学生报告了有害饮酒，其中包括大量饮酒和酒精相关问题的组合。许多大学饮酒者用酒精来应对焦虑和抑郁的影响，而这些饮酒的应对动机与当前的酒精相关问题和未来发展酒精依赖的更大风险有关。因此，双重关注管理消极情感状态和减少有害饮酒的简短干预可能代表着对仅针对酒精使用的现有方法的改进，特别是考虑到我们之前的研究结果，学生对学习减少焦虑和抑郁的技能更感兴趣，而不是酒精使用。我们研究项目的长期目标是开发出有效且具有成本效益的短期干预措施，这些干预措施可以进行测试，并随后在大学健康和咨询中心作为标准护理实施。这项探索性/发展性研究计划的重点是开发和试点测试一种新的单期干预的实施和效果，即饮酒者的动机和认知干预（MCID），它结合了动机访谈来减少危险饮酒和认知重构，以解决与酒精使用相关的焦虑和抑郁影响。该研究的第一阶段（n=20）将包括开发基于网络的评估程序、治疗手册和治疗完整性措施，以及培训两名咨询师在个人面对面会议期间提供MCID或短暂动机干预（BMI），仅针对危险饮酒。在第二阶段，我们将进行一项试点随机对照试验（n=72），以实现两个目标。首先，我们将测试MCID与两种有效的酒精干预措施的疗效：(1)在疗程长度和咨询师参与方面与MCID相等的比较酒精BMI；(2)仅由书面酒精反馈组成的最小控制条件。其次，我们将获得有关实施这三种干预措施的直接成本及其初步成本效益的数据。这项II期试点研究将在符合危险饮酒标准、有亚临床焦虑和/或抑郁水平并报告饮酒应对动机的大学生中进行。将通过基于网络的评估进行2个月、4个月和6个月的随访，以检查干预措施的酒精相关和情感结果。

DESCRIPTION (provided by applicant): Approximately thirty to sixty percent of college students in the United States report hazardous drinking in the past year, which includes a combination of heavy drinking episodes and alcohol related problems. Many college drinkers use alcohol to cope with anxious and depressed affect, and these coping motives for drinking are associated with current alcohol-related problems and greater risk for developing future alcohol dependence. Brief interventions with a dual focus on managing negative affective states and reducing hazardous drinking may therefore represent an improvement over extant approaches that target alcohol use only, particularly given our prior findings that students are more interested in learning skills to reduce their anxiety and depression than their alcohol use. The long-term goal of our research program is to develop efficacious and cost-effective brief interventions that can be tested and subsequently implemented as standard care at college health and counseling centers. The focus of this Exploratory/Developmental Research proposal is to develop and to pilot test the implementation and efficacy of a novel one-session intervention, the Motivational and Cognitive Intervention for Drinkers (MCID), which combines motivational interviewing to reduce hazardous drinking and cognitive restructuring to address anxious and depressed affect related to alcohol use. Phase I (n=20) of the study will involve the development of a web-based assessment program, treatment manuals and treatment integrity measures, as well as the training of two counselors to deliver MCID or a brief motivational intervention (BMI) targeting only hazardous drinking during an individual in-person session. During Phase II, we will conduct a pilot randomized controlled trial (n=72) to address two goals. First, we will test the efficacy of MCID against two efficacious alcohol interventions: (1) a comparison alcohol BMI equal to MCID in session length and counselor participation and (2) a minimal control condition consisting of only written alcohol feedback. Second, we will obtain data on the direct costs of implementing the three interventions and their preliminary cost-effectiveness. This Phase II pilot study will be conducted with a sample of college students who meet criteria for hazardous drinking, have subclinical levels of anxiety and/or depression, and report coping motives for drinking. Two-, four- and six-month follow-ups will be conducted via web-based assessment to examine alcohol-related and affective outcomes from the interventions. PUBLIC HEALTH RELEVANCE: The results of this study will provide the preliminary data necessary to design a full-scale clinical trial that will have sufficient power to test the efficacy and cost-effectiveness of the novel brief intervention in reducing hazardous drinking and negative affect. The combination of web-based assessment and counselor- delivered MCID presents a promising intervention that may be feasibly implemented as standard care at college health and counseling centers.