Brief motivational interventions (BMIs) for young adult alcohol abuse are among the most cost-effective preventive care measures, yet there has been relatively little theory-based research aimed at improving their efficacy and identifying mechanisms of change. Based on research indicating that low-levels of substance-free reinforcement is a risk factor for poor BMI response, this research team developed and pilot tested a supplemental session to traditional feedback and MI-based alcohol interventions. This session directly targets the behavioral economic mechanisms of substance-free reinforcement and delayed reward discounting by encouraging the development of and commitment to academic and career goals, and by and highlighting the impact of day-to-day patterns of heavy drinking and academic engagement on these goals. A pilot trial (R21AA016304) found that a two session (alcohol BMI + Substance-Free Activity Session; SFAS) intervention resulted in significantly greater reductions in alcohol problems (p = .01, db= .52) relative to a two session (alcohol BMI + Relaxation) active control condition. The BMI + SFAS was also associated with significantly greater reductions in heavy drinking for participants with lower levels of substance-free reinforcement at baseline. This was the first controlled study to demonstrate that a supplement to traditional BMIs can improve outcomes. The current proposal would improve and more extensively evaluate the efficacy of the SFAS in a randomized 3-group (BMI + SFAS vs. BMI + Relaxation Training vs. Assessment only) trial with 425 first and second year college students (projected 50% female and 20% minority) who report recent heavy drinking recruited from two large public universities. The results will determine whether the SFAS enhances the efficacy of a standard BMI while controlling for total contact time. Drinking and substance-free activity outcomes will be assessed 1, 4, 12 and 16 months post-intervention. It is hypothesized that at follow-up BMI + SFAS participants will report significantly lower levels of drinking and alcohol-related problems, and higher levels of constructive substance-free activities, than BMI + Relaxation and assessment only participants, and that the predicted advantage for BMI + SFAS will be mediated by increased participation in substance-free activities and reduced delay discounting. It is further hypothesized that the BMI + SFAS intervention will be more effective for participants who report high baseline alcohol reinforcing efficacy (measured using demand curve and proportional substance-related reinforcement measures) and greater delayed reward discounting than those who report low reinforcing efficacy and delayed reward discounting. This study will also evaluate the economic costs and benefits associated with the BMI + SFAS intervention relative to an active control condition. Should this behavioral economic supplement demonstrate efficacy and cost-effectiveness then clinicians would have a more effective modality for attempting to reduce alcohol use in young adult drinkers, and administrators would have an economic rationale for adopting the intervention in their universities.

Public Health Relevance

Brief motivational interventions (BMIs) for alcohol abuse are among the most cost-effective preventive care measures, and the development and evaluation of innovative methods for improving BMIs is one of the public health priorities highlighted in the 2010 National Drug Control Strategy. The goal of this research is to improve BMIs by adding a session focused on increasing engagement in constructive alternatives to alcohol use.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
Project #
Application #
Study Section
Neuroscience Review Subcommittee (AA)
Program Officer
Shirley, Mariela
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Memphis
Schools of Arts and Sciences
United States
Zip Code
Acuff, Samuel F; Luciano, Matthew T; Soltis, Kathryn E et al. (2018) Access to environmental reward mediates the relation between posttraumatic stress symptoms and alcohol problems and craving. Exp Clin Psychopharmacol 26:177-185
Acuff, Samuel F; MacKillop, James; Murphy, James G (2018) Applying behavioral economic theory to problematic Internet use: An initial investigation. Psychol Addict Behav 32:846-857
Acuff, Samuel F; Soltis, Kathryn E; Luciano, Matthew T et al. (2018) Depressive symptoms as predictors of alcohol problem domains and reinforcement among heavy drinking college students. Psychol Addict Behav 32:792-799
Lindgren, Kristen P; Hendershot, Christian S; Ramirez, Jason J et al. (2018) A dual process perspective on advances in cognitive science and alcohol use disorder. Clin Psychol Rev :
Colby, Suzanne M; Orchowski, Lindsay; Magill, Molly et al. (2018) Brief Motivational Intervention for Underage Young Adult Drinkers: Results from a Randomized Clinical Trial. Alcohol Clin Exp Res 42:1342-1351
Teeters, Jenni B; Soltis, Kathryn E; Murphy, James G (2018) A Mobile Phone-Based Brief Intervention With Personalized Feedback and Text Messaging Is Associated With Reductions in Driving After Drinking Among College Drinkers. J Stud Alcohol Drugs 79:710-719
Meshesha, Lidia Z; Utzelmann, Bettina; Dennhardt, Ashley A et al. (2018) A Behavioral Economic Analysis of Marijuana and Other Drug Use Among Heavy Drinking Young Adults. Transl Issues Psychol Sci 4:65-75
Voss, Andrew T; Soltis, Kathryn E; Dennhardt, Ashley A et al. (2018) Protective behavioral strategies mediate the relationship between behavioral economic risk factors and alcohol-related problems. Exp Clin Psychopharmacol 26:58-64
Acuff, Samuel F; Soltis, Kathryn E; Dennhardt, Ashley A et al. (2018) Evaluating Behavioral Economic Models of Heavy Drinking Among College Students. Alcohol Clin Exp Res 42:1304-1314
Joyner, Keanan J; Acuff, Samuel F; Meshesha, Lidia Z et al. (2018) Alcohol family history moderates the association between evening substance-free reinforcement and alcohol problems. Exp Clin Psychopharmacol 26:560-569

Showing the most recent 10 out of 21 publications