Hazardous alcohol consumption is one of the leading causes of preventable deaths in the United States.1,2 Further, it is highly comorbid with anxiety and depressive symptoms and disorders3; hazardous alcohol use is associated with increased anxiety/depression.4 Indeed, 'affectively-vulnerable hazardous drinkers' (i.e., drinkers with elevated negative mood states or psychopathology) are 'at risk' for higher drinking rates, more problematic drinking, worsened mental health, and greater disability.5?7 Specialty care options are needed to address the unique 'affective needs' of hazardous drinkers.8,9 One promising intervention approach is to employ personalized feedback interventions (PFI). These interventions are brief, efficient, and have been shown to be effective in a number of settings and across an array of populations.10?16 However, PFIs have not been evaluated among affectively vulnerable hazardous drinkers. In order to address the heterogeneity of negative mood states and disorders among hazardous drinkers4,17, there is a need to theoretically orient the intervention approach on underlying transdiagnostic processes that underpin affective psychopathology.18 Anxiety sensitivity (AS), the tendency to fear anxiety- related sensations,19,20 is a core transdiagnostic vulnerability factor underlying the etiology and maintenance of anxiety disorders21, other emotional disorders22, and hazardous drinking23. AS is malleable in response to psychosocial interventions24, making it a prime risk factor to target in prevention/intervention programs, including PFI approaches. Integrated treatments that address hazardous drinking via AS are nonexistant. As most hazardous drinkers typically do not access treatment because of such barriers as cost, time commitments, stigma, and logistics (e.g., travel, scheduling appointments),25,26 there is a need to develop an accessible, brief, integrated tool to explicitly address the drinking-affective vulnerability comorbidity via AS. To address this public health gap, the current proposal seeks to employ a computer-delivered integrated PFI that directly addresses hazardous drinking-AS in a personalized manner. Hazardous drinkers with elevated AS (N = 130) will be randomly assigned to receive one session of PFI or attention information control with follow-up assessments at one week and one month post-intervention. The PFI will focus on targeted feedback about drinking behaviors, AS, and adaptive coping strategies.
Rates of hazardous alcohol use among anxious/depressed persons is approximately two times that found in the general population. Hazardous alcohol use contributes to a variety of problems, ranging from interference with life functioning to psychological and physical complications. Yet, hazardous alcohol users with affective problems remain a hard-to-reach and underserved group. The present research proposes to evaluate the efficacy of a brief, computer-based personalized feedback intervention (PFI) to reduce hazardous drinking among hazardous drinkers with elevated anxiety sensitivity, a well-established transdiagnostic affective vulnerability construct associated with a heightened risk for anxiety and depressive symptoms as well as coping-based drinking, more severe alcohol dependence, and premature treatment dropout/hazardous alcohol use relapse. PFIs have been found to be cost-effective and efficacious for reducing hazardous alcohol use and related risk behaviors across a number of populations. If effective, this intervention approach will offer a cost- effective means to reach an underserved group of hazardous drinkers and reduce hazardous drinking in this high-risk population. The current proposal will serve as initial validation of this novel computer-based integrated PFI for hazardous drinking and affective vulnerability and, if successful, will serve as the foundation for future, larger grant-funded work establishing efficacy relative to other computer-based treatments, including standard PFI for hazardous drinking and/or PFI for affective vulnerabilities.
