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.

Public Health Relevance

Excessive alcohol consumption among college students continues to be a serious public health concern associated with a wide range of negative consequences. Development of efficacious intervention approaches remains a priority for NIAAA. The present research proposes expressive writing as a novel intervention approach, which has been used extensively in other domains but not as an alcohol intervention strategy. If effective, this intervention approach will offer an innovative advance which will obviate the need for any pre- assessment or programming of personalized feedback as currently required in most existing individually focused alcohol interventions for college students. In sum, the proposed expressive writing intervention approach has the potential to serve as an alternative to existing approaches and is capable of being more easily disseminated.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA023495-03
Application #
9318417
Study Section
National Institute on Alcohol Abuse and Alcoholism Initial Review Group (AA)
Program Officer
Shirley, Mariela
Project Start
2015-08-10
Project End
2020-07-31
Budget Start
2017-08-01
Budget End
2018-07-31
Support Year
3
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of Houston
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
036837920
City
Houston
State
TX
Country
United States
Zip Code
77204
Rodriguez, Lindsey M; Young, Chelsie M; Neighbors, Clayton et al. (2016) Cultural differences and shame in an expressive writing alcohol intervention. J Ethn Subst Abuse 15:252-267
Young, Chelsie M; Neighbors, Clayton; Dibello, Angelo M et al. (2016) Shame and Guilt-Proneness as Mediators of Associations Between General Causality Orientations and Depressive Symptoms. J Soc Clin Psychol 35:357-370
Rodriguez, Lindsey M; Young, Chelsie M; Neighbors, Clayton et al. (2015) Evaluating guilt and shame in an expressive writing alcohol intervention. Alcohol 49:491-8