(PS6-C66) Drinking and Affective Outcomes of a Small Randomized Control Trial for Hazardous Drinkers with Negative Affect: A Comparison of Three Treatment Conditions

Significance: This NIAAA-funded pilot study developed and tested the effects of a one-session brief intervention that integrated motivational interviewing with personalized feedback report for hazardous drinking and cognitive restructuring for depression and social anxiety symptoms (MCID). MCID was compared to two other one-session interventions on alcohol, depression and anxiety measures: attention-controlled Brief Motivational Intervention (BMI) and written Alcohol Feedback Only (FAD).

Participants. The intention-to-treat sample (ITT) consisted of 85 undergraduate students who were randomized to receive MCID (n=29), BMI (n=28) or FAD (n=28). The sample distributions were 62% women, 86% Whites, and mostly freshman and sophomore students at an urban public university. The participants reported 51.05 (SD=31.20, range 8 to 26) alcoholic drinks and 4.76 (SD= 2.75, range of 1 to 9) heavy drinking days within the past month. All participants scored in subclinical range of negative affect (depression, social anxiety, and/or generalized anxiety.

Treatment outcome. The groups did not differ significantly (p = 61) on treatment completion. All groups showed significant improvement on alcohol and negative affect measures between pre-intervention and follow-ups at two and/or four months post-intervention: total alcohol consumption (ps < .023), heavy drinking days (ps < .025),  depression (ps < .035), social anxiety ps < .004), and generalized (p=.027 at 2-month only). To test the main study hypotheses that MCID will show greater reduction in alcohol and negative affect behaviors during treatment follow-up, greater emphasis was placed on treatment effect sizes (h_p²) than p-values for the interaction effects given the small sample size. Effect sizes (ES) were determined from partial h_p² values of Treatment*Time interaction effects. Cohen’s guidelines (1988) suggest h_p² = .1379 for large ES, h_p² =  .0588 medium ES, and h_p² = .0099 for small ES. Small-to-medium and medium interaction effects were found for total alcohol consumption at 2-month (h_p² = .041) and 4-month follow-up (h_p² = .067), respectively. Group mean scores showed greater consumption reduction in MCID and BMI compared to FAD participants, but no difference between MCID and BMI groups. Small interaction effects were found for heavy drinking frequency at both 2-month and 4-month ((h_p² < .008). Similar to alcohol indicators, negative affect variables showed mixed results. In contrast to study prediction, BMI participants reported greater reduction compared to other intervention groups on generalized anxiety (h_p² =.102) and social anxiety (h_p² =.057) symptoms at 2-month, with both indicating medium effect sizes. Treatment changes were similar across the three interventions for depression at both assessments and for anxiety measures at 4-month.   

Conclusion. Study mixed results did not support the addition of cognitive restructuring for depression or anxiety to one-session alcohol interventions for hazardous drinkers with subclinical negative affect. The findings suggest that these intervention recipients need more than one session to benefit from cognitive restructuring for maladaptive thoughts associated with negative affect.