Alcohol Clin Exp Res. 2021 Aug 2. doi: 10.1111/acer.14681. Online ahead of print.


BACKGROUND: Behavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, particularly for individuals with low levels of environmental reward.

METHODS: Participants were 393 college students who reported at least 2 heavy drinking episodes in the past month. Participants were randomized to one of three conditions following a baseline assessment: standard alcohol-focused brief motivational intervention plus relaxation training session (BMI+RT), BMI plus Substance-Free Activity Session (BMI+SFAS), or assessment-only control condition (AO). This secondary analysis uses person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up, and to examine if environmental reward levels moderated the effectiveness of the interventions.

RESULTS: Piecewise growth mixture modeling identified two trajectories of reward availability: low-increasing (LR; n = 120) and high-stable (HR; n = 273). Depressive symptoms, cannabis use, sensation-seeking, and low life satisfaction were associated with a greater probability of classification in the LR trajectory. Alcohol severity was greater in the LR trajectory compared to the HR trajectory. For students in the LR trajectory, BMI+SFAS led to greater increases in reward availability and reduced levels of alcohol severity at 1, 6, and 12 months compared to BMI+RT and AO conditions, and also at 16 months compared to AO.

CONCLUSIONS: Young adults with low levels of environmental reward are at heightened risk for greater alcohol severity, and these individuals may show greater relative benefit from brief alcohol interventions that focus on increasing substance-free reward.

PMID:34342015 | DOI:10.1111/acer.14681

Source: ncbi 2

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