Department of Psychiatry, University of Missouri School of Medicine, Columbia, Missouri.
Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.
Alcohol Clin Exp Res. 2018 Jun;42(6):1145-1153. doi: 10.1111/acer.13637. Epub 2018 Apr 20.
Blackouts-or periods of alcohol-induced amnesia for all or part of a drinking event-have been identified as independent predictors of alcohol-related harm that may be used to identify individuals who would benefit from intervention. However, little is known about the prevalence and impact of blackouts among Veterans. This study examined blackouts as a moderator of young adult veteran response to a brief, online personalized normative feedback (PNF) intervention for heavy drinking.
Veterans scoring ≥3/4 (women/men) on the Alcohol Use Disorders Identification Test completed a baseline and 1-month assessment as part of a larger intervention trial (N = 571; 83% male; age M = 28.9, SD = 3.3). Participants were randomized to alcohol PNF (n = 285) or a video game attention control (n = 286). Hierarchical regression was used to examine the interaction between intervention condition and blackouts on alcohol-related outcomes at 1-month follow-up.
At baseline, 26% of participants reported loss of memory for drinking events in the past 30 days. The interaction between condition and blackouts was significant, such that PNF participants who had experienced blackouts at baseline reported greater decreases in drinking quantity at 1 month than those who had not, and only PNF participants who had experienced baseline blackouts reported a decrease in alcohol problems at follow-up.
PNF appears to be particularly effective for individuals who have experienced alcohol-induced blackout, perhaps because blackouts prime them for feedback on their alcohol use. While other negative consequences may also prime individuals for behavior change, blackouts are posited as a particularly useful screening tool because they are prevalent among young adults, have a strong association with alcohol-related harm, and are assessed in widely used clinical measures.
酗酒者会出现断片现象，即对某次饮酒事件的全部或部分内容失去记忆，这种现象已被确定为与酒精相关的伤害的独立预测因素，可用于识别可能受益于干预的个体。然而，目前对于退伍军人中断片现象的发生率和影响知之甚少。本研究考察了断片现象作为一个调节变量，对接受简短的在线个性化规范反馈（PNF）干预治疗重度饮酒的年轻成年退伍军人的影响。
酒精使用障碍识别测试（AUDIT）得分≥3/4（女性/男性）的退伍军人完成了基线和 1 个月的评估，作为一项更大的干预试验的一部分（N=571；83%为男性；年龄 M=28.9，SD=3.3）。参与者被随机分配到酒精 PNF 组（n=285）或视频游戏注意力对照组（n=286）。使用分层回归分析检验干预条件与断片现象在 1 个月随访时对酒精相关结果的交互作用。
在基线时，26%的参与者报告在过去 30 天内有过饮酒后失去记忆的经历。干预条件与断片现象之间的交互作用具有统计学意义，即基线时经历过断片现象的 PNF 组参与者在 1 个月时的饮酒量减少量大于未经历过断片现象的参与者，只有基线时经历过断片现象的 PNF 组参与者在随访时报告酒精问题减少。
PNF 似乎对经历过酒精性断片现象的个体特别有效，这可能是因为断片现象让他们对自己的饮酒行为有了反馈。虽然其他负面后果也可能让个体为行为改变做好准备，但断片现象被认为是一种特别有用的筛选工具，因为它在年轻成年人中普遍存在，与酒精相关的伤害有很强的关联，并且在广泛使用的临床测量中得到评估。
