Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.
Department of Psychology, Florida State University, Tallahassee, Florida, USA.
Alcohol Clin Exp Res. 2021 Oct;45(10):2147-2159. doi: 10.1111/acer.14681. Epub 2021 Aug 19.
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.
Participants were 393 college students who reported at least 2 heavy-drinking episodes in the past month. Participants were randomly assigned to 1 of 3 conditions following a baseline assessment: a standard alcohol-focused brief motivational intervention plus relaxation training session (BMI + RT), BMI plus Substance-Free Activity Session (BMI + SFAS), or an assessment-only control condition (AO). In a secondary analysis of the data from this study, we used person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up and examined whether environmental reward levels moderated the effectiveness of the interventions.
Piecewise growth mixture modeling identified 2 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 than the HR trajectory. For students in the LR trajectory, at 1, 6, and 12 months, BMI + SFAS led to greater increases in reward availability and reduced levels of alcohol severity compared with the BMI + RT and AO conditions and at 16 months compared with AO.
Young adults with low levels of environmental reward are at heightened risk for greater alcohol severity and may show greater benefit from brief alcohol interventions that focus on increasing substance-free reward than individuals who are not deficient in reward availability.
行为经济学理论预测，环境奖励的获取机会较少是酒精使用障碍（AUD）的一个风险因素。无物质活动课程（SFAS）是标准简短酒精干预的行为经济学补充，旨在增加环境奖励，因此可能具有有益的效果，特别是对环境奖励水平较低的个体。
参与者为 393 名大学生，他们在过去一个月内报告至少有 2 次重度饮酒发作。参与者在基线评估后随机分配到 3 个条件之一：标准酒精焦点简短动机干预加放松训练课程（BMI + RT）、BMI 加无物质活动课程（BMI + SFAS）或仅评估对照条件（AO）。在这项研究数据的二次分析中，我们使用基于个体的统计技术描述了在 16 个月的随访期间酒精严重程度和环境奖励的轨迹，并检查了环境奖励水平是否调节了干预措施的有效性。
分段增长混合模型确定了奖励可用性的 2 个轨迹：低增加（LR；n=120）和高稳定（HR；n=273）。抑郁症状、大麻使用、感觉寻求和低生活满意度与更有可能被归类为 LR 轨迹相关。LR 轨迹的酒精严重程度大于 HR 轨迹。对于处于 LR 轨迹的学生，在 1、6 和 12 个月时，与 BMI + RT 和 AO 条件相比，BMI + SFAS 导致奖励可用性增加更多，酒精严重程度降低，与 AO 相比，在 16 个月时也是如此。
环境奖励水平较低的年轻人更有可能出现更严重的酒精问题，并且可能从专注于增加无物质奖励的简短酒精干预中获益更多，而不是那些奖励可用性不缺乏的个体。
