Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
Addict Sci Clin Pract. 2021 Aug 24;16(1):54. doi: 10.1186/s13722-021-00262-6.
Findings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects.
Non-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator.
Analysis of importance displayed a significant effect of intervention condition on importance (p < 0.003) and yielded a significant index of moderated mediation (CI - 0.79, - 0.02), indicating that the conditional indirect effect of treatment condition on drinking through importance was stronger for those with higher alcohol severity. For all motivation indices, alcohol severity moderated the effect of post-intervention motivation levels on drinking (p's < 0.05). The direct effect of treatment condition on drinking was not significant in any model.
Findings highlight the relevance of considering one's degree of alcohol problem severity in BI and alcohol screening efforts among non-treatment seeking heavy drinkers. These nuanced effects elucidate both potential mechanisms and moderators of BI response. Trial registration Clinicaltrials.gov: NCT04710095. Registered January 14, 2021-retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT04710095 .
简短干预（BI）是否适用于和对有更严重饮酒问题的个体是否有效，研究结果不一。改变饮酒的动机已被证实为 BI 行为改变的一种机制。这项探索性研究检验了动机作为 BI 临床反应机制的各个方面，以及酒精问题严重程度作为治疗效果的调节因素。
非治疗性寻求重度饮酒者（平均年龄 35 岁；57%为男性）被随机分配接受 BI（n=27）或注意力匹配的对照组（n=24）。在基线和干预后评估了改变饮酒的三个动机指标：重要性、信心和准备度。采用调节中介分析，以治疗条件为焦点预测因子，动机变化为中介，1 个月随访时的每日饮酒量为结果，酒精严重程度因素为第二阶段的调节因素。
分析重要性显示，干预条件对重要性有显著影响（p<0.003），并产生了显著的调节中介指标（CI-0.79，-0.02），表明治疗条件对通过重要性对饮酒的条件间接效应在酒精严重程度较高者中更强。对于所有动机指标，酒精严重程度都调节了干预后动机水平对饮酒的影响（p<0.05）。在任何模型中，治疗条件对饮酒的直接效应都不显著。
研究结果强调了在 BI 和非治疗性重度饮酒者的酒精筛查努力中考虑个体的酒精问题严重程度的重要性。这些细微的影响阐明了 BI 反应的潜在机制和调节因素。
Clinicaltrials.gov：NCT04710095。2021 年 1 月 14 日注册-回顾性注册，https://clinicaltrials.gov/ct2/show/study/NCT04710095。
