Walukevich-Dienst Katherine, Graupensperger Scott, Piccirillo Marilyn L, Smith-LeCavalier Kirstyn N, Acolin Jessica, Larimer Mary E
Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Seattle, Washington, USA.
Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA.
Alcohol Clin Exp Res (Hoboken). 2025 Jun 2. doi: 10.1111/acer.70077.
Undergraduates with higher social anxiety symptoms are at risk for co-occurring substance misuse, heavier drinking in certain contexts, and experiencing more negative alcohol-related consequences. Among undergraduates broadly, online norms-based interventions provide consistent and cost-effective reductions in alcohol use and related risks. However, research on norms-based interventions for undergraduates with higher social anxiety symptoms is limited, and less is known about the longitudinal impacts of social anxiety symptoms on the efficacy of online, norms-based alcohol interventions.
Secondary analyses were conducted on data from a large randomized controlled trial (RCT) with undergraduates who reported past-month heavy episodic drinking and were randomized to an attention control or a norms-based intervention. Generalized linear models tested whether baseline social anxiety symptoms moderated the efficacy of receiving a norms-based intervention versus a nonalcohol-focused attention control condition at 3-, 6-, and 12-month follow-up.
Social anxiety symptoms moderated intervention efficacy on the number of typical drinks consumed and descriptive norms at 3 months, as well as injunctive norms at 3 and 12 months. However, these effects appeared to be primarily driven by the individuals with higher social anxiety symptoms in the attention control group. Overall, norms-based interventions demonstrated efficacy in reducing the number of typical drinks consumed, descriptive and injunctive norms, and negative consequences up to 12 months later, regardless of social anxiety symptoms.
Results demonstrated that online norms-based interventions were similarly efficacious for reducing drinking, negative consequences, and normative beliefs for undergraduates, regardless of social anxiety symptoms. Further, effects were maintained up to 12 months. Thus, existing alcohol-focused brief interventions are efficacious for those with higher social anxiety symptoms, even without adaptation for social anxiety-specific concerns. Individuals with higher social anxiety symptoms who did not receive an active intervention reduced drinking beliefs and behaviors, although reductions were not maintained over time.
社交焦虑症状较高的大学生存在同时滥用药物、在某些情况下饮酒量更大以及经历更多与酒精相关的负面后果的风险。在广大本科生中，基于规范的在线干预措施能持续且经济高效地降低酒精使用及相关风险。然而，针对社交焦虑症状较高的本科生的基于规范的干预措施的研究有限，且对于社交焦虑症状对在线基于规范的酒精干预效果的纵向影响了解较少。
对一项大型随机对照试验（RCT）的数据进行二次分析，该试验的对象是报告过去一个月有大量饮酒经历并被随机分配到注意力控制组或基于规范的干预组的本科生。广义线性模型测试了在3个月、6个月和12个月的随访中，基线社交焦虑症状是否调节了接受基于规范的干预与非酒精聚焦的注意力控制条件相比的效果。
社交焦虑症状在3个月时调节了干预对典型饮酒量和描述性规范的效果，以及在3个月和12个月时对 injunctive 规范的效果。然而，这些影响似乎主要由注意力控制组中社交焦虑症状较高的个体驱动。总体而言，基于规范的干预措施在长达12个月后显示出在减少典型饮酒量、描述性和 injunctive 规范以及负面后果方面的效果，无论社交焦虑症状如何。
结果表明，基于规范的在线干预措施对于减少本科生的饮酒、负面后果和规范信念同样有效，无论社交焦虑症状如何。此外，效果持续了长达12个月。因此，现有的以酒精为重点的简短干预措施对于社交焦虑症状较高的人是有效的，即使没有针对社交焦虑特定问题进行调整。未接受积极干预的社交焦虑症状较高的个体减少了饮酒信念和行为，尽管随着时间的推移这些减少并未持续。
