Brief Motivational Interventions for College Drinkers: What We Still Need to Know

[Clin Psychol Sci Prac 17: 72–76, 2010]
Isolating the mechanisms of change that lead to reduced risk for heavy drinking by college students—a high-risk population—will permit development of succinct, targeted, and thereby more effective interventions. Examinations of currently used empirically supported brief interventions provide a starting point for identifying mediators (i.e., mechanisms) of change. Extrapolating from such work, it appears that there may be utility in using face-valid and possibly gender-specific interventions. In moving forward, it behooves clinical researchers to continue to draw on theory to identify potential proximal predictors of change. Continuing to think broadly will allow us to not only refine the current content of brief interventions but also open up the opportunity to introduce new components to treatment.     

体育锻炼影响女大学生抑郁的多重中介效应

目的:分析女大学生体育锻炼、抑郁之间的关系,探讨社会支持、应对方式在体育锻炼与抑郁之间的中介作用。方法:抽取某高校255名女大学生,采用体育活动等级量表、抑郁自评量表、社会支持评定量表、大学生应对方式问卷进行调查;利用层级回归与偏差矫正的非参数百分位Bootstrap方法对社会支持与应对方式的中介效应进行分析与检验。结果:(1)体育活动量与抑郁显著负相关(r=-0.160,P0.05);(2)在社会支持与应对方式的所有因子中,只有主观支持、问题解决两因子与体育活动量(r=0.163,P0.05;r=-0.174,P0.01)和抑郁(r=-0.316,P0.01;r=0.283,P0.01)都相关显著;(3)多重中介模型分析和Bootstrap检验显示,主观支持与问题解决在体育锻炼与抑郁之间的并行多重中介作用的效应显著,其效应量占总效应量的51%,而体育锻炼对抑郁的直接作用不显著;在多重中介作用中,主观支持、问题解决的个别中介作用效应都显著,它们的中介效应量分别占总效应的27%、24%。结论:体育锻炼对于缓解女大学生抑郁具有积极作用;体育锻炼可通过主观支持与问题解决两条路径间接影响女大学生的抑郁水平,主观支持与问题解决在体育锻炼与女大学生抑郁间起并行多重中介作用。     

团体心理干预对贫困大学生心理资本的影响

目的:本研究根据Luthans的心理资本理论及干预模型,采用团体心理干预方式探究其对高校贫困大学生心理资本的辅导和干预效果。方法:研究采用教育实验法,设计实验组、对照组前后测实验,并使用心理资本问卷及症状自评量表(SCL-90)为测量工具。结果:1心理资本因子上,实验组与对照组后测结果差异显著(t=6.261,P0.001),实验组得分高于对照组;实验组前后测结果差异显著(t=-5.490,P0.001),心理资本后测得分高于前测;对照组前后测差异不显著;2在症状自评量表得分上,实验组后测得分显著低于对照组(t=-2.557,P0.05);实验组后测得分明显低于前测(t=5.214,P0.001);对照组实验前后测差异不显著(P0.05)。结论:以心理资本理论为基础设计的团体心理辅导干预方案能有效帮助贫困大学生提高心理资本水平。     

Effective school-based preventive interventions for alcohol use in Africa: a systematic review

BackgroundDespite recognition of the risks of alcohol use and importance of prevention from an early age, the effectiveness of school-based interventions in Africa has not been clarified.ObjectiveWe aimed to identify effective school-based alcohol use prevention interventions in Africa.MethodsWe searched eight databases for peer-reviewed articles published until February 3, 2019 that reported on randomized controlled trials, cluster randomized controlled trials, controlled clinical trials, pre-post quasi-experimental studies, cohort studies, and case-control studies. The full-texts of relevant studies were searched.ResultsFour of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, intervention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls.Conclusioninterventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students'' alcohol refusal self-efficacy.     

Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: a randomized controlled trial

Background

Current insights indicate that Web-based delivery may enhance the implementation of brief alcohol interventions. Previous research showed that electronically delivered brief alcohol interventions decreased alcohol use in college students and adult problem drinkers. To date, no study has investigated the effectiveness of Web-based brief alcohol interventions in reducing alcohol use in younger populations.

Objective

The present study tested 2 main hypotheses, that is, whether an online multicomponent brief alcohol intervention was effective in reducing alcohol use among 15- to 20-year-old binge drinkers and whether inclusion of normative feedback would increase the effectiveness of this intervention. In additional analyses, we examined possible moderation effects of participant’s sex, which we had not a priori hypothesized.

Method

A total of 575 online panel members (aged 15 to 20 years) who were screened as binge drinkers were randomly assigned to (1) a Web-based brief alcohol intervention without normative feedback, (2) a Web-based brief alcohol intervention with normative feedback, or (3) a control group (no intervention). Alcohol use and moderate drinking were assessed at baseline, 1 month, and 3 months after the intervention. Separate analyses were conducted for participants in the original sample (n = 575) and those who completed both posttests (n = 278). Missing values in the original sample were imputed by using the multiple imputation procedure of PASW Statistics 18.

Results

Main effects of the intervention were found only in the multiple imputed dataset for the original sample suggesting that the intervention without normative feedback reduced weekly drinking in the total group both 1 and 3 months after the intervention (n =575, at the 1-month follow-up, beta = -.24, P = .05; at the 3-month follow-up, beta = -.25, P = .04). Furthermore, the intervention with normative feedback reduced weekly drinking only at 1 month after the intervention (n=575, beta = -.24, P = .008). There was also a marginally significant trend of the intervention without normative feedback on responsible drinking at the 3-month follow-up (n =575, beta = .40, P =.07) implying a small increase in moderate drinking at the 3-month follow-up. Additional analyses on both datasets testing our post hoc hypothesis about a possible differential intervention effect for males and females revealed that this was the case for the impact of the intervention without normative feedback on weekly drinking and moderate drinking at the 1-month follow-up (weekly drinking for n = 278, beta = -.80, P = .01, and for n = 575, beta = -.69, P = .009; moderate drinking for n = 278, odds ratio [OR] = 3.76, confidence interval [CI] 1.05 - 13.49, P = .04, and for n = 575, OR = 3.00, CI = 0.89 - 10.12, P = .08) and at the 3-month follow-up (weekly drinking for n = 278, beta = -.58, P = .05, and for n = 575, beta = -.75, P = .004; moderate drinking for n = 278, OR = 4.34, CI = 1.18 - 15.95, P = .04, and for n = 575, OR = 3.65, CI = 1.44 - 9.25, P = .006). Furthermore, both datasets showed an interaction effect between the intervention with normative feedback and participant’s sex on weekly alcohol use at the 1-month follow-up (for n = 278, beta = -.74, P =.02, and for n = 575, beta = -.64, P =.01) and for moderate drinking at the 3-month follow-up (for n = 278, OR = 3.10, CI = 0.81 - 11.85, P = .07, and for n = 575, OR = 3.00, CI = 1.23 - 7.27, P = .01). Post hoc probing indicated that males who received the intervention showed less weekly drinking and were more likely to drink moderately at 1 month and at 3 months following the intervention. For females, the interventions yielded no effects: the intervention without normative feedback even showed a small unfavorable effect at the 1-month follow-up.

Conclusion

The present study demonstrated that exposure to a Web-based brief alcohol intervention generated a decrease in weekly drinking among 15- to 20-year-old binge drinkers but did not encourage moderate drinking in the total sample. Additional analyses revealed that intervention effects were most prominent in males resulting in less weekly alcohol use and higher levels of moderate drinking among 15- to 20-year-old males over a period of 1 to 3 months.

Trial Registration

ISRCTN50512934; http://www.controlled-trials.com/ISRCTN50512934/ (Archived by WebCite at http://www.webcitation.org/5usICa3Tx)     

贫困大学生人际交往心理障碍干预策略

目的探讨贫困大学生人际交往心理障碍干预的有效策略。方法采用团体辅导与自我教育模式对95名有不同程度交往心理障碍的医学贫困生实施16周的自我意识、人格和人际情商的系统心理理论辅导和心理体验训练。结果贫困生人际间的心理困扰得以明显改善,干预前、后各心理量表检测均分比较差异均有统计学意义,交往自卑(t=4.806,P<0.01),交往焦虑(t=4.862,P<0.01),交流恐惧(t=2.547,P<0.02),羞怯(t=8.573,P<0.01),孤独t=(3.506,P<0.01);贫困生自体心理困扰程度的纵向改善观察有效评价达94%以上。结论显示自我意识健全、人格品质优化和人际情商提升对贫困生人际交往心理障碍干预作用的可行性和实效性。     

Acceptability of a clinician-assisted computerized psychological intervention for comorbid mental health and substance use problems: treatment adherence data from a randomized controlled trial

Background

Computer-delivered psychological treatments have great potential, particularly for individuals who cannot access traditional approaches. Little is known about the acceptability of computer-delivered treatment, especially among those with comorbid mental health and substance use problems.

Objective

The objective of our study was to assess the acceptability of a clinician-assisted computer-based (CAC) psychological treatment (delivered on DVD in a clinic-setting) for comorbid depression and alcohol or cannabis use problems relative to a therapist-delivered equivalent and a brief intervention control.

Methods

We compared treatment acceptability, in terms of treatment dropout/participation and therapeutic alliance, of therapist-delivered versus CAC psychological treatment. We randomly assigned 97 participants with current depression and problematic alcohol/cannabis use to three conditions: brief intervention (BI, one individual session delivered face to face), therapist-delivered (one initial face-to-face session plus 9 individual sessions delivered by a therapist), and CAC interventions (one initial face-to-face session plus 9 individual CAC sessions). Randomization occurred following baseline and provision of the initial session, and therapeutic alliance ratings were obtained from participants following completion of the initial session, and at sessions 5 and 10 among the therapist-delivered and CAC conditions.

Results

Treatment retention and attendance rates were equal between therapist-delivered and CAC conditions, with 51% (34/67) completing all 10 treatment sessions. No significant differences existed between participants in therapist-delivered and CAC conditions at any point in therapy on the majority of therapeutic alliance subscales. However, relative to therapist-delivered treatment, the subscale of Client Initiative was rated significantly higher among participants allocated to the BI (F_2,54 = 4.86, P = .01) and CAC participants after session 5 (F_1,29 = 9.24, P = .005), and this domain was related to better alcohol outcomes. Linear regression modeled therapeutic alliance over all sessions, with treatment allocation, retention, other demographic factors, and baseline symptoms exhibiting no predictive value.

Conclusions

Participants in a trial of CAC versus therapist-delivered treatment were equally able to engage, bond, and commit to treatment, despite comorbidity typically being associated with increased treatment dropout, problematic engagement, and complexities in treatment planning. The extent to which a client feels that they are directing therapy (Client initiative) may be an important component of change in BI and CAC intervention, especially for hazardous alcohol use.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12607000437460; http://www.anzctr.org.au/trial_view.aspx?ID=82228 (Archived by WebCite at http://www.webcitation.org/5ubuRsULu)     

医学院校大学生生活方式现状调查及干预对策

目的:了解医学院校大学生生活方式的现状及主要影响因素,为改善其生活方式和提高其身心健康状况提供科学、合理的建议。方法:运用一般情况调查、健康生活方式评价量表(HLQ)进行问卷调查,采用Excel建立数据库,并用SPSS 19.0对数据进行统计分析。结果:1生活方式总标准分为67.19,运动锻炼维度标准得分最低值为46.83;2女大学生在运动锻炼(t=6.510,P0.01)、压力管理(t=2.258,P0.05)维度得分低于男大学生;3健康责任(t=3.654,P0.01)、人际支持(t=3.185,P0.01)、压力管理(t=3.333,P0.01)、生命欣赏(t=3.026,P0.01)维度得分高年级均低于低年级学生;4健康责任(F=5.829,P0.01)、压力管理(F=4.050,P0.05)维度得分非医学高于临床医学和护理学学生;5健康责任(t=-2.957,P0.01)、生命欣赏(t=-3.001,P0.01)维度得分农村大学生低于城市大学生。结论:医学院校大学生生活方式总体处于中等水平。     

高师生自我和谐及其与领悟社会支持的关系

目的考查高师生自我和谐现状,并进一步揭示高师生自我和谐与领悟社会支持之间的关系。方法采用自我和谐量表及领悟社会支持量表对223名高师生进行问卷调查。结果15．2％高师生表现出自我的不和谐。高师生自我灵活性得分显著高于常模分数。高师生在自我和谐总分及分量表得分不存在性别差异。理科学生的自我刻板性得分显著高于文科学生。领悟社会支持除与自我和谐呈显著负相关,并进入回归方程,解释变异的16．4％。结论高师生自我和谐水平没有降低,但其状况不容乐观,应加强高师生心理健康教育,特别要对女生、理科学生给予更多关注。领悟社会支持与自我和谐呈显著负相关,对自我和谐程度有一定的预澳,l作用．     

一所高校学生神经症患病状况分析

目的：探讨一所高校大学生神经症患病状况及相关因素。方法：采用与国内12地区神经症流行病学调查相似的方法对一所高校4465名学生神经症患病状况进行调查研究。结果：该校学生神经症现患病率为9．34％，高于10年前对该校进行的调查结果(6．44％)，焦虑症现患病率明显升高。男生高于女生，以三、四年级现患病率最高。由失恋引发的神经症占一定的比例，但神经症发病还是取决于多种因素的共同作用。结论：大学生中神经症的现患病率有上升趋势，心理社会因素对神经症的发生有重要作用。大学生心理问题不容忽视，是摆在我们精神卫生工作者面前的重要课题。     

学业受挫大学生与一般大学生上网状况比较

目的：探讨学业受挫大学生上网行为的特点。方法：以365名广东某大学学生作为研究对象，其中学业受挫学生73名，一般学生292名，采用CIAS、OCS、网络使用调查表等测验，对测试结果进行统计分析。结果：(1)学业受挫的大学生在上网时间、上网目的、自知网瘾程度、求助心态、学习态度、专业兴趣、上网后学业成绩等方面与一般学生相比均存在较为显著的差异。(2)学业受挫学生在时间管理、人际和健康、逃避因子得分均明显高于一般学生。结论：过度使用网络是导致大学生学习成绩下降的重要因素之一，学业受挫大学生病理性网络使用行为较一般大学生严重。     

高职生自我和谐发展的课堂干预研究

目的探讨心理课堂教学对提高高职生自我和谐发展的实际作用。方法采用自然教学实验法对随机抽取的4个教学班分为实验班和对照班进行为期半年的心理课程"整体教学"干预实验。结果高职生总体自我和谐发展水平处于中等偏上的水平。实验班学生的总体自我和谐发展(t=-2.101,P<0.05)较对照班有了显著提高。结论心理课堂教学是普及心理健康知识的重要干预措施,心理健康知识对高职生自我和谐发展至关重要。     

CBT技术对大学生进食障碍的个案干预

目的通过对进食障碍的认知行为治疗的个案研究,探讨认知行为治疗技术对我国患者的疗效。方法在6次会谈中使用CBT技术对患者的进食障碍进行干预。结果来访者焦虑、抑郁水平显著降低,进食行为基本得到控制,自引呕泻行为完全消失,体重增加,月经逐步恢复正常。结论用CBT技术对进食障碍进行干预可取得良好的疗效。     

问题性网络游戏使用量表在我国大学生中的信效度检验

目的:引入Kim编制的问题性网络游戏使用量表,并在大学生群体中对其信效度进行验证.方法:共收集735名大学生网络游戏使用的相关数据,并通过项目分析、验证性因素分析等方法检验量表的信效度.结果:①问题性网络游戏使用量表的所有项目与其所属因子的相关在0.43-0.78;②问题性网络游戏使用量表及五个因子的内部一致性系数均在0.70以上,相应的重测信度在0.62-0.75;③问题性网络游戏使用量表符合二阶因子结构(x2/df=4.52,RMSEA=0.069,GFI=0.90,CFI=0.92,IFI=0.92);与网络成瘾量表总分的相关系数为0.69.结论:网络游戏成瘾量表具有较好的信效度,可以用作考察我国大学生网络游戏使用研究的工具.