Brief Negative Affect Focused Functional Imagery Training Abolishes Stress-Induced Alcohol Choice in Hazardous Student Drinkers

This is the final version. Available from Hindawi via the DOI in this record. Data are available on request.Introduction. Imagery-based stress management therapies are effective at reducing alcohol use. To explore the therapeutic mechanism, the current study tested whether brief functional imagery training linked to personal negative affect drinking triggers would attenuate sensitivity to noise stress-induced alcohol seeking behaviour in a laboratory model. Methods. Participants were UK-based hazardous student drinkers (N=61, 80.3% women, aged 18–25) who reported drinking to cope with negative affect. Participants in the active intervention group (n=31) were briefly trained to respond to personal negative drinking triggers by retrieving an adaptive strategy to mitigate negative affect, whereas participants in the control group (n=30) received risk information about binge drinking at university. The relative value of alcohol was then measured by preference to view alcohol versus food pictures in two-alternative choice trials, before (baseline) and during noise stress induction. Results. There was a significant two-way interaction (p<.04) where the control group increased their alcohol picture choice from baseline to the noise stress test (p<.001), whereas the active intervention group did not (p=.33), and the control group chose alcohol more frequently than the active group in the stress test (p=.03), but not at baseline (p=.16). Conclusions. These findings indicate that imagery-based mood management can protect against the increase in the relative value of alcohol motivated by acute stress in hazardous negative affect drinkers, suggesting this mechanism could underpin the therapeutic effect of mood management on drinking outcomes.Alcohol Research UKAlcohol Chang

Brief online negative affect focused functional imagery training improves two-week drinking outcomes in hazardous student drinkers: a pilot randomised controlled trial

This is the final version. Available on open access from Springer Verlag via the DOI in this recordBackground Negative affect plays an important role in motivating problematic alcohol use. Consequently, training imagery-based adaptive responses to negative affect could reduce problematic alcohol use. The current study tested whether personalised online functional imagery training (FIT) to utilise positive mental imagery in response to negative affect would improve drinking outcomes in hazardous negative affect drinking students. Method Participants were 52 hazardous student drinkers who drink to cope with negative affect. Participants in the active group (n = 24) were trained online over 2 weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas participants in the control group (n = 28) received standard risk information about binge drinking at university. Measures of daily drinking quantity, drinking motives, self-efficacy and use of protective behavioural strategies were obtained at baseline and 2 weeks follow-up. Results There were three significant interactions between group and time in a per-protocol analysis: the active intervention group showed increased self-efficacy of control over negative affect drinking and control over alcohol consumption and decreased social drinking motives from baseline to 2-week follow-up, relative to the control intervention group. There were no effects on drinking frequency. Conclusion These findings provide initial evidence that online training to respond to negative affect drinking triggers by retrieving mental imagery of adaptive strategies can improve drinking-related outcomes in hazardous, student, negative affect drinkers. The findings support the utility of FIT interventions for substance use.Alcohol Change UKMedical Research Council (MRC

Associations between the Brief Assessment of Alcohol Demand (BAAD) questionnaire and alcohol use disorder severity in UK samples of student and community drinkers

This is the final version. Available on open access from Elsevier via the DOI in this recordValue based choice and compulsion theories of addiction offer distinct explanations for the persistence of alcohol use despite harms. Choice theory argues that problematic drinkers ascribe such high value to alcohol that costs are outweighed, whereas compulsion theory argues that problematic drinkers discount costs in decision making. The current study evaluated these predictions by testing whether alcohol use disorder (AUD) symptom severity (indexed by the AUDIT) was more strongly associated with the intensity item (maximum alcohol consumption if free, indexing alcohol value) compared to the breakpoint item (maximum expenditure on a single drink, indexing sensitivity to monetary costs) of the Brief Assessment of Alcohol Demand (BAAD) questionnaire, in student (n = 579) and community (n = 120) drinkers. The community sample showed greater AUD than the student sample (p = .004). In both samples, AUD severity correlated with intensity (students, r = 0.63; community, r = 0.47), but not with breakpoint (students, r = −0.01; community, r = 0.12). Similarly, multiple regression analyses indicated that AUD severity was independently associated with intensity (student, ΔR2 < 0.20, p < .001; community, ΔR2 = 0.09, p = .001) but not breakpoint (student, ΔR2 = 0.003, p = .118; community ΔR2 = 0.01, p = .294). There was no difference between samples in the strength of these associations. The value ascribed to alcohol may play a more important role in AUD severity than discounting of alcohol-associated costs (compulsivity), and there is no apparent difference between student and community drinkers in the contribution of these two mechanisms.Medical Research Council (MRC)Alcohol Research U

Brief interventions for negative - affect triggered alcohol seeking

A broad range of evidence indicates that negative affect is a key motivator and a major risk factor in the development and maintenance of dependence. Consequently, modern psychological therapies approaches seek to address this motivational process. Three therapeutic approaches that specifically aim to disrupt the relationship between negative affect and drug choice have been identified: Cognitive Behavioural Therapy (CBT), Mindfulness Based Interventions (MBIs) and Affect Regulation Therapy (ART0. However, the active ingredients of these interventions are poorly understood while at the same time these interventions are costly and often time consuming. Consequently, there is a need for brief, evidence-based interventions which isolates the active ingredient which targets negative mood-induced drug motivation that can easily be delivered in different settings. To this end, this thesis tested a range of ‘therapeutic’ manipulations for their capacity to abolish the effect of laboratory negative affect induction on measures of alcohol motivation. This thesis trialled three potential interventions inspired by CBT, MBIs and ART. A CBT inspired intervention which paired negative affect drinking triggers with adaptive strategies in undergraduate student drinkers showed no evidence of limiting stress-induced alcohol motivation. A brief negative affect focused functional imagery intervention in which participants paired their own personalised negative affect triggers and adaptive strategies did abolish stress-induced alcohol motivation in the laboratory and increased self-efficacy of control over negative affect drinking in hazardous student drinkers online over a 2-week period. To further isolate the active ingredients four experiments tested whether the core component of MBIs, breath counting would abolish negative affect alcohol motivation. In all four experiments, breath counting attenuated negative affect-induced alcohol choice and craving in hazardous community drinkers. However, our last study showed that the effects of breath counting on stress-induced alcohol motivation were not superior to that of a visual distraction task, suggesting that the therapeutic effects of breath counting may stem from cognitive load. These findings provide preliminary evidence for the efficacy of these interventions and would justify future trials to explore their clinical utility in modifying actual drinking or relapse outcomes. The potential of acute interventions to modify drinking in the natural environment is challenged by the broad spectrum of environmental stressors which hazardous drinkers are subjected to