Alcohol use continues to be a leading cause of mortality and morbidity in adults in the United States, charging the general healthcare system hundreds of billions of dollars in annual expenditures. The short and long-term effects of harmful alcohol consumption have been studied for decades, with physiological, psychological, and sociological consequences consistently spurring from the behavior. The motivations behind alcohol use, however, are much less clear than the established impacts, but do nonetheless play important roles in intervention design. This study aims to identify effects of reward availability in young adult alcohol recovery and treatment interventions.
The study’s sample is composed of 393 students from two large undergraduate universities in the southeastern United States (n=393, 60.8% female). Participants completed digital assessments which evaluated the following characteristics: demographics, reward availability (e.g., “naturally occurring” environmental reinforcements; via Environmental Suppressor subscale of the Reward Probability Index), depression (via Depression, Anxiety, and Stress Scale), cannabis use, sensation seeking (via Brief Sensation Seeking Scale), life satisfaction (via Extended Satisfaction of Life Scale), alcohol use (via Daily Drinking Questionnaire), alcohol consequences (via Young Adult Alcohol Consequences Questionnaire), and alcohol use disorder (via DSM-V criteria). Students were then randomly assigned to receive either a brief motivational interview with substance-free activity session (BMI+SFAS), a BMI plus relaxation session (BMI+RT), or solely the assessment. Follow up assessments were completed 1,6,12, and 16 months after baseline initiation. The data was analyzed primarily using confirmatory factor analysis followed by growth mixture modelling.
Results of the analysis found two primary trajectories of students regarding reward availability: those with a stable, elevated reward availability, and those with a low, increasing reward availability. Low reward availability was often associated with depression, cannabis use, sensation seeking, and low life satisfaction. Participants within the low reward availability trajectory who completed the BMI+SFAS were found to have decreased alcohol use severity when compared to the other treatment/control conditions.
Takeaway: brief motivational interviewing, in addition to substance free activity sessions, is suggested to help attenuate drinking severity in students with low environmental reward availability. Students with lower reward availability may be predisposed to dangerous drinking behaviors.