Cognitive control and drug use in the general population: Time 3 Follow-up

Background

Worldwide, alcohol use is a major contributor to the burden of disease and mortality. A sizeable literature suggests that brief web-based interventions that incorporate personalised normative and/or health consequences feedback are effective at reducing alcohol intake. The relative efficacy of an intervention that also includes individualised feedback about brain health has not been examined, nor has the utility of integrating a smartphone app component.

Research Questions / Hypotheses

We propose investigating the impact of a brief electronic intervention designed to provide participants with personalised feedback pertaining to alcohol intake—in the form normative and health consequences information—and cognition—in the form of an impulsivity index plus interpretation. We hypothesise that hazardous drinkers—as defined by the WHO (Babor et al., 2001; Saunders et al., 1993)—who receive personalised feedback pertaining to both alcohol consumption and cognition will reduce alcohol intake behaviour to a greater extent than those who receive personalised information about only their alcohol consumption and those who receive no feedback. Those hazardous drinkers who are provided only with personalized feedback related to alcohol consumption will reduce intake to a greater degree than those who receive no feedback. Relative to non-harmful drinkers, we predict reductions in alcohol consumption will be more evident among hazardous drinkers. A further supplementary aim will be to examine whether the addition of an app-based component results in greater reductions in alcohol intake behaviour.

Participants

This is Time 3 of this study and data collection is ongoing. Nonetheless, a total of 246 (Mage = 21.02, SD = 6.03; range 18 to 68; 72% female) participants (78.6% retention) undertook Time 2 at 62.67 (SD = 9.95) days post Time 1 commencement. Of these, 83 (Mage = 21.05, SD = 7.39; 72% female) were in the control condition, 90 (Mage = 21.08, SD = 5.41; 72% female) were in the Alc condition, and 73 were in the AlcCog (Mage = 20.92, SD = 5.03; 71% female) condition.

Methods

At Time 1, participants completed demographic questions, surveys of alcohol consumption (including a 14-day Timeline Followback procedure), measures of anxiety and depression, and cognitive tasks all online. At the completion of Time 1, participants were assigned to one of three feedback conditions using randomised block allocation with stratification based on total standard drinks consumed. This ensured participants in each of the feedback conditions were characterised by similar levels of alcohol intake. Participants in each feedback condition were designated as hazardous or non- harmful based on their (WHO) Alcohol Use Disorders Identification Test (AUDIT) score (Babor et al., 2001; Saunders et al., 1993). Participants in the hazardous group had AUDIT scores ≥8, while those in the non- harmful group had scores <8. Approximately 8 weeks after commencing Time 1, all the participants received an email inviting them to follow a URL link to take part in the Time 2 assessment period. At Time 2, participants completed surveys of alcohol consumption, measures of anxiety and depression, and cognitive tasks. A subsample utilised a smartphone app designed to track alcohol consumption in real- time over 14 days. These assessments were repeated at Time 3.

Results

Hazardous drinkers in both the Alc and AlcCog conditions reduced their alcohol intake by 31% to 50% more than those in the Control condition. Reductions were not related to whether participants completed web- plus app- based components or web-only components of the intervention. There was no change in the alcohol intake of non- harmful drinkers.

Implications

Hazardous drinkers respond well to brief electronic interventions that incorporate personalized normative and/or health consequences feedback. Further research is required to determine how best to make impulsivity- related brain- health consequences of drinking manifest and how to maximize the potential of smartphones apps. The full paper is available here: 10.1111/acer.15098