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The PTSD Checklist for DSM-5 (PCL-5) is the most widely used self-report measure of posttraumatic stress disorder (PTSD) and is frequently modeled as having four correlated factors consistent with the DSM-5 symptom structure. Some researchers have argued that item order may influence factor structure. Although two studies have examined this, they were both based on DSM-IV criteria, and neither utilized a randomized design. Thus, this study aimed to determine whether item order impacts the factor structure of the PCL-5, using two independent samples of community participants (N = 347, 67.7% female, 85.3% White) and veterans (N = 409, 83.6% male, 61.9% Black/African American). Approximately half of each sample was randomized to receive the PCL-5 in the original fixed order, whereas the other half received a uniquely randomized version. We compared the DSM-5 four-factor model to several theoretically relevant models and found improved model fit in the seven-factor hybrid model, community sample: ∆χ2 = 153.87, p < .001; veterans: ∆χ2 = 152.61, p < . 001. Consequently, the DSM-5 four-factor and seven-factor hybrid models were retained for invariance testing. Across both samples, measurement invariance was examined between the randomized and fixed-order groups. Configural invariance, partial metric invariance, and partial scalar invariance were achieved in both samples, ps = .054-.822, suggesting that the fit of the DSM-5 four-factor structure and the seven-factor hybrid model, as measured using the PCL-5, are not due to order effects. These findings support the continued use of the PCL-5 in a fixed fashion.

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Protective behavioral strategies (PBS) are behaviors that individuals use to mitigate harm related to risky behaviors. Though measures have been validated to assess alcohol- and cannabis-specific PBS use, an opioid-specific PBS measure has yet to be validated. The present study developed and validated a tool to assess the extent of PBS employed by individuals who use licit and/or illicit opioids. We recruited a community sample of adults who endorsed past-month opioid use (n = 345) via online platforms to complete a baseline survey, and 277 participants (80.2%) also completed the 1-month follow-up survey. From PBS measures of other substances, harm reduction strategies found in the literature, and expert feedback, we developed the 60-item Opioid Protective Behavioral Strategies Scale (OPBSS). We removed 14 items based on item and exploratory factor analyses, resulting in 46 retained items. A two-factor solution was supported: strategies focused on managing opioid use (Controlled Opioid Use) and preventing opioid-related harm (Serious Harm Reduction). The OPBSS subscales demonstrated high internal consistencies, fair-to-excellent test-retest reliability, significant positive associations with PBS measures for other substances, and robust associations with risky opioid use and opioid-related negative consequences, both concurrently and prospectively when controlling for other opioid characteristics. The 46-item OPBSS has promising psychometric properties. Importantly, more opioid PBS predicted less risky opioid use and related consequences, suggesting that opioid PBS may be a beneficial opioid prevention effort. However, additional psychometric work is needed to determine which PBS are most suitable for populations with distinct opioid use patterns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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Disparities exist in the engagement and success of individuals seeking medications for opioid use disorder (MOUD) treatment. Existing work suggests that individual-level factors such as cognitive functioning influence MOUD treatment, less is known about the role of environmental factors beyond the individual such as social determinants of health (SDOH). The aim of this systematic review was to summarize the literature of neuropsychological assessment in the context of MOUD treatment using an SDOH framework. We included peer-reviewed articles based in the United States and published in the English language that evaluated neuropsychological assessment on MOUD treatment outcomes. Three electronic databases were searched from January 2022 to September 2023 without restricting the date of publication for article inclusion. We identified 34 empirical articles that met inclusion criteria, the majority being nonrandomized clinical trials. Few studies examined differences in neuropsychological performance over time or in response to an adjunct intervention. Findings comparing cognitive functioning across MOUD and comparisons groups were mixed, as were findings from the studies that examined changes in cognitive functioning over time. Factors represented from the SDOH framework included educational attainment, premorbid intellectual functioning, and employment status. Neuropsychological domains and type of assessments varied, as did inclusion/exclusion and demographic characteristics. Existing literature is mixed on whether neuropsychological deficits in individuals with OUD are amenable to treatment, particularly among populations disproportionally disadvantaged by SDOH. More research is needed on the SDOH and other contextual factors that influence cognitive factors and MOUD treatment engagement and success.

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OBJECTIVE: Underage drinking disengagement (UDD; cognitive restructuring/minimizing agency) measures attitudes about the acceptability and responsibility of drinking. We examined demographic correlates of UDD, as well as the moderating effects of legal drinking status on the association between UDD and drinking. PARTICIPANTS: College student drinkers (n = 893; Mage = 19.48, range = 18-25; White = 74.1%; female = 68.1%) from a multi-site study. METHODS: An online confidential survey included the UDD Scale for College Students and the AUDIT-C. RESULTS: White and multiracial, underage students, or those living with others endorsed greater cognitive restructuring disengagement than Hispanic students, legal-age students, or those living alone or with parents, respectively. Greek membership and greater "party school" perceptions were related to more cognitive restructuring and minimizing agency. The associations between UDD and alcohol use were not moderated by legal drinking age status. CONCLUSION: Identifying and educating students at risk for UDD on the ramifications associated with underage drinking could combat drinking.

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Chronic pain and opioid use disorder (OUD) are public health crises and their co-occurrence has led to further complications and public health impacts. Provision of treatments for comorbid chronic pain and OUD is paramount to address these public health crises. Medications for OUD (MOUD) are gold standard treatments for OUD that have also demonstrated benefit in pain management. However, clinics that provide MOUD for chronic pain or OUD often lack behavioral treatments to address the challenges experienced by individuals with both conditions. Developing and implementing a behavioral treatment that complements MOUD may better equip clinics to provide comprehensive care to the growing proportion of clients who present with comorbid chronic pain and OUD. In the Healing Opioid misuse and Pain through Engagement (HOPE) Trial, we are using an effectiveness-implementation hybrid design to examine the benefits of an integrated behavioral treatment and to determine the feasibility of implementing the integrated treatment into clinics that provide MOUD. The treatment integrated 2 evidence-based treatments-Acceptance and Commitment Therapy and Mindfulness-Based Relapse Prevention-to target the emotional, behavioral, and physiological sequelae of OUD and chronic pain. Implementation feasibility will include assessing changes in implementation readiness and identifying facilitators and barriers to implementing the integrated treatment among all personnel employed in clinics that provide MOUD. This commentary offers an overview of the study and design and details adaptations we made to our study protocol, based largely on clinic personnel time constraints and variable clinic procedures during the COVID-19 pandemic.

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Objectives: Previous research cites mindfulness as a protective factor against risky substance use, but the specific association between dispositional mindfulness (DM) and cannabis use has been inconsistent. Despite known heterogeneity of DM facets across college students, much of the prior research in this area has relied on variable-centered approaches. Only a handful of prior studies within the cannabis literature have utilized person-centered approaches, and only one has specifically examined unique profiles of dispositional mindfulness in relation to patterns of use among college students. Method: The present study used latent profile analysis (LPA) to identify subtypes of DM and their relationships with cannabis use behaviors (i.e., hazardous use and consequences of use) in a sample of 683 U.S. college students who endorsed past-month cannabis use and participated in an online survey of substance use behaviors, hypothesizing that a three-profile model would be replicated. We also examined whether age and prior experience with mindfulness predicted DM profile membership (hypothesizing that these variables would differentially predict membership) and explored mean differences in alcohol use across profiles. Results: LPA results revealed three discrete profiles of DM: non-judgmentally aware, judgmentally observing, and moderate traits. Participants in the non-judgmentally aware profile were less likely to have prior mindfulness experience than the other profiles, but age did not predict profile membership. Judgmentally observing had more hazardous cannabis use and consequences than the other profiles, and no mean differences emerged on alcohol use. Conclusions: These results build upon the only known study that investigated how DM relates to cannabis use. Further research is needed to elucidate this relationship, which can inform the application of mindfulness interventions for hazardous cannabis use in college students. Pre-registration: This study was not pre-registered.

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BACKGROUND: Client discontinuation from outpatient addiction treatment programs is common, and the initial intake is the service delivery point with the highest attrition rate. Replacing the comprehensive intake assessment with a person-centered Motivational Interviewing (MI) intervention is a potential solution to address provider and client concerns about the disengaging, time-intensive nature of the typical initial intake. It remains unclear whether the use of an alternative to the standard intake at the initial visit can fit within typical organizational reporting requirements, whether it decreases attrition, and whether implementation of person-centered intake procedures within outpatient addiction treatment programs is feasible, acceptable, and can be sustained. PURPOSE: To describe the methods and design of an effectiveness-implementation hybrid type 1 trial of a Motivational Interviewing at Intake (MII) intervention using the Consolidated Framework for Implementation Research (CFIR). METHODS: The study will determine the effectiveness of two intake conditions: (1) standard comprehensive intake assessment (intake-as-usual [IAU]), and (2) MII consisting of a person-centered discussion between provider and client about the client's desire and intent to enter treatment. Although both interventions are focused on understanding client presenting complaints and needs for treatment, the delivery differs as the IAU uses a semi-structured assessment guide, while MII applies the theory of MI to have a conversation about treatment engagement. Adults seeking outpatient addiction treatment services will be randomly assigned to the MII condition (n = 75) or the IAU condition (n = 75). Primary outcomes will be client engagement (i.e., treatment entry, attendance, and completion) obtained from the electronic medical record. Secondary outcomes (client motivation and therapeutic alliance) will be putative mechanisms of client engagement assessed immediately before and after the intake. The trial also will explore determinants of effective, sustainable implementation using assessments of organizational readiness and capacity to change, as well as interviews on MII implementation feasibility. CONCLUSION: This trial of an MII intervention will investigate the feasibility of a motivational intervention as an initial contact with substance use treatment-seeking clients as well as indicators of intervention effectiveness within the systems where it is employed. Trial registration Clinicaltrials.gov identifier: NCT05489068.

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Background: Protective behavioral strategies (PBS) are cognitive-behavioral strategies that students use to prevent risky drinking. Prior work supports PBS as a mechanism of change following a brief motivational intervention (BMI) among college students. This study investigated the necessity of discussing PBS by examining changes in PBS use and drinking following an alcohol intervention that used the parent method of Motivational Interviewing (MI), or Pure MI. Methods: Data came from a pilot study that looked at the effects of Pure MI that targeted risky social drinking behavior. The study comprised 42 college students who endorsed hazardous drinking in the last 2 weeks and social anxiety symptoms. Participants completed measures of safe and heavy drinking behaviors at baseline and one-month follow-up. Results: The results showed that PBS use increased from baseline to one-month follow-up. Further, the reduction in heavy drinking in social situations was partially explained by an increase in PBS use from pre- to post-intervention. Conclusions: Despite not introducing PBS into discussions during the MI intervention, we found that students who used more PBS reported reduced heavy drinking in social situations. Implications from the study suggest that interventions focused on student motivation rather than knowledge can promote safe and reduce hazardous drinking behaviors.

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BACKGROUND: Anxiety is implicated in the course and prognosis of alcohol use disorder (AUD); however, it is unclear how current AUD treatments affect the joint trajectories of anxiety and alcohol use. We used data from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study to examine the longitudinal relationship between subclinical anxiety symptoms and alcohol use during and following AUD treatment in adults with AUD and no comorbid anxiety disorders. METHODS: Univariate and parallel process growth models using five waves of COMBINE study data were analyzed from 865 adults randomized to medication (n = 429) or medication plus psychotherapy (n = 436). Weekly drinking quantity and average weekly anxiety symptoms were measured at baseline, mid-treatment, end-of-treatment, and three follow-up periods. RESULTS: Significant positive associations of anxiety symptoms and drinking were found at mid-treatment and over time. Temporal associations revealed that higher mid-treatment anxiety predicted decreases in drinking over time. Baseline anxiety and drinking predicted mid-treatment anxiety and drinking. Only baseline anxiety predicted increases in drinking over time. Group differences revealed mid-treatment drinking predicted decreases in anxiety over time in the medication group. CONCLUSIONS: Findings demonstrate the influence of subclinical anxiety on alcohol use during and up to one year after AUD treatment. Baseline anxiety symptoms may influence drinking behavior over the course of treatment. Findings suggest that greater attention to negative affect in AUD treatment is warranted even for those individuals who do have a comorbid anxiety disorder.

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Objective/Participants: In a large, diverse sample of college students (N = 2,230), this online study investigated racial/ethnic differences on type of discriminatory event experienced and perceived stress, and whether discrimination-related stress was associated with mental health symptoms. Methods: Prevalence of lifetime/past year discriminatory events was assessed and frequency of discrimination-related stress was compared across racial/ethnic groups. Correlations between discrimination-related stress and mental health symptoms were also examined. Results: All racial/ethnic groups reported experiencing all types of discriminatory events, though prevalence was lowest for White students. Racial/ethnic minority (i.e., Asian, Black, Latinx) students reported greater discrimination-related perceived stress compared to White, non-Hispanics. Across all racial/ethnic groups, discrimination-related stress was positively associated with negative mental health outcomes (e.g., anxiety/depressive symptoms). Conclusions: These results highlight the need to continue efforts to reduce discriminatory experiences of racial/ethnic minority students and to incorporate antiracism interventions in universities to mitigate the pervasive negative experiences of minority students.

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BACKGROUND: There is significant heterogeneity in alcohol and cannabis use patterns among college students, with some engaging in use patterns that heighten their risk for adverse consequences. Person-centered approaches can help identify those subgroups of students with riskier use patterns. Latent Profile Analyses (LPA) were conducted to identify subgroups based on alcohol and cannabis use frequency and quantity, to explore demographic covariates and to examine mean differences across subgroups on alcohol- and cannabis-related consequences, simultaneous use, and other substance use. METHODS: Participants were 2,423 college students (Mage = 20.1; 72  % female) recruited from seven US universities who endorsed past-month alcohol and cannabis use and completed an online survey of substance use behaviors. RESULTS: A four-profile solution was the best fitting model. Profile 1 represented "light, infrequent alcohol and cannabis use" (73.8 %), Profile 2 represented "heavy, infrequent alcohol and moderate, frequent cannabis use" (15.9 %), Profile 3 represented "moderate, frequent alcohol and cannabis use" (5.6 %) and Profile 4 represented "very heavy, frequent alcohol and heavy, frequent cannabis use" (4.7 %). Students who identify as male, White non-Hispanic, and/or Greek-affiliated were more likely to be in the heavy alcohol use profiles. Profiles 3 and 4 represent high-risk profiles, with both having a higher likelihood of simultaneous use, Profile 3 endorsing more cannabis consequences, and Profile 4 endorsing more alcohol consequences. CONCLUSION: Results suggest that heavy alcohol or heavy co-use heightens risk for serious adverse consequences.

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Objective: Fear of negative evaluation (FNE) is a key trait of social anxiety and has been linked to isolation and low self-esteem. Impulsivity has been shown to amplify the risk of socially anxious individuals engaging in risky behaviors such as suicidal behaviors; yet little research has examined associations between FNE and suicidality or the relationship between FNE and impulsivity. Participants/Methods: This study tested whether FNE was associated with suicidal ideation in a sample of 1,816 college students from 10 universities. Analyses also examined whether impulsivity-like traits moderated the relationship between FNE and suicidal ideation. Results: Results showed that FNE was significantly associated with suicidal ideation and the positive association between FNE and suicidal ideation was strongest among individuals with higher negative urgency and lower perseverance. Conclusions: These findings highlight FNE as an important risk factor of suicidal ideation in college students and illuminates potential influence of impulsivity on this relationship.

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A drinking game (DG) is a widely practiced social activity that tends to encourage rapid alcohol consumption. While social restrictions during the pandemic (COVID-19) academic year were implemented as a health measure across many colleges/universities, the extent to which college student drinkers continued to play DGs in-person is not well understood. Because theory and research suggest that drinking motives are proximal correlates of drinking behaviors, we examined which drinking motives increased the likelihood of playing DGs in-person, and playing DGs in-person in a group of 10 + people during the 2020-21 pandemic academic year. College students (past-year drinkers) from 12 universities completed an online survey (N = 900; Mage = 19.42, Range = 18-25; SDage = 1.45, White = 73.1%, 69.2% female). Of the students surveyed, 590 students played DGs, with 460 students only playing DGs in-person. Of the students who played DGs in-person, 274 students reported that the maximum number of people they played DGs with in-person exceeded the CDC's recommended guidelines (10 + people). Accounting for demographics, general alcohol use, and perceived COVID-19 threat, social drinking motives were positively associated with an increased likelihood of playing DGs in-person; the inverse was found for coping motives. Drinking motives were not associated with the likelihood of playing DGs with 10 + people but greater alcohol use and lower perceived threat of COVID-19 were. Given that the pandemic did not deter many student drinkers from playing DGs in-person, further investment in targeted intervention and public health initiatives aimed at substance-free alternatives promoting engagement and enhancement of social activities may be needed.

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Purpose: The opioid epidemic in the United States has resulted in mass mortality and economic costs exceeding $1 trillion. Poor health-related quality of life is evident among individuals entering treatment for opioid use disorder (OUD). Yet, little research has examined the influence of quality of life on risky opioid use among non-treatment-seeking adults. To help inform OUD prevention efforts, this study examined the association among quality of life domains, opioid use motives, and risky opioid behaviors in a community sample of opioid users. Methods: Participants (N = 278) were adults who endorsed past month opioid use and were not currently in treatment for OUD. Participants responded to questions regarding their opioid use and misuse, opioid use motives, opioid use consequences, and quality of life. Results: The physical health domain of quality of life was associated with risky opioid use. Specifically, poorer physical health predicted risky opioid use and this relationship was partially explained by more social and pain motives to use opioids. Surprisingly, no other quality of life domains predicted risky opioid use. Conclusion: This study represents a meaningful first step in identifying optimal targets for OUD prevention efforts with community samples. Our findings suggest that physical health is an important quality of life indicator to prevent opioid-related harm and development of OUD.

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OBJECTIVE: For individuals in alcohol use disorder (AUD) treatment, many argue that holistic indicators such as quality of life (QoL) should be more consistently used in addition to drinking-related indicators. QoL increases from pre- to post-AUD treatment, but the mechanisms are unclear. The present study examined the roles of positive and negative affect in QoL change during AUD treatment and additionally explored the relationship between QoL change and medication adherence. METHOD: We examined the mediating roles of end-of-treatment positive affect (i.e., vigor) and negative affect (i.e., stress and tension) in the relationship between baseline (BL) and 26-week QoL among participants in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence study randomized to medication management (MM; n = 468) or medication management plus combined behavioral intervention (MMCBI; n = 479) for AUD. We also explored whether changes in QoL were associated with medication adherence. RESULTS: Change in psychological health QoL was mediated by increased vigor (i.e., positive affect) and decreased stress, and change in environmental QoL was mediated by decreased stress. There were also differences by treatment group, with stress mediating changes in environmental QoL among participants in MM, and vigor mediating changes in psychological health QoL among participants in MMCBI. Medication adherence was not associated with greater QoL after controlling for posttreatment alcohol use. CONCLUSIONS: The present study identified potential mechanisms of QoL change in AUD treatment, thus contributing to the growing knowledge surrounding alternative indicators of treatment success for AUD treatment and recovery. Targeting affective states and stress during treatment may improve QoL and recovery outcomes for persons with AUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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PURPOSE: To assess the quality of curricular research on the Screening Brief Intervention and Referral to Treatment (SBIRT) approach and determine the presence of useful training modalities, particularly motivational interviewing (MI) training, across health care training curricula. METHOD: The authors conducted a systematic review of published, peer-reviewed studies in PubMed, ERIC, CINAHL, Ovid HealthSTAR, and PsycINFO databases through March 2021 for English-language studies describing SBIRT, a curriculum for health care trainees, and curricular intervention outcomes. After the records were independently assessed, data were extracted and 20% of the studies were double-coded for interrater reliability. RESULTS: Of 1,856 studies, 95 were included in the review; 22 had overlapping samples and were consolidated into 10 nested studies, leaving 83 total. Interrater reliability ranged from moderate (κ = .74, P < .001) to strong (κ = .91, P < .001) agreement. SBIRT training was delivered to trainees across many professions, including nursing (n = 34, 41%), medical residency (n = 28, 34%), and social work (n = 24, 29%). Nearly every study described SBIRT training methods (n = 80, 96%), and most reported training in MI (n = 54, 65%). On average, studies reported 4.06 (SD = 1.64) different SBIRT training methods and 3.31 (SD = 1.59) MI training methods. Their mean design score was 1.92 (SD = 0.84) and mean measurement score was 1.89 (SD = 1.05). A minority of studies measured SBIRT/MI skill (n = 23, 28%), and 4 studies (5%) set a priori benchmarks for their curricula. CONCLUSIONS: SBIRT training has been delivered to a wide range of health care trainees and often includes MI. Rigor scores for the studies were generally low due to limited research designs and infrequent use of objective skill measurement. Future work should include predefined training benchmarks and validated skills measurement.

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Objective: Stimulant use among college students is a significant public health concern due to its consequential effects. Given that many students reportedly use prescription stimulants for academic purposes, empirical investigations are needed to identify those students at risk for prescription stimulant misuse (PSM). The purpose of the current study was to examine the role of coping styles on the association between prescription stimulant use and related consequences. We hypothesized that more maladaptive (vs. adaptive) coping strategies would mediate this association, particularly for underclassmen (freshmen/sophomores) and men.Method: Participants were n = 787 college students across seven universities in the United States who completed an online survey assessing substance use and coping behaviors. Prior to hypothesis testing, we conducted factor analysis on the COPE measure and found support for a three-factor solution, which we named maladaptive coping, adaptive coping, and supportive coping.Results: Prescription stimulant use was positively related to stimulant-related negative consequences. Multiple mediation analyses indicated that the maladaptive coping factor partially mediated this direct association. Multi-group analyses revealed that maladaptive coping style was a significant mediator for college women in the sample, but not men. Conclusions: These results scratch the surface of the relationship between coping and risky stimulant use among college students and imply that the building of coping strategies is a useful target in identifying at-risk students.

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Students with anxiety or mood issues tend to engage in more problematic drinking, but less is known about those students with co-occurring anxiety and mood symptoms. This study compares rates of weekly alcohol use, hazardous drinking, and alcohol-related negative consequences in a sample of 699 college students with symptoms of comorbid anxiety and depression (35% of the sample) compared to their non-symptomatic drinking peers, as well as the moderating role of gender. We found main effects of gender and comorbidity status such that participants with comorbid symptoms of anxiety and depression or who were male reported higher rates of weekly alcohol use, more hazardous drinking and more alcohol-related negative consequences than their non-symptomatic and female peers. We also found an interaction effect on alcohol-related negative consequences such that male participants with comorbid anxiety and depression reported more alcohol-related negative consequences than all other groups. These findings imply that while any student drinker with both anxiety and depression may be considered at higher risk for problematic drinking behavior, the risk of negative consequences in particular may be highest in the men of that group.

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Objective: Co-use of alcohol and marijuana has increased among college students, though comparisons among simultaneous (i.e., use of both substances such that effects overlap), dual (i.e., use of both substances within a similar time period but without overlapping effects), and marijuana-only use are limited. This study aimed to understand differences between simultaneous, dual, and marijuana-only users on marijuana use rates, consequences, and context of use in a multi-university study. Method: College students (N = 4,764; Mage = 19.9 years) who were mainly female (70.6%) and White (67.9%) completed an online survey. The Marijuana Use Grid captured marijuana use quantity/frequency, and the Brief Marijuana Consequences Questionnaire and the Cannabis Use Disorders Identification Test-Revised assessed problem use. Location, method of consumption, and social context of use also were assessed. Results: Fifty-five percent of the sample endorsed lifetime use of alcohol and marijuana. Of these students, 36.1% endorsed past-month simultaneous use, 10.8% endorsed past-month dual use, and 6.4% endorsed past-month marijuana-only use. Simultaneous users reported more marijuana use and problems than dual users. Marijuana-only users did not differ from simultaneous users on marijuana use indices, though they reported greater use than dual users as well. Simultaneous users used marijuana in plant form, at parties, and with unknown others a greater percentage of the time than dual users, while dual users used edibles and ingested marijuana a greater percentage of the time. Conclusions: Given their greater levels of marijuana use and marijuana-related problems, screening and interventions for simultaneous alcohol-marijuana use are needed in college students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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The importance of attending to the therapeutic process despite the challenges in manualizing it is demonstrated in the empirical evolution of motivational interviewing (MI). Whereas manuals exist for adaptations of MI, no manual has been developed and tested for MI in its pure form (pure MI). This study evaluated the feasibility and initial efficacy of a pure MI intervention manual - MI for risky social drinking (MI-RSD) - designed to target risky social drinking behaviors in college students with social anxiety. A pilot sample of 42 college students completed measures of alcohol use and mental health symptoms and the MI-RSD intervention. We developed a manual for the 2-session MI-RSD intervention, trained 4 clinical doctoral students, and used observer-, therapist- and participant-completed measures to evaluate fidelity. Therapists met beginner proficiency in MI fidelity and participant gave high ratings of therapist adherence to MI and working alliance, demonstrating intervention feasibility. Also, participants reported significant reductions in hazardous drinking and evaluation fears, but not in social interaction anxiety. We offer preliminary evidence that pure MI can be manualized and effective. Specifically, MI-RSD represents an alternative to MI adaptations in mitigating alcohol-related harm for young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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