Are online norms-based alcohol interventions efficacious for college students with higher social anxiety?

Abstract

Background: Undergraduates with higher social anxiety symptoms are at risk for co-occurring substance misuse, heavier drinking in certain contexts, and experiencing more negative alcohol-related consequences. Among undergraduates broadly, online norms-based interventions provide consistent and cost-effective reductions in alcohol use and related risks. However, research on norms-based interventions for undergraduates with higher social anxiety symptoms is limited, and less is known about the longitudinal impacts of social anxiety symptoms on the efficacy of online, norms-based alcohol interventions.

Methods: Secondary analyses were conducted on data from a large randomized controlled trial (RCT) with undergraduates who reported past-month heavy episodic drinking and were randomized to an attention control or a norms-based intervention. Generalized linear models tested whether baseline social anxiety symptoms moderated the efficacy of receiving a norms-based intervention versus a nonalcohol-focused attention control condition at 3-, 6-, and 12-month follow-up.

Results: Social anxiety symptoms moderated intervention efficacy on the number of typical drinks consumed and descriptive norms at 3 months, as well as injunctive norms at 3 and 12 months. However, these effects appeared to be primarily driven by the individuals with higher social anxiety symptoms in the attention control group. Overall, norms-based interventions demonstrated efficacy in reducing the number of typical drinks consumed, descriptive and injunctive norms, and negative consequences up to 12 months later, regardless of social anxiety symptoms.

Conclusions: Results demonstrated that online norms-based interventions were similarly efficacious for reducing drinking, negative consequences, and normative beliefs for undergraduates, regardless of social anxiety symptoms. Further, effects were maintained up to 12 months. Thus, existing alcohol-focused brief interventions are efficacious for those with higher social anxiety symptoms, even without adaptation for social anxiety-specific concerns. Individuals with higher social anxiety symptoms who did not receive an active intervention reduced drinking beliefs and behaviors, although reductions were not maintained over time.

Keywords: alcohol; normative beliefs; personalized feedback intervention; social anxiety; undergraduates.