Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Adults Reporting Hazardous Drinking and Chronic Pain: A Randomized Controlled Trial.

OBJECTIVE: Among individuals with chronic pain, the rate of hazardous alcohol use is elevated compared to the general population. Yet, hazardous drinkers with chronic pain remain an underserved group. There is a need to develop and test alternative and complementary interventions to reduce hazardous alcohol use among this high-risk segment of the general population; targeting pain-related anxiety, a candidate mechanism, is one theoretically-informed route. METHOD: Our approach followed a staged model (1a/1b) to develop and test a novel personalized feedback intervention (PFI). Phase 1A collected qualitative feedback from (N = 9; 77.8% female, Mage = 33.86, SD = 8.75) participants to refine intervention content and evaluate treatment acceptability and feasibility. For phase 1B, individuals (N=118; 57.3% male, Mage = 35.24, SD = 11.90) participated in a pilot randomized clinical trial for our novel PFI compared to a health information control condition on alcohol use, intention/motivation to reduce drinking, pain-related anxiety, and expectancies for alcohol analgesia/pain coping for hazardous drinkers with chronic pain. RESULTS: Phase 1a results provided support for the feasibility of using a PFI to target pain-related anxiety, and results from Phase 1b indicated that participants reduced drinking and primary outcomes changed in the expected directions, but there were no differential effects of the intervention. CONCLUSIONS: The current data provide preliminary evidence for the utility of computer-based brief interventions to encourage behavior change. However, further refinement of the intervention to target pain-related anxiety is warranted.

Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study.

Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ ; retrospective registration at ClinicalTrials.gov NCT06308744 ) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = -0.56; 95% confidence interval, -0.43 to -0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries.