A Meta-Analysis of Computer-Delivered Drinking Interventions for College Students: A Comprehensive Review of Studies From 2010 to 2016.

OBJECTIVE: Computer-delivered drinking interventions (CDIs) are administered to tens of thousands of college students each year, yet recent evidence for their efficacy has not been summarized. This meta-analysis extends the work of past reviews and investigates the efficacy of CDIs in reducing college students' alcohol consumption and alcohol-related harms. METHOD: Following the systematic review standards set by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the literature was searched for published and unpublished data available from 2010 to 2016. We reviewed 35 randomized controlled trials (64 CDIs, N = 20,068, 57% female) that compared CDIs with control conditions for college students and calculated between- and within-groups weighted mean effect sizes. We analyzed effects at three follow-up assessment points (short term = ≤6 weeks, intermediate term = 7-26 weeks, long term = ≥27 weeks). RESULTS: Within-group effect sizes showed that CDI participants did make reductions in drinking over time; however, between-groups effect sizes revealed that these effects rarely differed from those of control participants. CDIs were associated with very small but statistically significant reductions in quantity (d = 0.06, 95% CI [0.02, 0.10]) and frequency (d = 0.07, 95% CI [0.02, 0.12]) of alcohol consumption when compared with controls at short-term follow-up. However, at intermediate (d = -0.07, 95% CI [-0.11, -0.02]) and long-term follow-ups (d = -0.06, 95% CI [-0.12, -0.01]), CDIs were associated with statistically significantly more alcohol-related problems than controls. CONCLUSIONS: Computer-delivered drinking interventions result in small reductions in college students' alcohol consumption over time. However, these interventions rarely reduce drinking more than controls and may be associated with some increased risk of harm over time.

Mind-Body Considerations in Orofacial Pain.

This article summarizes the cognitive, behavioral, and emotional factors that contribute to the onset and maintenance of orofacial pain. These orofacial pain conditions illustrate the dynamic interplay of the mind and body and the importance of multimodal treatment approaches addressing simultaneously the cognitive, behavioral, and physiologic dimensions of facial pain. Cognitive and behavioral treatments of temporomandibular disorders based on the outcomes of randomized controlled trials are also discussed with an emphasis on using a biopsychosocial perspective when working with the persons who have temporomandibular disorders.

Elementary and middle school predictors of high school drinking problems and maladaptive coping.

By ages 15-16, a subset of adolescents report problem drinking and engagement in maladaptive coping behaviors, both of which presage future alcohol use disorders. This paper reports on a test of whether these behaviors can be predicted by characteristics of those youth at ages 10-11. In a sample of 1889 adolescents measured in the spring of 5th, 6th, and 10th grade, we found that early pubertal onset, 5th grade drinking behavior, negative affect, low conscientiousness, and urgency all predicted adolescent problem drinking and dysfunctional coping five years later. Reciprocal mediation pathways between 5th and 6th grade drinker status and urgency levels (the disposition to act rashly when highly emotional) predicted 10th grade problem drinking. Fifth grade drinker status positively predicted 10th grade emotion-oriented coping and negatively predicted 10th grade task-oriented coping, and these effects appear to have been mediated by 6th grade urgency. Mid-adolescent drinking problems and maladaptive coping may be influenced by transactions among multiple factors. Implications for intervention are discussed.