Objective: To investigate the effectiveness of brief intervention for modifying alcohol expectancies, readiness to change, and problem alcohol use in persons with traumatic brain injury (TBI).
Design: Randomized controlled trial, with 3-month follow-up.
Setting: Three level I Trauma Centers.
Participants: One hundred four persons with complicated mild, moderate, or severe TBI, with preinjury problem alcohol use, who had emerged from posttraumatic amnesia.
Intervention: Twenty- to 30-minute brief intervention (education and motivational interview).
Main Measures: Alcohol Expectancy Questionnaire-III Global Positive Expectancies and Cognitive and Physical Impairment scales; Readiness to Change Questionnaire; problem alcohol use.
Results: After controlling for relevant covariates, there was an effect of treatment on expectation that alcohol use would result in cognitive and physical impairment. This effect was moderated by injury severity, and was only effective for those with severe injury. There was no treatment effect on global positive expectancies, readiness to change, or problem alcohol use. Attribution of injury to alcohol use was associated with the expectation that alcohol use would result in cognitive and physical impairment, and at one center, in greater readiness to change.
Conclusions: Although the brief intervention did not have an impact on problem alcohol use, positive alcohol expectancies, or readiness to change, the results of this study suggest that brief intervention can be effective for educating on the negative impact of alcohol use for people with severe TBI who have emerged from posttraumatic amnesia. Attribution of the injury to alcohol use could potentially increase readiness to change in some settings, and might be used to generate discussion about the negative impact of alcohol use.
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris County Hospital District and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Drs Sander and Clark); Department of Physical Medicine & Rehabilitation, The Ohio State University, Columbus (Drs Bogner and Corrigan); Department of Pediatrics and Department of Biostatistics, College of Public Health, University of Arkansas for Medical Sciences, Little Rock (Dr Nick); and Trauma Services, Grant Medical Center, OhioHealth, Columbus, Ohio (Ms Rozzell)
Corresponding Author: Angelle M. Sander, PhD, Baylor College of Medicine/Harris County Hospital District Brain Injury Research Center, 2323 S. Shepherd Dr., Ste. 907, Houston, TX 77019 (firstname.lastname@example.org).
This work was supported by grants from the National Institute on Disability and Rehabilitation Research, US Department of Education (grants H133B031117, H133B090023, H133A070043, and H133A070029). The authors thank the patients and staff of Harris County Hospital District's Ben Taub General Hospital and Quentin Mease Community Hospital, particularly Dr Shankar Gopinath, Dr Claudia Robertson, and Dr Faye Chiou-Tan. The authors also thank Monique Pappadis and Mike Mahaffey for conducting masked follow-up assessments in Texas and Ohio, respectively; Diana Mazzei for conducting the intervention with Spanish-speaking participants; and Beth Windisch, Ann Smith, and Peggy Shecket for conducting interviews. The authors extended their appreciation to the patients and staff of Ohio Health, and the Wexner Medical Center at Ohio State University.
The authors declare no conflicts of interest.