Alcohol expectancies and social self-efficacy as mediators of differential intervention outcomes for college hazardous drinkers with social anxiety

The current pilot study examined the roles of two cognitive factors – positive alcohol expectancies of social anxiety reduction and drink refusal self-efficacy relevant to social situations – in mediating greater reduction in alcohol behaviors by the Brief Intervention for Socially Anxious Drinkers (BISAD; n = 21) compared to an alcohol psychoeducation (n = 20) in a sample of college hazardous drinkers with social anxiety. Mediation analysis results indicated that decreased positive alcohol expectancies and increased drink refusal self-efficacy relevant to social situations accounted for an average of 67% of the variance in treatment outcomes as measured by total quantity of alcohol consumption, heavy drinking days and problems related to alcohol use in the past month. Study results may enhance the understanding of cognitive factors' role in alcohol treatment outcomes, which could in turn improve the efficacy of interventions aimed to reduce hazardous drinking and comorbid social anxiety.

► We examined change in cognitive factors as mediators of treatment outcome. ► Decreased positive alcohol expectancies mediated alcohol outcomes at follow-up. ► Increased drink refusal self-efficacy mediated alcohol outcomes at follow-up. ► Results enhance understanding of cognitive mediators in alcohol treatment outcome.