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This study aims to create and test an intervention that helps college students re-evaluate their beliefs about food and alcohol disturbance (FAD) and, in turn, reduce how often they engage in it or intend to in the future. The main questions it aims to answer are:
Participants will take part in one 2-hour in-person laboratory-based study session where they will fill out surveys, learn about FAD, and engage in exercises designed to challenge their existing beliefs about it. They will also complete a follow-up survey online one month after their in-person study visit.
Food and alcohol disturbance (FAD) is the use of any compensatory behavior (e.g., caloric restriction) within the context of a drinking episode for the purpose of 1) compensating for alcohol-related calories and/or 2) enhancing the effects of alcohol. FAD occurs at alarmingly high rates among undergraduates and is associated with a myriad of deleterious consequences. Expectancy effects (i.e., beliefs regarding the anticipated outcomes of a behavior) have been shown to influence the initiation and maintenance of alcohol and disordered eating behaviors. Prior work suggests that expectancies for these behaviors can be modified via expectancy challenges (i.e., ECs; interventions that aim to undermine expectancies by providing learning opportunities that demonstrate the discrepancy between the actual versus perceived effects of a behavior). An EC has never been applied to FAD. However, given that FAD is comprised of both alcohol and disordered eating behaviors, and preliminary work suggests that FAD expectancies share some similarities with alcohol and restriction expectancies, it is likely that an EC could be similarly applied to FAD. Thus, the purpose of the proposed project is to develop an effective and acceptable EC designed to modify FAD expectancies and reduce FAD among undergraduates, informed by the alcohol EC literature.
Participants will be randomized to a 120-minute in-person non-experiential (i.e., no alcohol administration) EC designed to undermine FAD expectancies (experimental group) or a control group. To make existing expectancies salient, the EC will include audio recordings of reported FAD expectancies from students who engaged in FAD in my preliminary qualitative work (Berry & Looby, 2024). Participants will then engage in discussions to evaluate whether these effects are pharmacological or perceived. The intervention will also provide psychoeducation on expectancies, FAD, alcohol, and the effects of compensatory behaviors on weight, which will prompt participants to reevaluate their extant expectancies. This will be followed by a reflective writing exercise to allow participants to further elaborate on any changes to their challenged expectancies. FAD expectancies will be assessed at baseline, immediately post-intervention, and one-month follow-up. FAD frequency will be assessed at baseline and follow-up. Additionally, participants in the experimental group will provide feedback on the intervention's acceptability and feasibility post-intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FAD Expectancy Challenge Condition | Experimental | Participants in the experimental condition will be delivered the FAD expectancy challenge intervention. |
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| Disordered Eating Psychoeducation | No Intervention | Participants in the control condition will receive psychoeducation on disordered eating behaviors, with only a brief mention of FAD, and excluding any discussion of expectancies and consequences. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Food and alcohol disturbance expectancy challenge | Behavioral | The intervention will focus on strengthening negative FAD expectancies and weakening positive FAD expectancies. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Food and Alcohol Disturbance Expectancy Questionnaire | The Food and Alcohol Disturbance Expectancy Questionnaire is a 30-item self-report questionnaire that assesses positive and negative expectancies for FAD. Participants will be asked to indicate the extent to which they believe or expect each FAD-related outcome to occur if they engaged in FAD, using a five-point scale from 0 (Strongly Disagree) to 5 (Strongly Agree). Scores on each factor will be summed and averaged, with higher scores indicating stronger expectancies. | This measure will be administered to all participants at baseline, immediately post-intervention, and at the study's one-month follow-up |
| Food and Alcohol Disturbance Intentions Questions | Two questions will be used to assess intentions to engage in FAD for both caloric compensation and alcohol enhancement motives. Items will be rated on a scale from 0 (Very unlikely) to 10 (Very likely), with higher scores indicating greater intentions to engage in FAD. | This measure will be administered to all participants at baseline, immediately post-intervention, and at the study's one-month follow-up |
| College Eating and Drinking Behaviors Scale | The CEDBS is a 21-item questionnaire that measures the frequency of past-month FAD. Items are rated on a scale from 1 (Never) to 6 (Always), with higher scores indicating more frequent FAD. | This measure will be administered at baseline and at the one-month follow-up |
| Food and Alcohol Disturbance Timeline Followback | This measure will assess past-month FAD frequency, including FAD motives and compensatory behaviors. The number of days that participants reported engaging in FAD will be summed, with higher scores indicating more frequent FAD. | This measure will be administered at baseline and at the one-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Brief Young Adult Alcohol Consequences Questionnaire | The Brief Young Adult Alcohol Consequences Questionnaire is a 24-item self-reported questionnaire that assesses past-month alcohol-related negative consequences using a dichotomous "Yes" or "No" response item format. A composite score indicating how many consequences participants experienced will be created by summing the number of alcohol problems reported. Higher scores will represent greater alcohol consequences. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Katherine A Berry, MS | Contact | 307-314-2669 | kberry11@uwyo.edu | |
| Alison Looby, PhD | Contact | 307-314-2314 | alooby@uwyo.edu |
| Name | Affiliation | Role |
|---|---|---|
| Katherine A Berry, MS | University of Wyoming | Principal Investigator |
| Alison Looby, PhD | University of Wyoming | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Wyoming | Laramie | Wyoming | 82071 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38918931 | Background | Berry KA, Looby A. "If You Don't Eat, You Can Get Drunk Faster": A Qualitative Investigation of Food and Alcohol Disturbance (FAD) Expectancies. Subst Use Misuse. 2024;59(11):1647-1655. doi: 10.1080/10826084.2024.2369161. Epub 2024 Jun 25. | |
| 39168054 | Background | Berry KA, Choquette EM, Looby A, Rancourt D. Unification of the food and alcohol disturbance literature: A systematic review. Clin Psychol Rev. 2024 Nov;113:102486. doi: 10.1016/j.cpr.2024.102486. Epub 2024 Aug 14. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Dec 19, 2024 | Feb 7, 2025 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D000067292 | Alcohol Drinking in College |
| ID | Term |
|---|---|
| D000428 | Alcohol Drinking |
| D004327 | Drinking Behavior |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D005502 | Food |
| D000431 | Ethanol |
| ID | Term |
|---|---|
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
| D000438 | Alcohols |
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| This measure will be administered at baseline and at the one-month follow-up |
| 34292851 | Background | Shepherd CB, Berry KA, Ye X, Li K. Food and alcohol disturbance among US college students: a mixed methods scoping review. J Am Coll Health. 2023 Aug-Sep;71(6):1715-1731. doi: 10.1080/07448481.2021.1947300. Epub 2021 Jul 22. |
| D009930 |
| Organic Chemicals |