The influence of cognitive and affective components of the sentinel event on alcohol use following a brief intervention with trauma patients.

Abstract

Alcohol-related injury is a sentinel event, an unanticipated medical event that may prompt a re-evaluation of health behaviors, such as alcohol use. Few studies have examined the psychological components of the sentinel event that motivate behavior change. In the present study, we examined the influence of cognitive and affective components of an alcohol-related injury on changes in alcohol use following a brief intervention. Injured patients (n = 411) who were drinking prior to their injury admission were recruited from three urban Level I trauma centers and randomized to receive brief advice or brief motivational intervention with or without a 1-month booster session. Assessments were completed at baseline and 3-, 6-, and 12-month follow-ups. Three groups were created based on endorsement (yes/no) of items assessing cognitive and affective components of the injury event: neither component, the cognitive component only, and both the cognitive and affective components. Mixed-effects models indicated that participants who endorsed both the cognitive and affective components had greater reductions in peak alcohol use from baseline to 3-month follow-up than those who did endorsed neither component. By contrast, participants who endorsed the cognitive component, but not the affective component, had greater increases in average drinks per week and percentage of days of heavy drinking from 3- to 12-month follow-ups than those who endorsed neither component. These results provide preliminary support for further consideration of an affective component of alcohol-related injuries that may motivate subsequent reductions in drinking following a sentinel event.