Decisional Balance: Theory, History, Research, and Directions for Alcohol Research



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This study seeks to replicate and extend decisional balance (DB) research by implementing a DB intervention among heavy drinking undergraduates, and comparing the traditional non-weighted DB proportion (DBP; Collins, Carey, & Otto, 2009) to a DBP that is weighted based on the relative importance of items. We expected that consistent with previous findings, the intervention would result in decreased drinking compared to control. We further expect that the weighted DBP would be a better predictor of reduced drinking compared to the non-weighted DBP or control. Additionally, we expect that intervention efficacy would be moderated by initial DBP. One hundred and eighty heavy drinking undergraduates (Mean age = 24.37, SD = 6.81, 27% male) completed study materials including measures of alcohol consumption and DB at baseline (pre- and post-intervention) and again during a one month follow-up assessment. Results showed that consistent with expectations, the intervention predicted follow-up drinking (drinks per week). Furthermore, consistent with expectations, the weighted DBP was associated with reduced drinks per week and marginally associated with reduced problems. Results further indicated that the actual weight values did not moderate intervention efficacy. This finding suggests that the process of weighting pros and cons may be instrumental in moving individuals toward change, regardless of the actual values of the weights. The broad, long-term objective of the current study is to lay the groundwork for enhancing future interventions by increasing empirical knowledge of the role motivation plays in heavy alcohol use and factors in predicting drinking.



Motivation to change, Motivation, Motivational interviewing, Ambivalence