Examining the Effectiveness of Dynamic Visual Noise (DVN) for Reducing Alcohol Cravings and Consumption in College Students

Strength of alcohol craving will be measured using the Craving Experiences Questionnaire - Strength (CEQ-S). The measure inquires about the individual's past-week craving experiences. Higher average scores indicate stronger past-week cravings. Changes in mean craving will be calculated as changes in mean strength of past-week alcohol craving at follow-up relative to baseline for each condition.

Frequency of alcohol craving will be measured using the Craving Experiences Questionnaire - Frequency (CEQ-F). The measure inquires about the individual's past-week craving experiences. Higher average scores indicate more frequent past-week craving. Changes will be calculated as changes in mean frequency of past-week alcohol craving at follow-up relative to baseline for each condition.

At baseline and follow-up, participants will complete the Daily Drinking Questionnaire (DDQ) to indicate the extent of their past-week alcohol consumption. Higher total scores indicate more past-week alcohol consumption. Changes will be calculated as changes in mean past-week alcohol use at follow-up relative to baseline for each condition.

Attentional bias will be measured at the initial laboratory session and at the 1-week final follow-up via the Alcohol Visual Probe task. Changes will be examined as mean changes in reaction time at follow-up minus reaction time at baseline for each condition.

Participants will view their assigned intervention (i.e., DVN or SVN) as part of the initial baseline visit. Participants will first undergo a craving induction paradigm. Participants will then complete the CEQ-Strength-Now (CEQ-S-N) to indicate the strength of their current craving. Then, participants will view the DVN or SVN (depending on their assigned condition). After viewing the task, participants will complete the CEQ-S-N again. Higher average scores on the CEQ-S-N indicate stronger current moment cravings. Immediate changes in craving will be calculated as the average CEQ-S-N score before viewing the task minus average CEQ-S-N score after viewing the task. A mean change score will be calculated for each condition.

During the intervention phase, participants will be able to freely access their assigned intervention whenever they experience a craving. When they access the intervention, participants will first be asked to indicate, using a 0-100 Visual Analogue Scale (VAS), the strength of their current cravings for alcohol (i.e., "How strong is your craving for alcohol RIGHT NOW?"). They will then view their assigned intervention for at least 30 seconds. Immediately after viewing their intervention, they will complete the same VAS item. The change score will be calculated as the craving score before viewing minus the craving score after each viewing. A mean change score will be calculated for each condition.

Negative affect (NA) is proposed to be an associative stimulus that may elicit cravings under the Elaborated Intrusion theory. However, DVN has never been examined in the context of affect. As such, the one and only exploratory aim of the study is to examine whether DVN affects NA, longitudinally and/or immediately. NA will be measured through the use of the NA subscale of the Positive and Negative Affect Schedule (PANAS) at baseline and final follow-up. Changes will be calculated as changes in mean NA at follow-up relative to baseline. Mean change scores will be calculated for each condition.

Negative affect (NA) is proposed to be an associative stimulus that may elicit cravings under the Elaborated Intrusion theory. However, DVN has never been examined in the context of affect. As such, the one and only exploratory aim of the study is to examine whether DVN affects NA, longitudinally and/or immediately. NA will be measured through the use of the NA subscale of the Positive and Negative Affect Schedule (PANAS). Participants will complete the measure immediately before and after viewing the DVN/SVN during their baseline session. Changes in NA will be calculated as average NA score after viewing minus average NA score before viewing. Mean change scores will be calculated for each condition.

To characterize and describe the sample in terms of their alcohol use and related experiences, participants will complete the Alcohol Symptom Checklist (ASC), a measure of alcohol use severity wherein each item corresponds to a diagnostic criteria of alcohol use disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders 5th edition. Higher total scores indicate more severe past-year alcohol use. Mean scores will be calculated for each condition.

To characterize and describe the sample in terms of their alcohol use and related experiences, participants will complete the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) at baseline. Higher total scores indicate more negative alcohol consequences experienced in the past month. Mean scores will be calculated for each condition.

To characterize and describe the sample in terms of their alcohol use and related experiences, participants will complete the DDQ for their past-month alcohol use at baseline. Higher total scores indicate greater quantity and frequency of alcohol use. Mean past-month alcohol use will be calculated for each condition.

During the intervention period, participants will have free access to their assigned intervention. After they view the intervention, they will be asked two questions regarding the extent to which they paid attention to the intervention. Questions will include:

• How many times did you look away from the task, even if only for a brief moment?
• If you looked away at any point, approximately how long did you look away for in total? (Participants select a response option between "N/A; I did not look away" to 15+ seconds).

Average number of times and average duration of looking away will be calculated for each condition.

During the intervention period, participants will have free access to their assigned intervention and be instructed to view it at least once per day but ideally any time they experience a craving. The average number of times the intervention was accessed will be calculated for each condition as an indicator of acceptability and feasibility.

We will be gathering data on whether participants have consumed alcohol that day, when the most recent time they consumed alcohol was, and whether they are currently under the influence of alcohol. After participants finish viewing their assigned task, answer questions about their current craving, and answer the attention validation items, they will answer the following questions about their recent alcohol use:

• Have you consumed any alcohol since the last time you completed this task?
• Approximately, how many hours has it been since your last alcoholic drink (round to the closest hour)?
• Are you currently experiencing any effects of alcohol? That is, have you recently consumed alcohol and are experiencing alcohol intoxication (i.e., feeling "tipsy" or "drunk"?)