Background and aims: Efficacy of brief alcohol interventions for young adults with internalizing distress (i.e. symptoms of depression, anxiety and stress) is unclear. We tested the moderating effect of internalizing distress on the efficacy of alcohol single- and multicomponent personalized feedback interventions (PFIs).

Design: Secondary data were analyzed from a randomized controlled trial (RCT) testing the efficacy of single and multicomponent PFIs, compared with an attention-only control condition.

Setting: Participants were sampled from two West Coast universities in the United States. All study protocols were completed online.

Participants: Participants (n = 1137) were college students (63% female; M_age = 20.1 years; 62.6% non-Hispanic white) who reported on internalizing distress at baseline. Some individuals reported clinically significant symptoms (depression: mild/moderate = 24.0%, severe/extremely severe = 10.5%; anxiety: mild/moderate = 19.6%, severe/extremely severe = 11.4%; and stress: mild/moderate = 37.5%, severe/extremely severe = 6.0%).

Interventions: There were four different alcohol single-component PFIs administered and an attention-only PFI control. Alcohol PFIs varied in their complexity and single-component PFIs (i.e. personalized normative feedback) were compared with multicomponent PFI (i.e. containing additional alcohol-focused psychoeducation).

Measurements: Baseline levels of internalizing distress were measured using the summed total of the Depression, Anxiety and Stress Scales (DASS). Drinking outcomes (alcohol consumption, peak eBAC, alcohol-related consequences) were measured at baseline, 3, 6 and 12 months post-intervention.

Findings: Alcohol PFI (compared with attention-only control) reduced alcohol consumption and related consequences at 6-month [rate ratio (RR)_Consumption = 0.85, P = 0.004] or 12-month follow-ups (RR_Consumption = 0.76, P < 0.001; RR_Consequences = 0.85, P = 0.020), regardless of baseline DASS score. Participants with higher DASS scores (compared with those with lower DASS scores) reported lower 6-month alcohol consumption after receiving a single-component intervention (RR = 0.80, P < 0.001). However, individuals with higher DASS scores (compared to those with lower DASS scores) reported more 6-month alcohol-related consequences after receiving a multicomponent intervention (RR = 0.78, P = 0.004).

Conclusions: Personalized feedback interventions may demonstrate efficacy towards reducing drinking in young adults and appear similarly beneficial across levels of internalizing distress, although lower-complexity interventions may be more efficacious.

Keywords: alcohol; alcohol consumption; alcohol‐related consequences; internalizing distress; personalized feedback interventions; tailoring.

© 2025 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

背景与目的： 目前尚不清楚针对有内化困扰（即抑郁、焦虑和压力症状）的年轻成年人进行简短酒精干预的效果。我们测试了内化困扰对酒精单一成分和个人化反馈干预（PFIs）有效性的调节作用。

设计： 从一个随机对照试验（RCT）中分析了二次数据，该试验评估了单一和多成分PFIs与仅关注控制条件的疗效。

环境： 参与者来自美国西海岸两所大学。所有研究方案均在线完成。

参与者： 参与者（n = 1137）是大学生，其中63%为女性；平均年龄（M_age) = 20.1岁；62.6%为非西班牙裔白人），他们在基线时报告了内化困扰。一些个体表现出临床显著的症状：抑郁（轻度/中度=24.0%，重度/极度严重=10.5%）；焦虑（轻度/中度=19.6%，重度/极度严重=11.4%）；以及压力（轻度/中度=37.5%，重度/极度严重=6.0%）。

干预措施： 有四种不同的酒精单一成分PFIs被施用，并且有一个仅关注的PFI控制组。酒精PFIs在复杂性上有所不同，单一成分PFIs（即个性化规范反馈）与多成分PFI（即包含额外的酒精聚焦心理教育）进行比较。

测量： 基线内化困扰水平使用抑郁、焦虑和压力量表(DASS)的总分来衡量。饮酒结果（酒精摄入量，峰值eBAC，与酒精相关的后果）在基线、干预后3个月、6个月和12个月时进行测量。

发现： 相比仅关注控制组，酒精PFI减少了6个月[消费比率(RR)_Consumption = 0.85, P = 0.004]或12个月随访时的酒精摄入量和相关后果(RR_Consumption = 0.76, P Consequences = 0.85, P = 0.020)，不论基线DASS评分如何。与DASS评分较低的参与者相比，DASS评分较高的参与者在接受单一成分干预后报告了更低的6个月酒精摄入量(RR = 0.80, P

结论： 个性化反馈干预可能对减少年轻成年人的饮酒表现出有效性，并且似乎对内化困扰水平的影响同样有益，尽管较低复杂性的干预可能更有效。

关键词：酒精；酒精摄入量；与酒精相关的后果；内化困扰；个性化反馈干预；定制。

© 2025 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.