Replication of factors related to blackout incidence in U.S. high school students: A brief report

Examining Premeditation and Urgency as Moderators of the Longitudinal Association Between Alcohol-Induced Blackouts and AUDIT Scores Among Adolescents and Young Adults

BACKGROUND

Adolescence and young adulthood are developmental periods where both initiation and escalation of alcohol consumption is common. While existing literature highlights the potential role alcohol-induced blackouts (AIBs) may have on the development of alcohol use disorders as well as how impulsivity is associated with alcohol use, research to date has not been conducted within the United States. Therefore, this study aimed to examine longitudinal associations between AIBs and hazardous alcohol use risk (AUDIT) in adolescents and young adults, while exploring the moderating effects of impulsivity facets (i.e., premeditation and urgency).

METHODS

Participants were recruited for a longitudinal ecological momentary assessment (EMA) study in Texas, examining cognitions and alcohol use. The analytical sample comprised 556 participants (58.6% female, 70.8% White, Mage = 21.5, SD = 2.5). Data were collected at baseline and a 12-month follow-up.

RESULTS

Utilizing generalized linear regression models, results revealed a significant prospective association between AIBs and AUDIT scores. Findings indicated premeditation significantly moderated this association, whereas urgency did not.

CONCLUSION

Targeting prevention programs, particularly toward adolescents and young adults with a history of AIBs, especially those with elevated levels of premeditation, may be effective in mitigating the risk of alcohol use disorder development.

A randomized controlled trial testing the efficacy of the eCHECKUP TO GO on drinking games participation and behavior among high school seniors

BACKGROUND

Among high school students, seniors report the highest levels of hazardous drinking behavior, including playing drinking games. Technology-based interventions are a promising approach for reducing hazardous drinking behavior among this age group.

OBJECTIVES

This randomized controlled trial investigated the efficacy of the eCHECKUP TO GO, an online personalized feedback intervention, on reducing the frequency of playing drinking games, the number of drinks consumed while playing drinking games, and the number of drinks consumed on occasions when drinking games were played among high school seniors (ClinicalTrials.gov Identifier NCT03613818).

METHOD

Participants were recruited from two high schools. Class periods were randomized to the intervention condition or an assessment-only control condition. Participants completed online surveys at baseline, 30-day, and 6-month assessments. The subsample in this study (N = 109) consisted of high-risk drinkers (i.e., students reporting binge drinking in the past two weeks at baseline).

RESULTS

We did not find any significant differences in frequency of playing drinking games between the intervention and control conditions. For number of drinks consumed, students in the intervention condition reported a significant reduction in the number of drinks consumed while playing drinking games (p < 0.01) and total number of drinks consumed on drinking game occasions (p < 0.04) at the 30-day follow-up relative to students in the control condition. Reductions within the intervention group were sustained at the 6-month follow-up.

CONCLUSIONS

Results support the efficacy of the eCHECKUP TO GO for decreasing hazardous alcohol use among high school seniors.

A longitudinal study of the relationship between alcohol-related blackouts and attenuated structural brain development

PURPOSE

Alcohol-related blackouts (ARBs) are common in adolescents and emerging adults. ARBs may also be indicative of persistent, alcohol-related neurocognitive changes. This study explored ARBs as a predictor of altered structural brain development and associated cognitive correlates.

METHODS

Longitudinal growth curve modeling estimated trajectories of brain volume across 6 years in participants from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study (n = 800, 213 with lifetime ARB history). While controlling for demographics and overall alcohol use, ARB history was analyzed as a predictor of brain volume growth in regions associated with alcohol-related cognitive change. Post hoc analyses examined whether ARBs moderated relationships between brain morphology and cognition.

RESULTS

ARBs significantly predicted attenuated development of fusiform gyrus and hippocampal volume at unique timepoints compared to overall alcohol use. Alcohol use without ARBs significantly predicted attenuated fusiform and hippocampal growth at earlier and later timepoints, respectively. Despite altered development in regions associated with memory, ARBs did not significantly moderate relationships between brain volume and cognitive performance.

CONCLUSION

ARBs and overall alcohol use predicted altered brain development in the fusiform gyrus and hippocampus at different timepoints, suggesting ARBs represent a unique marker of neurocognitive risk in younger drinkers.

A daily-level examination of willingness to pregame, blackout, and hook up across drinking days: Associations with respective behavioral outcomes among adolescents and young adults

Research indicates general willingness to drink (i.e., "How willing are you to drink tonight?") fluctuates day-to-day and is associated with daily-level drinking. However, it is unknown whether willingness to engage in specific alcohol-related behaviors is associated with actual engagement in those behaviors above and beyond general willingness to drink at the daily level. The present study examined whether daily-level willingness to engage in specific behaviors (i.e., pre-gaming, blacking out, hooking up) predicted engaging in those respective behaviors on drinking days above and beyond one's general willingness to drink. Participants included adolescents and young adults who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. Participants (N = 675; 43 % male) who reported drinking on weekend days (i.e., Friday and Saturday [N = 3,727 days]), were included. The study involved a 3-week EMA burst design with bursts occurring quarterly over 12 months. Multilevel logistic regressions indicated on drinking days when participants reported being more willing than their own average to pre-game (OR = 1.77, p <.001), black out (OR = 1.46, p <.05), or drink before hooking up (OR = 1.68, p <.001), they were more likely to pregame, black out, and hook up, respectively, whereas general willingness to drink was not associated with any outcomes at the daily level.Results suggest willingness to engage in specific behaviors may be essential to target in prevention programming in comparison to general willingness to drink when aiming to reduce specific risk behaviors.

Prologue to the special issue on predrinking and drinking game behaviors among adolescents and young adults in the United States and across the globe: Definitions and overview of prevalence rates

Predrinking and drinking games (DGs) are common risky drinking practices among adolescents and young adults in many different countries around the world. However, most studies on these behaviors have been conducted with university student samples in a limited number of countries. Despite the risks of negative alcohol-related consequences associated with predrinking and DGs, these activities are quite prevalent among young people. In this prologue, we provide definitions for predrinking and DGs and an extensive overview of the known prevalence rates of predrinking and DGs among young people around the world. This special issue addresses known gaps in the literature by including articles which (a) use differing methodologies to examine predrinking or DGs behavior, (b) consider psychosocial and contextual factors that influence these behaviors, and (c) examine young people's perceptions of alcohol policies and interventions. Taken together this Special Issue offers an international view on how and why young people around the world engage in these risky drinking practices, and potential ways to address these behaviors.

Occasion-level investigation of playing drinking games: Associations with cognitions, situational factors, alcohol use, and negative consequences among adolescents and young adults

The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of drinks consumed, and the negative consequences experienced at the occasion level. Participants were 15-25-year-olds (N = 688; 43% male, 47% White, Non-Hispanic, Mean age = 21.18) who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week) that was repeated quarterly over the 12-month study (up to 2x/day) per participant. Multilevel models showed that occasion-level risks (higher willingness, higher descriptive norms, and less familiarity with people) were associated with playing DGs. When examining the within-person associations between DGs and number of drinks, results showed that playing DGs was associated with consuming more drinks. For consequences, DGs were not uniquely predictive of experiencing more consequences and riding in a vehicle with a driver who had been drinking. This study contributes to the literature by examining associations between cognitions and situational factors with DGs and the role DGs play in experiencing negative consequences among a diverse sample of adolescents and young adults.

A Longitudinal Examination of Alcohol-Related Blackouts as a Predictor of Changes in Learning, Memory, and Executive Function in Adolescents

INTRODUCTION

In adolescents, the relationship between alcohol-related blackouts (ARBs) and distinct cognitive changes lasting beyond intoxication is unclear. We examined ARBs as a predictor of persistent changes in the development of learning, memory, and executive function in participants from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study.

METHODS

Descriptive analyses of the NCANDA sample (N = 831, 50.9% female, 12-21 years at baseline) identified ARB patterns within participants with an ARB history (n = 106). Latent growth curve modeling evaluated ARB-related performance changes on four neuropsychological measures across five years, excluding baseline data to reduce the magnitude of practice effects over time (n = 790). Measures included the Penn Conditional Exclusion Test (PCET), Penn Letter N-back Test (PLBT), Penn Facial Memory Test immediate (PFMT_i), and delayed (PFMT_d) recognition trials, and the Rey Complex Figure Test copy (RCFT_c), immediate recall (RCFT_i), and delayed recall (RCFT_d) trials. Multivariate models were fit for raw accuracy scores from each measure, with ARB history (i.e., presence of past-year ARBs) as the main independent variable. Age, sex, race, socioeconomic status, assessment site, and alcohol use (i.e., past-year frequency) were included as covariates. Interaction effects between ARB history and alcohol use frequency were tested.

RESULTS

By year five, 16% of participants had experienced at least one ARB (59% of whom reported > 1 ARB and 57% of whom had an ARB lasting > 1 h). After controlling for demographics and alcohol use, ARB history predicted attenuated PFMT_d performance growth at year one. Interaction effects between ARB history and alcohol use frequency predicted attenuated PFMT_d performance growth at years one and two. ARB history predicted attenuated RCFT_i and RCFT_d performance growth by year four, but not PCET or PLBT performance over time. By contrast, greater past-year alcohol use predicted attenuated PFMT_i and PFMT_d performance growth between years two and four in adolescents without an ARB history.

CONCLUSION

We found that ARBs predict distinct, lasting changes in learning and memory for visual information, with results suggesting that the developing brain is vulnerable to ARBs during adolescence and emerging adulthood.

Intentions and motives to experience alcohol-induced blackout among young adults in college

Blackouts are typically considered a negative consequence of alcohol use. Yet some college students report consuming alcohol with the intention of blacking out. This study examined intentions and motives for blackout drinking among young adults in college. College students with a past-year history of blackout (N = 350, 56% female, 73% White) completed an anonymous online survey. Descriptive statistics were used to examine the incidence of blackout intentions, and individuals who did and did not report future blackout intentions were then compared on drinking patterns, depressive symptoms, social norms, and outcome expectancies. Overall, 135 participants (39%) reported consuming alcohol in the past 30 days with the intention of losing memory of the night's events, and 107 (31%) reported blackout intentions in the next 30 days. When asked (via open text box) to indicate their motives for past blackout intentions, the majority of participants provided responses that fit with coping, social, or enhancement drinking motives. A larger proportion of men than women reported blackout intentions. As a group, those reporting future blackout intentions reported heavier, more frequent, and more problematic drinking, as well as more symptoms of depression and more positive (but not negative) outcome expectancies. A substantial subset of college students reporting a blackout in the past year also endorsed intentions to experience a blackout in the next 30 days. Given strong associations between intentions and subsequent behavior, interventions targeting blackout styles of drinking are warranted. The extent to which "blackout" drinking motives differ from traditional drinking motives is unclear. (PsycInfo Database Record (c) 2020 APA, all rights reserved).