Predictors of change in binge drinking over a 3-month period

Protective and risk factors for increased alcohol use in Latinx college students on the U.S./Mexico border

Alcohol use is prevalent among undergraduates, however, limited research on drinking among Latinx college students exists. This study examined potential risk and protective factors of alcohol use and consequences. Participants (n = 382) completed multiple measures including alcohol use frequency and the Rutgers Alcohol Problem Index (RAPI). Linear regression models identified predictors of monthly and yearly drinking days and RAPI. Findings indicated that alcohol use frequency was associated with increasing age, parental alcohol use disorder, greater anger, and lower self-efficacy. Alcohol-related consequences were positively associated with anxiety and adverse childhood experiences. Early alcohol prevention and intervention efforts appear warranted.

Alcohol mixed energy drink usage and risk-taking among college students in Western New York State

Alcohol mixed energy drinks (AmED) may promote excessive alcohol intake and risk-taking among college students. Objective: To understand the relationship between AmED use and risky behavior as well as attitudes and motivations for AmED use. Participants: Undergraduate college students N = 422 (Study 1), N = 37 (Study 2). Methods: Using a mixed-methods approach, we first surveyed undergraduate students about their AmED and alcohol consumption and a series of risk behaviors, self-efficacy, and beliefs (Study 1). We then conducted focus groups within the same population to better understand attitudes, knowledge, and motivations for using AmED (Study 2). Results: Recent AmED use was significantly associated with an increased number of reported binge drinking occasions and self-reported driving while intoxicated events. Our qualitative data analyses revealed two major themes associated with AmED consumption: factors encouraging AmED use and decisions about driving while under the influence of alcohol. Conclusions: These findings add to the literature of beliefs and motivations for AmED use among college students.

Not by associations alone: The role of contextual factors, individual differences, and propositional learning in the malleability of implicit alcohol attitudes

Alcohol attitudes predict unique variance in drinking behavior and have been the target of manipulations and interventions to reduce high-risk alcohol use among youth and adults. However, whether these manipulations create long-lasting changes in alcohol-related attitudes and drinking behavior is unclear. The current mini-review focuses on evaluative conditioning (EC), a manipulation which pairs alcohol-related stimuli repeatedly with affectively valanced stimuli to create new semantic associations in memory; such associations underlie reflexive or impulsive behaviors like high-risk alcohol use. Across experimental studies, EC has been shown to promote negative alcohol attitudes and reduce alcohol consumption. However, recent evidence suggests the effectiveness of EC may depend on the depth of learning facilitated during the task, which may strengthen the semantic associations through propositional learning. While researchers have experimentally promoted greater depth of learning through the manipulation of contextual factors, we review evidence that alcohol-related individual differences also impact the effectiveness of alcohol EC, particularly when these factors are explicitly linked to the stimuli used during the manipulation. This review provides future directions for researchers and practitioners aiming to shape alcohol-related attitudes and behaviors. Specifically, the malleability of alcohol-related attitudes may depend on propositional learning facilitated by contextual and individual factors. Researchers and practitioners should incorporate these factors into interventions like EC aiming to reduce high-risk alcohol consumption.

Impact of Pretreatment Change on Mechanism of Behavior Change Research: An Applied Example Using Alcohol Abstinence Self-Efficacy

OBJECTIVE

With the growing recognition that, for some, significant changes in drinking occur before the first treatment session (i.e., pretreatment change), researchers have called for the careful assessment of when change occurs and its potential impact on mechanism of behavior change (MOBC) research. Using a commonly hypothesized MOBC variable, alcohol abstinence self-efficacy, the primary aim of this study was to examine the effect of pretreatment change on the study of MOBCs.

METHOD

Sixty-three individuals diagnosed with alcohol dependence were recruited to participate in a 12-week cognitive-behavioral treatment. Participants completed weekly assessments of self-efficacy and drinking behaviors.

RESULTS

Multilevel time-lagged regression models indicated that pretreatment change significantly moderated the effect of self-efficacy on the number of drinking days, such that among those higher on pretreatment change, higher self-efficacy ratings predicted lower rates of drinking days in the week until the next treatment session. In contrast, pretreatment change did not moderate the effect of self-efficacy on the rate of heavy drinking days.

CONCLUSIONS

Results from the current study add to a small but growing body of research highlighting the importance of pretreatment change when studying MOBCs. Further, these results provide important insights into the conditions in which self-efficacy may play an important role in treatment outcomes.

Binge Drinking

Alcohol is the substance most frequently abused by children and adolescents in the United States, and its use is associated with the leading causes of death and serious injury at this age (ie, motor vehicle accidents, homicides, and suicides). Among youth who drink, the proportion who drink heavily is higher than among adult drinkers, increasing from approximately 50% in those 12 to 14 years of age to 72% among those 18 to 20 years of age. In this clinical report, the definition, epidemiology, and risk factors for binge drinking; the neurobiology of intoxication, blackouts, and hangovers; genetic considerations;and adverse outcomes are discussed. The report offers guidance for the pediatrician. As with any high-risk behavior, prevention plays a more important role than later intervention and has been shown to be more effective. In the pediatric office setting, it is important to ask every adolescent about alcohol use.

Categories of alcohol outcome expectancies and their relationships to alcohol related consequences

Extensive research has generally supported a significant and positive relationship of positive outcome expectancies with the amount of alcohol consumed among young adult drinkers, a group generally considered at high risk. Researchers have also naturally been interested in the relationships between these beliefs about drinking and the negative consequences experienced among those who abuse alcohol. Interestingly, those studies found significant positive associations of the number of alcohol outcome expectancies with drinking related consequences, independent of the amount of alcohol being consumed, suggesting that some consequences may be a function of beliefs rather than chemical effects. In addition, there has been evidence that age related differences may exist in the experience of positive outcome expectancies and their associations with consumption. One area that has not been examined is how different categories of alcohol outcome expectancies may be associated with different types of consequences among young adults. Young adults between ages 18–30 were assessed for different categories of alcohol outcome expectancies as well as different types of alcohol consequences. Study hypotheses were partially supported in that specific categories of expectancies were significantly associated with different types of consequences in multiple regression models, but not in the pattern that was predicted from a review of the literature. Expectancies with themes of personal power were consistently found to be significantly and positively associated with various types of consequences after controlling for alcohol consumption. The paper discusses the clinical relevance of these findings with regard to young adult drinkers.

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Positive outcomes expectancies were significantly associated with various types of alcohol related consequences.

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The pattern of results may suggest the importance of considering positive expectancies associated with enhancing personal power.

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The clinical relevance of the study is discussed in the context of harm reduction and outcome expectancy challenges.

Ethnic identity, drinking motives, and alcohol consequences among Alaska Native and non-Native college students

This research involves the examination of drinking motives, alcohol consequences, and ethnic identity in a sample of Native and non-Native college student drinkers in Alaska. Although more Alaska Native students are abstinent from alcohol compared to any other ethnic group, Native students who do drink experience greater alcohol consequences and dependence symptoms. Therefore, we attempted to examine the influence of ethnic identity on alcohol consequences in a diverse sample of Native and non-Native students in Alaska. Findings showed that drinking motives, as measured by the Drinking Motives Questionnaire (social, coping, enhancement, and conformity), significantly predicted alcohol consequences after controlling for frequency of monthly binge drinking. In addition, after controlling for depression, binge drinking, and drinking motives, one aspect of ethnic identity (Affirmation, Belonging, and Commitment) was significantly negatively related to alcohol consequences, whereas another aspect of ethnic identity (Ethnic Identity Search) was not. Taken together, these findings suggest that interventions for college student alcohol misuse that target Native students should be culturally grounded and focused on enhancing the Affirmation, Belonging, and Commitment to one's ethnic heritage and should address drinking motives, especially drinking to cope, as a way to reduce alcohol related harm.

The relationship between cannabis outcome expectancies and cannabis refusal self-efficacy in a treatment population

BACKGROUND AND AIMS

Self-efficacy beliefs and outcome expectancies are central to Social Cognitive Theory (SCT). Alcohol studies demonstrate the theoretical and clinical utility of applying both SCT constructs. This study examined the relationship between refusal self-efficacy and outcome expectancies in a sample of cannabis users, and tested formal mediational models.

DESIGN

Patients referred for cannabis treatment completed a comprehensive clinical assessment, including recently validated cannabis expectancy and refusal self-efficacy scales.

SETTING

A hospital alcohol and drug out-patient clinic.

PARTICIPANTS

Patients referred for a cannabis treatment [n = 1115, mean age 26.29, standard deviation (SD) 9.39].

MEASUREMENTS

The Cannabis Expectancy Questionnaire (CEQ) and Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ) were completed, along with measures of cannabis severity [Severity of Dependence Scale (SDS)] and cannabis consumption.

FINDINGS

Positive (β = -0.29, P < 0.001) and negative (β = -0.19, P < 0.001) cannabis outcome expectancies were associated significantly with refusal self-efficacy. Refusal self-efficacy, in turn, fully mediated the association between negative expectancy and weekly consumption [95% confidence interval (CI) = 0.03, 0.17] and partially mediated the effect of positive expectancy on weekly consumption (95% CI = 0.06, 0.17).

CONCLUSIONS

Consistent with Social Cognitive Theory, refusal self-efficacy (a person's belief that he or she can abstain from cannabis use) mediates part of the association between cannabis outcome expectancies (perceived consequences of cannabis use) and cannabis use.

Polysubstance use in cannabis users referred for treatment: drug use profiles, psychiatric comorbidity and cannabis-related beliefs

BACKGROUND

Population-based surveys demonstrate cannabis users are more likely to use both illicit and licit substances, compared with non-cannabis users. Few studies have examined the substance use profiles of cannabis users referred for treatment. Co-existing mental health symptoms and underlying cannabis-related beliefs associated with these profiles remains unexplored.

METHODS

Comprehensive drug use and dependence severity (Severity of Dependence Scale-Cannabis) data were collected on a sample of 826 cannabis users referred for treatment. Patients completed the General Health Questionnaire, Cannabis Expectancy Questionnaire, Cannabis Refusal Self-Efficacy Questionnaire, and Positive Symptoms and Manic-Excitement subscales of the Brief Psychiatric Rating Scale. Latent class analysis was performed on last month use of drugs to identify patterns of multiple drug use. Mental health comorbidity and cannabis beliefs were examined by identified drug use pattern.

RESULTS

A three-class solution provided the best fit to the data: (1) cannabis and tobacco users (n = 176), (2) cannabis, tobacco, and alcohol users (n = 498), and (3) wide-ranging substance users (n = 132). Wide-ranging substance users (3) reported higher levels of cannabis dependence severity, negative cannabis expectancies, lower opportunistic, and emotional relief self-efficacy, higher levels of depression and anxiety and higher manic-excitement and positive psychotic symptoms.

CONCLUSION

In a sample of cannabis users referred for treatment, wide-ranging substance use was associated with elevated risk on measures of cannabis dependence, co-morbid psychopathology, and dysfunctional cannabis cognitions. These findings have implications for cognitive-behavioral assessment and treatment.

The role of self-efficacy in the treatment of substance use disorders

Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. The present paper reviews the recent literature on self-efficacy in the substance abuse field. In numerous studies of substance abuse treatment, self-efficacy has emerged as an important predictor of outcome, or as a mediator of treatment effects. Despite these repeated positive findings, the self-efficacy concept has had little impact on the design of treatments. Since the concept was first introduced, there have been numerous suggestions regarding the means by which self-efficacy may be enhanced in clinical settings, but very little by way of empirical tests of those suggestions. This review concludes with a number of recommendations for further research to improve understanding of this potentially valuable concept and its interactions with other variables, and to develop effective strategies for enhancing self-efficacy.

Readiness to change and post-intervention drinking among Hispanic college students living on the US/Mexico border

OBJECTIVE

The purpose of the present study was to examine readiness to change as a predictor of post-intervention alcohol consumption among Hispanic college student drinkers taking part in a brief harm reduction intervention.

METHOD

Participants of the intervention study were 109 Hispanic college students residing on the US/Mexico border who self-identified as regular drinkers. This manuscript reports findings from a subset of participants who had complete data at 3-month follow-up (N=84). Participants completed the Readiness to Change Questionnaire, the Rutgers Alcohol Problem Index, and the Form-90 Steady Pattern drinking assessment prior to receiving an intervention.

RESULTS

Hierarchical least-squares regression was used to predict baseline readiness to change scores from alcohol consumption and related consequences, and then to predict 3-month post-intervention drinking from baseline drinking and readiness to change. Alcohol consumption and consequences significantly predicted readiness to change at baseline, and follow-up drinking was significantly predicted from baseline drinking, readiness to change, and an interaction between the two variables. Findings indicated that readiness to change may function differently in people with varying levels of alcohol involvement.

CONCLUSIONS

Greater readiness to change predicted reduced alcohol consumption only among the heaviest drinkers; among lighter drinkers, greater readiness to change predicted increased alcohol consumption. Possible explanations for this finding are discussed.

The effects of self-efficacy statements in humorous anti-alcohol abuse messages targeting college students: who is in charge?

This study examined the effect of self-efficacy statements in humorous anti-alcohol abuse television advertisements on college students. A posttest only group design experiment was conducted with 124 college students. It was found that highly rebellious individuals who watched ads with a self-efficacy statement (i.e., "You Are in Control of the Situation") indicated lower alcohol expectancies, higher risk perceptions, and higher intentions to change their drinking behaviors than those in the non-self-efficacy condition. The findings suggest that health promotional messages should be tailored to rebellious college students, particularly those who are at risk, in a manner that not only gains their attention but also minimizes possible defensive reactions to the given messages. Humorous messages with self-efficacy statements could offer ways to communicate with rebellious college students regarding their drinking problems.

Disinhibited characteristics and binge drinking among university student drinkers

Binge drinking is a major problem at North American universities. Disinhibited traits have provided insight on other patterns of alcohol involvement, but less is known about how they relate to bingeing. Drinkers at a large urban university (n=293) completed the Barratt Impulsiveness Scale 11 (BIS-11), the Aggression Questionnaire, and the Thrill and Adventure Seeking and Boredom Susceptibility scales. Binge drinking was assessed using the NIAAA recommendation for standardizing binge frequency. Hierarchical regression was used to evaluate relationships between disinhibited traits and bingeing. BIS-11 Motor Impulsiveness, Thrill and Adventure Seeking and Boredom Susceptibility predicted bingeing. As about 15% of the variability in bingeing was due to disinhibition facets, they should be considered in future models of student vulnerability to bingeing.

Binge drinking in young adults: Data, definitions, and determinants

Binge drinking is an increasingly important topic in alcohol research, but the field lacks empirical cohesion and definitional precision. The present review summarizes findings and viewpoints from the scientific binge-drinking literature. Epidemiological studies quantify the seriousness of alcohol-related problems arising from binge drinking, with a growing incidence reported in college-age men over the last 2 years. Experimental studies have found neurocognitive deficits for frontal lobe processing and working memory operations in binge-drinking compared with nonbinge alcohol drinkers. The findings are organized with the goals of providing a useful binge-drinking definition in the context of the empirical results. Theoretical implications are discussed on how binge drinking may alter neurophysiological and neurocognitive function.

Brief alcohol intervention in the emergency department: moderators of effectiveness

OBJECTIVE

Prior research supports the effectiveness of brief interventions for reducing alcohol misuse among patients in the emergency department (ED). However, limited information is available regarding the mechanisms of change, which could assist clinicians in streamlining or amplifying these interventions. This article examines moderators of outcomes among ED patients, ages 19 and older, who participated in a randomized controlled trial of a brief intervention for alcohol misuse.

METHOD

Injured patients (N= 4,476) completed a computerized survey; 575 at-risk drinkers were randomly assigned to one of four brief intervention conditions, and 85% were interviewed again at 3-month and 12-month follow-ups.

RESULTS

Regression models using the generalized estimating equations approach examined interaction effects between intervention condition (advice/no advice) and hypothesized moderator variables (stage of change, self-efficacy, acute alcohol use, attribution of injury to alcohol) on alcohol outcomes over time. Overall, participants who reported higher levels of self-efficacy had lower weekly consumption and consequences, whereas those with higher readiness to change had greater weekly consumption and consequences. Furthermore, individuals who attributed their injury to alcohol and received advice had significantly lower levels of average weekly alcohol consumption and less frequent heavy drinking from baseline to 12-month follow-up compared with those who attributed their injury to alcohol but did not receive advice.

CONCLUSIONS

This study provides novel data regarding attribution for alcohol-related injury as an important moderator of change and suggests that highlighting the alcohol/injury connection in brief, ED-based alcohol interventions can augment their effectiveness.

Social cognitive determinants of betel quid chewing among college students in southern Taiwan: a revised Attitudes-Social Influence-Efficacy Model

Through Structural Equation Modeling, this study aimed to revise and examine the Attitudes-Social Influence-Efficacy Model in explaining the psychosocial process of betel quid use among Southern Taiwan college students. A representative sample of 3,741 college students were recruited from 14 colleges through stratified and random cluster sampling, yielding 3,162 valid participants. Results showed that the revised ASE model accounted for 26.5% of the variance in betel quid use and had a better model-fit evaluation than the original model. Intention to chew affected the use of betel quid, while both social influence and refusal self-efficacy had a direct impact on intention and use as well as an indirect effect on use through intention. Additionally, both positive and negative outcome expectancies predicted intention and betel quid use via refusal self-efficacy. Our results supported the revised ASE model for explaining the psychosocial processes of betel quid use, suggesting that more attention should be given towards the development of school-based preventive programs on diminishing social influence and promoting refusal self-efficacy in betel quid use.

Binge Drinking, Cognitive Performance and Mood in a Population of Young Social Drinkers

BACKGROUND

Binge drinking may lead to brain damage and have implications for the development of alcohol dependence. The aims of the present study were to determine individual characteristics as well as to compare mood states and cognitive function between binge and nonbinge drinkers and thus further validate the new tool used to identify these populations among social drinkers.

METHODS

The lowest and the highest 33.3% from a database of 245 social drinkers' binge scores derived from the Alcohol Use Questionnaire (AUQ) were used as cutoff points to identify nonbinge drinkers and binge drinkers in a further population of 100 young healthy volunteers. Personality characteristics, expectations of the effects of alcohol and current mood were evaluated. Cognitive performance was tested with a Matching to Sample Visual Search task (MTS) and a Spatial Working Memory task (SWM) both from the CANTAB battery, and a Vigilance task from the Gordon Diagnostic System.

RESULTS

The binge drinkers had less positive mood than the nonbinge drinkers. In the MTS choice time on an 8-pattern condition and movement time on an 8- and 4-pattern condition was found to be faster in the binge drinkers compared to nonbinge drinkers. A gender by binge drinking interaction in the SWM and the Gordon Diagnostic System task revealed that female binge drinkers were worse on both these tasks than the female nonbinge drinkers.

CONCLUSIONS

These results confirm previous findings in binge drinkers and suggest that in a nondependent alcohol-drinking group, differences can be seen in mood and cognitive performance between those that binge drink and those that do not.