Peer influences on college drinking: a review of the research

A text message intervention aimed at nurturing peer outreach to help meet drinking limit goals: A remote pilot randomized trial in non-collegiate young adults

OBJECTIVE

Scalable interventions attempting to nurture peer outreach to help young adults meet drinking limit goals remain under-developed. To address this gap, we developed ASPIRE, a text message intervention focused on coaching individuals to engage with close peers to assist them in meeting drinking limit goals.

METHOD

Non-collegiate young adults who had reported one or more heavy drinking days in the preceding month and were at least contemplating change were recruited through social media. Participants were randomly assigned to one of three 6-week text message interventions: Control, Goal Support, or ASPIRE. All groups completed baseline assessments and received weekly text message assessments on Thursdays and Sundays. Control and ASPIRE groups were prompted to complete web-based outcome assessments at 6- and 12-weeks.

RESULTS

We enrolled 92 young adults from 31 US states (65% female; 73% White). All groups had high text response rates but intervention usability was sub-optimal. Follow-up rates were 87% at 6-weeks and 79% at 12-weeks. Compared to Control, ASPIRE participants reported significantly more peer support and less peer pressure to drink. ASPIRE exhibited higher goal confidence compared to the Goal Support group. Using multiple imputation, there were no significant differences in drinking outcomes between groups.

CONCLUSIONS

Preliminary findings from this pilot study suggest that a text message intervention focused on nurturing peer outreach to help meet drinking limit goals holds promise in altering peer support and pressure as well as boosting drinking limit goal confidence. Design improvements are needed to reduce alcohol consumption.

Detecting and Understanding Social Influence During Drinking Situations: Protocol for a Bluetooth-Based Sensor Feasibility and Acceptability Study

BACKGROUND

High-risk alcohol consumption among young adults frequently occurs in the presence of peers who are also drinking. A high-risk drinking situation may consist of particular social network members who have a primary association with drinking. Fine-grained approaches such as ecological momentary assessment (EMA) are growing in popularity for studying real-time social influence, but studies using these approaches exclusively rely on participant self-report. Passive indicators of peer presence using Bluetooth-based technology to detect real-time interactions have the potential to assist in the development of just-in-time interventions.

OBJECTIVE

This study seeks to examine the feasibility and acceptability of using a Bluetooth-based sensor and smartphone app to measure social contact in real-world drinking situations.

METHODS

Young adults (N=20) who drink heavily and report social drinking will be recruited from the community to participate in a 3-week EMA study. Using a social network interview, index participants will identify and recruit 3 of their friends to carry a Bluetooth beacon. Participants will complete a series of EMA reports on their own personal Android devices including random reports; morning reports; first-drink reports; and signal-contingent reports, which are triggered following the detection of a beacon carried by a peer participant. EMA will assess alcohol use and characteristics of the social environment, including who is nearby and who is drinking. For items about peer proximity and peer drinking, a customized peer list will be presented to participants. Feedback about the study protocol will be ascertained through weekly contact with both index and peer participants, followed by a qualitative interview at the end of the study. We will examine the feasibility and acceptability of recruitment, enrollment of participants and peers, and retention. Feasibility will be determined using indexes of eligibility, enrollment, and recruitment. Acceptability will be determined through participant enrollment and retention, protocol compliance, and participant-reported measures of acceptability. Feasibility and acceptability for peer participants will be informed by enrollment rates, latency to enrollment, compliance with carrying the beacon, and self-reported reasons for compliance or noncompliance with beacon procedures. Finally, EMA data about peer proximity and peer drinking will support the validity of the peer selection process.

RESULTS

Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025.

CONCLUSIONS

The protocol allows us to examine the feasibility and acceptability of a Bluetooth-based sensor for the detection of social contact between index participants and their friends, including social interactions during real-world drinking situations. Data from this study will inform just-in-time adaptive interventions seeking to address drinking in the natural environment by providing personalized feedback about a high-risk social context and alerting an individual that they are in a potentially unsafe situation.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50650.

Heterogeneous peer effects of college roommates on academic performance

Understanding how student peers influence learning outcomes is crucial for effective education management in complex social systems. The complexities of peer selection and evolving peer relationships, however, pose challenges for identifying peer effects using static observational data. Here we use both null-model and regression approaches to examine peer effects using longitudinal data from 5,272 undergraduates, where roommate assignments are plausibly random upon enrollment and roommate relationships persist until graduation. Specifically, we construct a roommate null model by randomly shuffling students among dorm rooms and introduce an assimilation metric to quantify similarities in roommate academic performance. We find significantly larger assimilation in actual data than in the roommate null model, suggesting roommate peer effects, whereby roommates have more similar performance than expected by chance alone. Moreover, assimilation exhibits an overall increasing trend over time, suggesting that peer effects become stronger the longer roommates live together. Our regression analysis further reveals the moderating role of peer heterogeneity. In particular, when roommates perform similarly, the positive relationship between a student's future performance and their roommates' average prior performance is more pronounced, and their ordinal rank in the dorm room has an independent effect. Our findings contribute to understanding the role of college roommates in influencing student academic performance.

Investigating cognitive and motivational proximal outcomes in a randomized clinical trial of writing about the future self to reduce drinking

BACKGROUND

Drinking identity (the extent to which one links the self with drinking alcohol) is a unique risk factor for college students' hazardous drinking that is not directly targeted by existing interventions. We conducted a study that aimed to decrease drinking identity among college students with hazardous drinking. We adapted a writing task about the future self and tested whether three writing sessions could decrease drinking identity and change drinking. We also investigated whether two additional factors (writing perspective and inclusion of participants' social networks) would enhance task impact. The present study evaluated whether posited proximal cognitive and motivational outcomes (drinking identity, self-efficacy, readiness to change, and drinking intentions) changed immediately after each writing session.

METHOD

The study is a randomized clinical trial in which hypotheses and analyses were pre-registered. Participants were 328 college students who met hazardous drinking criteria. The study had a 2 (narrative writing topic: low-risk drinker vs. reduced smartphone use) × 2 (writing perspective: first-person vs. non-first-person) × 2 (social network instruction: instructed to include vs. not) factorial design. Proximal outcomes were drinking identity, self-efficacy, readiness to change, and drinking intentions. The clinical outcome was alcohol consumption. Participants completed three laboratory sessions at weekly intervals that included the writing task and pre- and post-task assessments.

RESULTS

Results were largely null, except that readiness to reduce drinking was higher in the low-risk drinker condition and increased over the lab sessions. Time effects indicated that reductions in drinking identity, drinking intentions, and alcohol consumption, and increases in self-efficacy were observed but did not change above and beyond control conditions.

CONCLUSIONS

Findings indicate the need to strengthen the writing task and select a more appropriate control task to target proposed proximal outcomes. Future studies might try personalizing the task, evaluating its efficacy with individuals motivated to change their drinking, and using a control task that does not involve imagining a future self.

Associations between frequency of exposure to peer-generated alcohol-related posts and alcohol use within a social network of college students

Peer alcohol use, commonly assessed via perceptions of how many drinks peers consume, is a robust predictor of college drinking. These perceptions are formed by in-person exposure to peer drinking but also may be affected by seeing alcohol-related content (ARC) shared on peer social media accounts. Most research assesses exposure by asking about the frequency of ARC sharing by a whole friend group, potentially missing influences from specific friends. Social network methods collect information about specific friends and their behavior but few studies have used these methods to examine the effects of ARC on drinking, nor have they examined potential moderators of this relationship. The purpose of this study was to examine whether perceived frequency of exposure to ARC shared by social network members on social media is associated with participant alcohol use after controlling for network members' self-reported alcohol use, and if participant gender and relationship qualities with network members moderate this association. Participants were 994 college students (Mage = 21.17, SD = 0.47; 61.8 % female; 55.4 % White; 12.3 % Hispanic) who completed a web-based survey. Due to the social network design, network autocorrelation analyses were conducted, which revealed that greater perceived frequency of exposure to network member ARC was significantly associated with higher alcohol quantity above and beyond network members' alcohol use. Peer ARC had a unique association with drinking behavior independent of in-person peer alcohol use, although the cross-sectional design precludes making causal inferences. Clinicians delivering alcohol interventions to college students may wish to discuss exposure to ARC as another important source of peer influence and how media literacy may help reduce the effects.

Writing about the future self to shift drinking identity: An experimental investigation

College student drinking is prevalent and costly to public and personal health, leading to calls to identify and target novel mechanisms of behavior change. We aimed to manipulate drinking identity (a cognitive risk factor for hazardous drinking) via three sessions of narrative writing about a future self. We tested whether writing could shift drinking identity and would be accompanied by changes in alcohol consumption and problems. Participants were college students meeting hazardous drinking criteria (N = 328; Mage = 20.15; 59% women, 40% men, 1% gender-diverse; 60% white; 23% Asian; 12% multiple races; 2% other racial groups; 8% identified as Hispanic/Latino/a/x). The study had a 2 [narrative writing topic: low-risk drinker vs. reduced smartphone use] × 2 [writing perspective: first person vs. non-first-person] × 2 [social network instruction: instructed to include vs. not] factorial design. Outcomes were drinking identity, drinking refusal self-efficacy, alcohol consumption, alcohol-related problems, and craving. Participants completed three writing sessions and online follow-up assessments at 2, 4, and 12 weeks. The study is a registered clinical trial; hypotheses and analyses were preregistered (https://osf.io/vy2ep/). Contrary to predictions, narrative writing about a future self as a low-risk drinker did not significantly impact outcomes. Null results extended to expected interactions with writing perspective and social network instructions. The narrative writing task did not shift drinking or alcohol-related outcomes. Future experimental work may benefit from greater flexibility in conceptualizing a future self, recruiting individuals interested in behavior change, and more sensitive measures of drinking identity.

Neither a problem nor my problem: Risk factors for underage drinking disengagement among college students

OBJECTIVE

Underage drinking disengagement (UDD; cognitive restructuring/minimizing agency) measures attitudes about the acceptability and responsibility of drinking. We examined demographic correlates of UDD, as well as the moderating effects of legal drinking status on the association between UDD and drinking.

PARTICIPANTS

College student drinkers (n = 893; Mage = 19.48, range = 18-25; White = 74.1%; female = 68.1%) from a multi-site study.

METHODS

An online confidential survey included the UDD Scale for College Students and the AUDIT-C.

RESULTS

White and multiracial, underage students, or those living with others endorsed greater cognitive restructuring disengagement than Hispanic students, legal-age students, or those living alone or with parents, respectively. Greek membership and greater "party school" perceptions were related to more cognitive restructuring and minimizing agency. The associations between UDD and alcohol use were not moderated by legal drinking age status.

CONCLUSION

Identifying and educating students at risk for UDD on the ramifications associated with underage drinking could combat drinking.

The Role of Subjective Norm in Persuasion Through the Restoration of Personal Freedom

Human behavior is largely influenced by social norms. While the social norm approach is frequently used in public health campaigns, their effectiveness is inconsistent. This study investigated the role of normative reactance - the amplification of subjective norms as a means of restoring threatened freedom - across two health behaviors: college drinking and STD testing. A 2 (message threat: low vs. high) × 2 (health topic: college drinking vs. STD testing) between-subjects experiment was conducted with 765 participants. The results indicated that, similar to attitudes, subjective norms could also be amplified as a self-justification strategy to restore threatened freedom, which led to reduced intention to follow a message recommendation. In addition, results showed that the role of subjective norms and attitudes can vary across health behaviors and individual differences, particularly concerning an individual's degree of self-monitoring. Theoretical implications, limitations, and future directions are discussed.

Investigating key latent factors influencing alcohol consumption among the tribal male adolescents in Dooars region, West Bengal

BACKGROUND

Alcohol consumption among tribal male adolescents in India is a significant social concern. Tribal adolescents are particularly vulnerable and tend to lean toward alcohol addiction. Therefore, it is crucial to introduce some necessary footsteps to reduce alcohol consumption. The primary objective of this study is to investigate the association of various latent factors with the alcohol-drinking behavior of tribal adolescents.

METHODS

The study collected data from 600 tribal adolescents from the Dooars region, with 241 of them reported consuming alcohol. The study aimed to confirm the theoretical development of hypotheses regarding peer pressure, parental discord, stress, attitude toward alcohol, and food insecurity as exogenous latent factors influencing the alcohol-drinking behavior of tribal adolescents. In this context, the study adopted both measurement and structural models using Partial Least Squares-Structural Equation Modeling (PLS-SEM).

RESULTS

The findings revealed a significant path relationship between alcohol drinking behavior and various exogenous factors like peer pressure (β = 0.214, p = .000), parental discord (β = 0.121, p = .009), stress (β = 0.170, p = .000), attitude toward alcohol (β = 0.110, p = .004), and food insecurity (β = 0.510, p = .000). This study developed a reflective measurement model, and the evaluation of reflective measurement models was conducted, assessing internal consistency, convergent validity, and discriminant validity, yielding satisfactory results.

CONCLUSION

To tackle alcohol issues among tribal adolescents in the Dooars region, effective strategies should be employed. These include educating in schools, highlighting tribal role models, aiding peers with alcohol dependence, providing life skills training, and addressing parental discord and food insecurity through awareness campaigns, workshops, and better infrastructure.

A Bluetooth-Based Smartphone App for Detecting Peer Proximity: Protocol for Evaluating Functionality and Validity

BACKGROUND

While ecological momentary assessment (EMA) is commonly used to study social contexts and social influence in the real world, EMA almost exclusively relies on participant self-report of present circumstances, including the proximity to influential peers. There is the potential for developing a proximity sensing approach that uses small Bluetooth beacons and smartphone-based detection and data collection to collect information about interactions between individuals passively in real time.

OBJECTIVE

This paper aims to describe the methods for evaluating the functionality and validity of a Bluetooth-based beacon and a smartphone app to identify when ≥2 individuals are physically proximal.

METHODS

We will recruit 20 participants aged 18 to 29 years with Android smartphones to complete a 3-week study during which beacon detection and self-report data will be collected using a smartphone app (MEI Research). Using an interviewer-administered social network interview, participants will identify up to 3 peers of the same age who are influential on health behavior (alcohol use in this study). These peers will be asked to carry a Bluetooth beacon (Kontakt asset tag) for the duration of the study; each beacon has a unique ID that, when detected, will be recorded by the app on the participant's phone. Participants will be prompted to respond to EMA surveys (signal-contingent reports) when a peer beacon encounter meets our criteria and randomly 3 times daily (random reports) and every morning (morning reports) to collect information about the presence of peers. In all reports, the individualized list of peers will be presented to participants, followed by questions about peer and participant behavior, including alcohol use. Data from multiple app data sets, including beacon encounter specifications, notification, and app logs, participant EMA self-reports and postparticipation interviews, and peer surveys, will be used to evaluate project goals. We will examine the functionality of the technology, including the stability of the app (eg, app crashes and issues opening the app), beacon-to-app detection (ie, does the app detect proximal beacons?), and beacon encounter notification when encounter criteria are met. The validity of the technology will be defined as the concordance between passive detection of peers via beacon-to-app communication and the participant's EMA report of peer presence. Disagreement between the beacon and self-report data (ie, false negatives and false positives) will be investigated in multiple ways (ie, to determine if the reason was technology-related or participant compliance-related) using encounter data and information collected from participants and peers.

RESULTS

Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025.

CONCLUSIONS

This Bluetooth-based technology has important applications and clinical implications for various health behaviors, including the potential for just-in-time adaptive interventions that target high-risk behavior in real time.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50241.

Long-term impact of familismo and ethnic identity on latinx college student drinking and high-risk consequences

Familismo, ethnic pride, and ethnic shame were examined as longitudinal predictors of Latinx college student alcohol use and high-risk alcohol-related consequences. Latinx students completed measures during the fall of their first (T1), second (T2), and fourth (T4) year of college. T1 familismo was positively associated with T2 ethnic pride and negatively associated with T2 ethnic shame. T2 ethnic pride was negatively associated with T4 drinking, while T2 ethnic shame was positively associated with T4 drinking. T4 drinking was positively associated with T4 consequences. Results suggest that Latinx ethnic pride and ethnic shame during the second-year of college act as mediators between first-year familismo and fourth-year drinking and consequences.

Alcohol and marijuana use, consequences, and perceived descriptive norms: Differences between two- and four-year college students

Objective: Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Participants: Data were drawn from a cross-sectional subsample of two- and four-year students aged 18-23 (n = 517) participating in a longitudinal study on alcohol use. Results: Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Conclusions: Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population.

Examination of Brief Parent-Based Interventions to Reduce Drinking Outcomes on a Nationally Representative Sample of Teenagers

PURPOSE

Examine brief parent interventions (PBIs) on a nationally representative sample of teenagers (ages 15-18 years) to change drinking, teens declining (i.e., saying no) to ride with impaired drivers, and increase parent communication about alcohol.

METHODS

Parent-teen dyads (N = 1,176) recruited from a web panel completed online surveys at baseline (T1), 30 days (T2), 6 months (T3), and 12 months (T4) post baseline (Psex: 54% female; Tsex: 49% female; Tage: M = 16.33, SD = 1.09; 76% White, 27% Hispanic). Dyads were randomly assigned to: Active Control (n = 390, 33.1%), Surgeon General (SG; n = 393, 33.4%), or Mothers Against Drunk Driving PBI (MADD; n = 393, 33.4%). Aim 1 was an intent-to-treat analysis of the efficacy comparing the Active Control, SG, and MADD conditions on typical weekend drinking and declining riding with an impaired driver from T1 to T4. Aim 2 examined differences in parent communication at T2 by different levels of engagement. Aim 3 examined differences in efficacy comparing the SG and MADD engagement subgroups at T4. Aims were evaluated by comparing means using Tukey's test to reduce experiment-wise error.

RESULTS

Aim 1 revealed no differences in drinking, but participants in the SG and MADD conditions were able to maintain increases in declining riding with impaired drivers. Aim 2 revealed highly engaged participants reported higher parent communication than moderate and low participants. Aim 3 revealed some highly engaged participants reported less drinking and more declining riding with impaired drivers.

DISCUSSION

PBIs may be successful in helping teens decline rides with impaired drivers. Highly engaged parents reported more positive program outcomes than moderate and low engaged parents.

Alcohol consumption as a socially contagious phenomenon in the Framingham Heart Study social network

We use longitudinal social network data from the Framingham Heart Study to examine the extent to which alcohol consumption is influenced by the network structure. We assess the spread of alcohol use in a three-state SIS-type model, classifying individuals as abstainers, moderate drinkers, and heavy drinkers. We find that the use of three-states improves on the more canonical two-state classification, as the data show that all three states are highly stable and have different social dynamics. We show that when modelling the spread of alcohol use, it is important to model the topology of social interactions by incorporating the network structure. The population is not homogeneously mixed, and clustering is high with abstainers and heavy drinkers. We find that both abstainers and heavy drinkers have a strong influence on their social environment; for every heavy drinker and abstainer connection, the probability of a moderate drinker adopting their drinking behaviour increases by [Formula: see text] and [Formula: see text], respectively. We also find that abstinent connections have a significant positive effect on heavy drinkers quitting drinking. Using simulations, we find that while both are effective, increasing the influence of abstainers appears to be the more effective intervention compared to reducing the influence of heavy drinkers.

Dynamic social network analysis of a brief alcohol intervention trial in heavy-drinking college students shows spillover effects

BACKGROUND

Heavy-drinking college students tend to have close social networks, and there is theoretical and empirical support for the idea that behavior change can spread through those networks via close ties. The objective of this research was to determine whether intervention-induced behavior change in a subset of heavy drinkers in a sociometric (whole) college class-year social network is transmitted to other heavy drinkers in the network, resulting in reduced behavioral risk and change in network ties.

METHODS

We conducted a controlled trial in which most of a first-year college class (N = 1236; 56.9% female) was enrolled, with alcohol use and social network ties measured early in each of three semesters. Following a baseline assessment, the network was divided into two groups, brief motivational intervention (BMI) and natural history control (NHC) according to dormitory residence location. A subset of heavy drinkers in each group was selected, and those in the BMI group received an in-person intervention.

RESULTS

Using stochastic actor-oriented modeling, we found a significant tendency for participants in the BMI group to shed ties with individuals with similar drinking behaviors between the first and second semesters, relative to the NHC group. Furthermore, heavy drinkers with reciprocal ties to intervention recipients in the BMI group showed a significant reduction in drinks per week.

CONCLUSIONS

Individual alcohol interventions appear to have effects both on behavior and network connections among individuals who did not receive the intervention. Continued research is needed to identify the optimal conditions for the diffusion of behavior change.

Confirming Eight-Factor Structure of the Substance Use Motives Measure in a Sample of US College Students

The 2020 National Survey on Drug Use indicates nearly three quarters of individuals ages 18-25 have used substances in the past year. Research suggests individuals who use substances to cope with negative mood states are typically more substance-involved, report more psychological distress, and have a more extensive treatment history. Additionally, the high rate of polysubstance use among substance using adults in the U.S. highlights the need for broadband measures that can adequately capture use, consequences, and motivations for use of multiple substances. However, most measures assessing motives for use are typically substance specific. Recently, Biolcati and Passini (2019) developed a brief, but comprehensive model of broad substance use motives (i.e., Substance Use Motives Measure, SUMM) based on well-established motives questionnaires (e.g., DMQ-R, MMQ). They found support for their proposed eight-factor model in an online sample of Italian citizens (ages 18-60). No studies to date have examined the psychometric properties of the SUMM with an English-speaking or US college student sample. The current study evaluates the factor structure of the SUMM in a sample of 143 college students (74.8% female, 77.6% White, and 94.4% non-Hispanic/Latinx) at a large, southeastern university in the United States. Results of a confirmatory factor analysis showed support for the previously identified eight-factor structure for the SUMM, with acceptable model fit and internal consistency of each factor found. Findings support using the SUMM as a broad measure of substance use motives, but more research is needed to assess measurement invariance across different groups and to evaluate external, concurrent, and convergent validity using other well-established measures of substance use motives, severity, and psychiatric symptomatology.

Political Party Collective Norms, Perceived Norms, and Mask Wearing Behavior: A Test of the Theory of Normative Social Behavior

The theory of normative social behavior (TNSB) postulates that people are influenced by others' behaviors, which they observe from messages and experience. In addition to focusing on perceived (i.e., descriptive and injunctive) norms, the TNSB was expanded to include collective norms, which represent what people actually do. Testing this expanded theoretical model, the current study examined whether two types of collective norms - collective political norms and collective regional norms - interacted with descriptive norms to influence pandemic mask wearing behavior expectations among U.S. adults (N = 444). The interaction was statistically significant for collective political norms (β = -.74, p = .009) but not collective regional norms (β = -.16, p = .85). Specifically, descriptive norms were related to increased mask wearing expectation for all values of political party collective norms, but the effects were stronger when political party collective norms were low (i.e., low mask wearing behavior was normative). The findings support the inclusion of collective norms in the TNSB, clarify the relationships among different types of norms, and provide insights for norms-based interventions.

Do you 'like' problems? The linkage between college students' interactions with alcohol-related content on social media and their alcohol-related problems

INTRODUCTION

Alcohol-related content (ARC) on social media and drinking motives impact college students' drinking. Most studies have examined peer-generated ARC on drinking outcomes but have yet to extend this relationship to other sources of influence. The current study explores the link between drinking motives, alcohol company ARC, celebrity ARC, and alcohol-related problems among college students.

METHODS

Students (N = 454) from two US universities completed a cross-sectional online survey assessing demographics; drinking motives (Drinking Motives Questionnaire-Revised; Cooper, Psychol Assess. 1994;6:117-28); following/awareness of alcohol company ARC; engagement with celebrity ARC; peak drinks (most drinks consumed on one occasion); and alcohol-related problems (e.g., passed out).

RESULTS

Greater celebrity ARC was linked to coping, enhancement, and conformity motives, and peak drinks. Frequent engagement with celebrity ARC was associated with higher problems. Positive indirect effects were observed from celebrity ARC to problems through coping and conformity motives, and peak drinks. After having adjusted for the influence of celebrity ARC, no significant pathways were found between alcohol company ARC and any of the drinking motives, peak drinks or problems, nor were there any indirect effects between alcohol company ARC and problems.

DISCUSSION AND CONCLUSIONS

Results revealed that a possible explanation for why students who engaged with celebrity ARC experience problems was due to coping and conformity motives as well as peak drinks. Interventions targeting alcohol cognitions might assess engagement with and exposure to different sources of ARC given their potential to influence problems.

Following social media influencers who share alcohol-related content is associated with college drinking

INTRODUCTION

Frequent exposure to peer-shared alcohol-related content (ARC) on social media is associated with greater alcohol consumption and related consequences among undergraduates. Social media influencers also share ARC; yet, the effect of exposure to influencer-shared ARC on alcohol outcomes has not been examined. The current study examined whether following influencers who share ARC and the frequency of sharing were associated with alcohol outcomes, and associations between influencer type (e.g., actors) and alcohol outcomes.

METHODS

Undergraduates (N = 528) from two universities in the United States completed an online survey assessing demographics, social media use, alcohol use and related consequences. They listed up to five influencers they followed and viewed the most content from. A series of linear regression models were conducted.

RESULTS

Having a larger proportion of influencers sharing ARC was associated with greater quantity, frequency and peak drinks, but not consequences. Frequency of influencers sharing ARC was associated with greater quantity and peak drinks, but not frequency or consequences. Findings remained significant, even after controlling for peer ARC. Actor ARC, everyday person ARC and 'other' type influencer ARC were associated with several alcohol outcomes.

DISCUSSION AND CONCLUSIONS

This study added to the literature by examining how following influencers who share ARC, and sharing frequency, were associated with drinking outcomes over and above exposure to peer ARC. It also examined whether ARC content from specific types of influencers was associated with alcohol outcomes. Findings highlight that the source of ARC is relevant when studying the effects of ARC exposure on college drinking.

Teen Well Check: an e-health prevention program for substance use, sexual assault, and sexual risk behaviors for adolescents in primary care

Objective: Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours; however, to date no integrated prevention programmes address all three risk behaviours. The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault, and sexual risk among adolescents in primary care settings.Methods: The current study included content analysis of interviews with adolescents in primary care (aged 14-18; n = 25) in the intervention development process, followed by usability and acceptability testing with qualitative interviews among adolescents in primary care (aged 14-18; n = 10) and pediatric primary care providers (n = 11) in the intervention refinement process. All data were collected in the Southeastern U.S.Results: Feedback on Teen Well Check addressed content, engagement and interaction, language and tone, aesthetics, logistics, inclusivity, parent/guardian-related topics, and the application of personal stories. Overall, providers reported they would be likely to use this intervention (5.1 out of 7.0) and recommend it to adolescents (5.4 out of 7.0).Conclusions: These findings suggest preliminary usability and acceptability of Teen Well Check. A randomized clinical trial is needed to assess efficacy.

Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis

Adolescent substance use is a major public health issue that can result in enduring physical, psychological, and social consequences. This study seeks to examine the relationship between community capacity for prevention and the 4-week prevalence rate of substance use, including tobacco, alcohol, other drugs, and binge-drinking, among students in Germany ranging from grades 5 to 11. This study employed a cross-sectional design and used baseline data from 28 communities participating in the CTC-EFF study. The sample consisted of 7210 students who were surveyed about their substance use behavior. Additionally, 158 local key informants were surveyed on ten capacity domains, which included commitment, knowledge and skills, resources, leadership, inclusiveness, prevention collaboration, sectoral-collaboration, cohesion, problem-solving skills, and needs orientation. Furthermore, a total capacity score was calculated as the mean of the ten capacity domains. To examine the associations between community capacity and substance use behavior, logistic multi-level models were utilized. The analysis shows a negative association between community capacity (total score) and any substance use (OR = 0.28, 95% CI 0.12-0.56). Specifically, higher levels of total community capacity are associated with lower odds of alcohol use (OR = 0.30, 95% CI 0.13-0.80), tobacco use (OR = 0.09, 95% CI 0.01-0.60), and binge-drinking (OR = 0.67, 95% CI (0.46-0.99). Further analyses of distinct community capacity domains indicate that higher levels of sectoral-collaboration (OR = 0.62, 95% CI 0.37-0.97), knowledge and skills (OR = 0.74, 95% CI 0.40-0.79), resources (OR = 0.52, 95% CI 0.36-0.76), and problem-solving skills (OR = 0.71, 95% CI 0.36-0.89) are associated with lower odds of any substance use. The study findings suggest that community capacity is associated with substance use behavior, emphasizing the importance of capacity building in interventions targeting the reduction of substance use among adolescents.

Whose Approval Matters Most? Examining Discrepancies in Self- and Other- Perceptions of Drinking

BACKGROUND

Research demonstrates that perceptions of others' attitudes toward drinking behaviors (injunctive norms) are strong predictors of alcohol consumption and problems. Personalized normative feedback (PNF) aims to reduce the discrepancy between one's perception of others' attitudes toward drinking and others' actual attitudes toward drinking. An implicit assumption of PNF is that self and (perceived) other attitudes toward drinking are aligned (thus, shifting one's perceptions of others' attitudes shifts one's own attitudes). However, there is minimal research on the extent to which alignment (or discrepancy) in self-other attitudes toward drinking is associated with alcohol-related outcomes.

METHODS

College students (N = 1,494; Mage = 20.11, 61.0% female, 66.4% White) who endorsed past-month heavy episodic drinking reported injunctive norms toward drinking on weekends, drinking daily, drinking to black out, and drinking and driving. Participants reported their perceptions of attitudes toward these drinking behaviors for three reference groups: close friends, typical university-affiliated peers, and parents. Outcomes included weekly drinking, alcohol problems, and alcohol-related risk.

RESULTS

Response surface analyses indicated that alignment in approval (versus alignment in disapproval) of drinking demonstrated a linear association with alcohol-related outcomes. Discrepancies in self-peer and self-parent attitudes were associated with alcohol-related outcomes and one's own attitudes (versus one's ratings of others' attitudes) of drinking were more strongly associated with outcomes.

CONCLUSIONS

Results provide evidence of how self-other discrepancies in attitudes toward drinking are associated with alcohol-related outcomes. Future work is needed to test whether self-other discrepancies in attitudes toward drinking impacts response to norms-based interventions.

Impact of the COVID-19 pandemic on college students' mental health and lifestyle factors

Objective: This study examines how mental health and health behaviors evolved among college students nationwide before and during the onset of the COVID-19 pandemic. Participants: Data collected from college students across various campuses in Fall 2019 (N = 33,372) and Fall 2020 (N = 34,168) as part of the Healthy Minds Study. Methods: The online survey was delivered via Qualtrics. Data was analyzed through an unpaired two-samples T-test and a two-proportion Z-test. Results: The results show a significant difference of depression and anxiety symptoms in college students during Fall 2020 compared to Fall 2019. Sleep patterns significantly shifted during the pandemic. Substance use, perceived need for counseling, and the amount of time students spent exercising all significantly differed during the COVID-19 pandemic. Conclusion: In the context of declines in mental health among college students, college campuses should implement mental health support models addressing students' individual health risk and lifestyle behaviors.

The impact of cultural identity, parental communication, and peer influence on substance use among Indigenous youth in Canada

Heavy drinking and smoking have been found to be among the leading causes of morbidity and mortality within Indigenous youth in North America. The focus of this study was to examine the relative roles of cultural identity, parent-child communication about the harms of substance use (SU), and perception about peers' opinions on heavy drinking and cigarette smoking among Indigenous youth. Strong Indigenous cultural identity, parent-child communication about SU, and affiliation with peers who do not use and/or who disapprove of substance use were all expected to reduce risk for heavy drinking and smoking. Substance use beliefs were hypothesized to mediate these effects. Youth (N  =  117; Mage  =  14.07; grades 6-11) from two Indigenous communities in Quebec completed self-reports. Consistent with the hypotheses, strong cultural identity predicted increased negative beliefs about substance use, which predicted reduced drinking and smoking. Similarly, affiliating with peers who did not use alcohol predicted decreased positive beliefs about alcohol use, which predicted reduced drinking. Affiliating with peers who did not smoke cigarettes predicted reduced cigarette smoking. Parental influences were not supported in this model. Intervention strategies may benefit from targeting cultural identity, peer groups, and substance use beliefs among Indigenous youth.

The effectiveness of digital health technologies for reducing substance use among young people: a systematic review & meta-analysis

BACKGROUND

Substance use amongst young people poses developmental and clinical challenges, necessitating early detection and treatment. Considering the widespread use of technology in young people, delivering interventions digitally may help to reduce and monitor their substance use.

AIMS

We conducted a systematic review and two meta-analyses to assess the effectiveness of digital interventions for reducing substance use (alcohol, smoking, and other substances) among young people aged 10 to 24 years old.

METHOD

Embase, Global Health, Medline, PsychINFO, Web of Science and reference lists of relevant papers were searched in November 2020. Studies were included if they quantitatively evaluated the effectiveness of digital health technologies for treating substance use. A narrative synthesis and meta-analysis were conducted.

RESULTS

Forty-two studies were included in the systematic review and 18 in the meta-analyses. Digital interventions showed small, but statistically significant reductions in weekly alcohol consumption compared to controls (SMD= -0.12, 95% CI= -0.17 to -0.06, I2=0%), but no overall effect was seen on 30-day smoking abstinence (OR = 1.12, 95% CI = 0.70 to 1.80, I2=81%). The effectiveness of digital interventions for reducing substance use is generally weak, however, promising results such as reducing alcohol use were seen. Large-scale studies should investigate the viability of digital interventions, collect user feedback, and determine cost-effectiveness.

PRISMA/PROSPERO

This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in November 2020 (CRD42020218442).

Do brief motivational interventions increase motivation for change in drinking among college students? A two-step meta-analysis of individual participant data

BACKGROUND

Brief motivational interventions (BMIs) are one of the most effective individually focused alcohol intervention strategies for college students. Despite the central theoretical role of motivation for change in BMIs, it is unclear whether BMIs increase motivation to change drinking behavior. We conducted a two-step meta-analysis of individual participant data (IPD) to examine whether BMIs increase motivation for change. N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually delivered motivational interviewing with personalized feedback (MI + PF), stand-alone personalized feedback (PF), and group-based motivational interviewing (GMI).

METHODS

We included 15 trials of BMI (N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually-delivered motivational interviewing with personalized feedback (MI + PF), stand-alone personalized feedback (PF), and group-based motivational interviewing (GMI). Different measures and responses used in the original trials were harmonized. Effect size estimates were derived from a model that adjusted for baseline motivation and demographic variables for each trial (step 1) and subsequently combined in a random-effects meta-analysis (step 2).

RESULTS

The overall intervention effect of BMIs on motivation for change was not statistically significant (standard mean difference [SMD]: 0.026, 95% CI: [-0.001, 0.053], p = 0.06, k = 19 comparisons). Of the three subtypes of BMIs, GMI, which tended to provide motivation-targeted content, had a statistically significant intervention effect on motivation, compared with controls (SMD: 0.055, 95% CI: [0.007, 0.103], p = 0.025, k = 5). By contrast, there was no evidence that MI + PF (SMD = 0.04, 95% CI: [-0.02, 0.10], k = 6, p = 0.20) nor PF increased motivation (SMD = 0.005, 95% CI: [-0.028, 0.039], k = 8, p = 0.75), compared with controls. Post hoc meta-regression analysis suggested that motivation sharply decreased each month within the first 3 months postintervention (b = -0.050, z = -2.80, p = 0.005 for k = 14).

CONCLUSIONS

Although BMIs provide motivational content and normative feedback and are assumed to motivate behavior change, the results do not wholly support the hypothesis that BMIs improve motivation for change. Changing motivation is difficult to assess during and following interventions, but it is still a theoretically important clinical endpoint. Further, the evidence cautiously suggests that changing motivation may be achievable, especially if motivation-targeted content components are provided.

Epidemiological Correlates of Substance Abuse Among In-Facility Clients of De-addiction and Rehabilitation Centres of District Dehradun: A Cross-Sectional Study

Background The increasing production, distribution, promotion, and availability of substances contemporaneous with the changing values of society have resulted in rising substance abuse as an emerging public health concern in India. A prevalence of 32-37% has been reported for substance abuse in various studies conducted in Uttarakhand but there is a dearth of data on socio-epidemiological factors affecting substance abuse. Materials & methods A facility-based observational cross-sectional study was conducted in selected de-addiction and rehabilitation centers of district Dehradun. Data were collected using multistage systematic random sampling from clients admitted to the facility. Results The mean age of in-facility participants was 28 ± 8 years and most of them started taking drugs after the age of 18 years. The most common substance of abuse was alcohol (61.7%) followed by tobacco smoking (15.6%). Both 'peer pressure' and 'curiosity' play a major role in predisposition to substance use. Further, we found that age (p=0.002), and level of education (p <0.001) were important determinants for substance abuse. At the same time, among other factors, the influence of occupation notably did not have a statistically significant association. Conclusion Sensitization and capacity building of both providers and the community is integral to effective strategizing for the prevention and control of substance abuse. Regional studies including the current study can be of help in framing drug policies and management guidelines including prioritizing the importance of the establishment of de-addiction and rehabilitation centers at the district level.

Substance-Specific Risk Factors for Cannabis and Alcohol Use Among Young Adults Following Implementation of Nonmedical Cannabis Legalization

Laws regarding cannabis are rapidly changing in the USA as more states legalize nonmedical cannabis for adults aged 21 and older. Previous research has examined whether legalization has led to an increase in cannabis use as well as the use of other substances. The current study examined changes in cannabis- and alcohol-specific risk factors following legalization of nonmedical cannabis. We used 6 years of annual cross-sectional data (2014-2019) from 12,951 young adults age 18 to 25 who resided in Washington state. Risk factors examined include perceiving that use was common among same-age peers, believing use was acceptable, having easy access, and low perceived physical and psychological harm from use. Logistic regression models estimated annual rate of increase in these risk factors. All cannabis-specific risk factors increased among those aged 21+ (range of ORs for annual rate of change: 1.07-1.31) while significant increase in cannabis-related risk factors among those under age 21 was limited to perceptions of cannabis use being common (medical use: OR=1.08, 95% CI: 1.03, 1.12; nonmedical use: OR=1.13, 95% CI: 1.08, 1.18) and low perceived physical harm of occasional use (OR=1.08, 95% CI: 1.03, 1.13). Although descriptive norms for past-year use of alcohol among those aged 21+ increased (OR = 1.09, 95% CI: 1.02, 1.17), other risk factors for alcohol did not change significantly or, in the case of low perceived physical and psychological harm, decreased among both those under age 21 and those aged 21+ (range of ORs = 0.90-0.94). Given these findings show an increase in cannabis-specific risk factors since legalization was implemented, particularly among those young adults aged 21+, preventive interventions correcting risk misperceptions and related risk factors among young adults aged 21+ may prove efficacious in reducing use and resultant negative consequences.

A cross-national study on adolescent substance use: Intentions, peer substance use, and parent-adolescent communication

This longitudinal two-wave cross-national study investigated whether intentions, friends' substance use, and parent-adolescent substance-use specific communication predict adolescent alcohol and cannabis use 1 year later, while estimating reversed links. The temporal order between these two substances was also examined. We used multi-group cross-lagged panel modeling on data from 2 ethnically and socioeconomically diverse samples: Sint Maarten (N = 350; M_age  = 14.19) and the Netherlands (N = 602; M_age  = 13.50). Results showed that in the Netherlands, cannabis use predicts more subsequent problems (alcohol use, intention to use cannabis, and affiliation with cannabis-using friends). But for Sint Maarten, alcohol use predicts more subsequent problems (cannabis use, intention to use alcohol, and affiliation with alcohol-using friends). These opposing results demonstrate that caution is warranted when generalizing results across countries.

A bibliometric analysis of emerging adulthood in the context of higher education institutions: A psychological perspectives

In recent years, there has been a rise in studies aimed at better understanding the needs and traits of emerging adults and the role that higher education institutions play in their development and success. Despite the relevance of higher education institutions to the emerging adulthood development, there has been scant work done to synthesise the literature on this topic. A bibliometric method was utilised to retrieve 2484 journal articles from Web of Science (WoS). Utilizing co-citation analysis and co-word analysis, we determined the most influential publications, mapped the knowledge structure, and predicted future trends. The results of the co-citation analysis indicate five clusters, while the co-word analysis indicates four. The results could be used as a roadmap for the future of research on emerging adults by a variety of interested parties, including policymakers, university administrators, funders, and academics.

Social incentives are stronger predictors of drinking decisions than alcohol incentives in young adults: The role of alcohol use disorder

This study investigated the influence of social incentives, alcohol incentives, and responsibility disincentives on decisions to attend and drink at party events in young adult college students (n = 82; 55 women, 27 men) where 36 (20 women; 16 men) had an Alcohol Use Disorder (AUD) and 46 (35 women; 11 men) were control participants without an AUD. In this within-subjects design, participants were presented with a series of hypothetical drinking event scenarios that varied in terms of social incentives (knowing many vs. few people), alcohol incentives (more vs. less alcohol available), and next-day responsibility disincentives (high vs. moderate vs. low). Participants were asked whether they would attend the event and how many drinks they would consume. Social incentives significantly predicted both decisions to attend party events and decisions about how much to drink for all participants. Participants were more likely to decide to attend and drink more at high social incentive party events (where they knew more people). However, while low social incentives generally discouraged attendance decisions, AUD participants were more likely than controls to decide to attend party events in low social incentive contexts. Alcohol incentives did not affect attendance decisions. However, alcohol incentives did increase drinking amount decisions for AUD participants. Finally, while disincentives decreased attendance and drinking amount decisions in general, AUD participants were less deterred by responsibility disincentives than controls. The results highlight the important influence of social rewards on drinking-related decisions and suggest individual differences in how incentives and disincentives affect drinking decisions in persons with an AUD.

University students' (binge) drinking during COVID-19 lockdowns: An investigation of depression, social context, resilience, and changes in alcohol use

RATIONALE

The first COVID-19 lockdown impacted the social life and behaviors of university students, such as alcohol use. While previous studies have reported changes in students' alcohol use during the lockdown, knowledge of risk groups like binge drinkers is limited.

OBJECTIVE

The purpose of this study is to investigate how the first lockdown impacted the alcohol use of university students who were regular binge drinkers before the lockdown.

METHODS

Cross-sectional data were used to explore self-reported changes in alcohol use and associated psychosocial effects in regular binge drinking versus regular drinking university students (N = 7355) during the first COVID-19 lockdown (Spring 2020) in the Netherlands.

RESULTS

University students generally drank less alcohol and reduced binge drinking behaviors during the lockdown. Being a binge drinker who increased/maintained alcohol use, or a regular drinker who increased, was associated with older age, fewer servings of alcohol per week before COVID-19, higher contact with friends, and not living with parents. Among regular binge drinkers, men increased their alcohol use during the lockdown significantly more than women. Among regular drinkers, those with high depressive symptoms and low resilience had increased alcohol use.

CONCLUSIONS

These findings give insight into significant changes in drinking behaviors among university students during the first COVID-19 lockdown. More importantly, it underscores the need to reckon vulnerable students considering drinking type and associated psychosocial variables for increasing or maintaining higher alcohol use during societal stress periods. In the present study, an unexpected at-risk group emerged among regular drinkers who increased alcohol use during the lockdown in association with their mental state (i.e., depression and resilience). As the COVID-19 pandemic, and the possibility of similar scenarios in the future, is still present in the current student life, specific preventive strategies and interventions should be targeted accordingly.

Individual Differences in Affect Dynamics and Alcohol-Related Outcomes

Background: To examine whether individual differences in intensive longitudinal data-derived affective dynamics (i.e. positive and negative affect variability and inertia and positive affect-negative affect bipolarity) - posited to be indicative of emotion dysregulation - are uniquely related to drinking level and affect-regulation drinking motives after controlling for mean levels of affective states. Method: We used a large sample of college student drinkers (N = 1640, 54% women) who reported on their affective states, drinking levels and drinking motives daily for 30 days using a web-based daily diary. We then calculated from the daily data positive and negative affect variability, inertia, affect bipolarity and mean levels of affect and used these as predictors of average drinking level and affect-regulation drinking motives (assessed using both retrospective and daily reporting methods). Results: Findings from dynamic structural equation models indicated that mean levels of affect were uniquely related to drinking motives, but not drinking level. Few dynamic affect predictors were uniquely related to outcomes in the predicted direction after controlling for mean affect levels. Conclusion: Our results add to the inconsistent literature regarding the associations between affective dynamics and alcohol-related outcomes, suggesting that any effects of these indicators, after controlling for mean affect levels, might be more complex than can be detected with simple linear models.

Development and validation of the alcohol-related content poster prototype scale: Exploring the impact of social media prototypes on college students' drinking

BACKGROUND

Drinking is a public health concern among college students. Viewing and posting alcohol-related content (ARC) on social media may influence students' favorable prototypes of people who post, thereby impacting their drinking. This study created a measure to explore students' ARC poster prototypes. We validated our measure by examining the prototypes as mediators of the associations between viewing and posting ARC and drinking behaviors.

METHODS

Students (N = 8065) were asked to complete measures related to viewing and posting ARC, drinking behaviors, and adjectives that described their perceptions of the prototypical college student who posts ARC on social media.

RESULTS

Exploratory and confirmatory factor analysis yielded three prototypical images of students who post ARC on social media: hedonistic, despondent, and sociable. There were significant pathways between viewing and posting ARC and drinking. The sociable prototype emerged as a significant mediator of the association between ARC viewing and posting and drinking.

CONCLUSIONS

Understanding the role of students' poster prototypes may be important for informing targeted interventions. Our results indicate that the underlying reason for increased drinking among students with greater ARC engagement is that they perceived other ARC viewers and posters as being more sociable. Future research may focus on modifying these perceptions.

The event-based influence of incentivizing and physical contexts on daily alcohol initiation and consumption

BACKGROUND

Young adults often decide to engage in heavy drinking. Learning more about the real-time factors that predict decisions to initiate a drinking episode and how much is consumed in any single drinking episode is necessary in developing our understanding of momentary alcohol use and discrete decisions surrounding alcohol use.

METHODS

The current study examined the association between contextual factors and decisions to initiate and consume alcohol in 104 young adult individuals over 2 weeks via mobile daily diary. Participants responded to daily notifications about decisions to drink or not and the contextual factors surrounding each event. The contextual factors included the situation (e.g., bar setting and pregaming) and incentives (e.g., alcohol, social, and mood enhancement).

RESULTS

Multilevel analyses revealed that incentives predicted both the initiation of drinking and the amount consumed. Event-based alcohol and mood incentives predicted the initiation of drinking, while alcohol, mood, and social/party incentives predicted how much was consumed at a specific event. However, context had a more complex association with drinking outcomes. Being in a bar, alone, or at a residence predicted decisions to initiate drinking, while being in a bar, pregaming situation, or other party situation with others who are drinking predicted how much a person drank.

CONCLUSIONS

The results highlight the importance of studying event-specific predictors of drinking decisions and the complex association between context/location and the type of drinking decision or outcome.

Investigation of the determinants of alcohol use among women in Oshikoto region, Namibia

Background

Alcohol abuse is one of the world's main public health issues. Alcohol use is growing among African women, and it has become an underlying factor in women's health risk profiles.

Objective

The purpose of this study is to investigate the factors that influence women's alcohol consumption in the Oshikoto Region.

Materials and Methods

The study used a quantitative research method with a cross-sectional, analytical design. Data were gathered using interview-led questionnaires from 121 women aged 18-49 years at two state hospitals in the Oshikoto region's two selected constituencies. The Statistical Package for the Social Sciences, version 26, was used to evaluate the data.

Results

The subjects' median age was 33 years old. The bulk of the participants, 84 (69.4%), resided in rural areas. 49 (40.5%) of the participants were unmarried, and the majority (62%) had children. According to the results, 64 (52.89%) of respondents use alcohol to cope with their problems on occasion. When they are anxious, approximately 56 (46.28%) of the respondents use alcohol to relax and ignore their problems. In the univariable log-binomial regression analysis, a family history of alcohol use (p-value 0.019), peer pressure (p-value 0.004), and spending the majority of time at Cuca shops (p-value 0.000) were all linked with an increased risk of harmful alcohol use.

Conclusion

Identifying the determinants of alcohol use may aid in the creation of recommendations for preventative measures and alcohol awareness programs.

Daily-level associations between alcohol use cognitions and normative perceptions among adolescents: An intensive longitudinal study

BACKGROUND

Adolescence is an important developmental period in which to understand the cognitive underpinnings of risky alcohol use. Normative perceptions, such as descriptive and injunctive norms, are one of the strongest and most consistent predictors in adolescent drinking research. Thus, it is essential to examine which drinking cognitions (e.g., attitudes, prototypes, perceived vulnerability) are associated with normative drinking perceptions using repeated daily-level data among adolescents. The present study assessed associations between drinking cognitions and normative perceptions using an intensive daily longitudinal design.

METHODS

Participants were ages 15-17 years (N = 306; 61.4% female; M_age (SD) = 16.0 (0.8)) who were part of a larger ecological momentary assessment study (EMA) on drinking cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week, up to 2x/day) that was repeated quarterly over the 12-month study. The present analyses used the afternoon assessment for all measures.

RESULTS

Our multilevel model results demonstrated that drinking attitudes, prototypes of a typical drinker, and perceived vulnerability were positively associated with both descriptive and injunctive drinking norms between individuals and within individuals across days.

CONCLUSIONS

Current findings have important clinical implications as they demonstrated how specific drinking cognitions were associated with variability in normative perceptions at the daily level. Findings support the delivery of intervention messaging to adolescents on days when drinking attitudes, prototypes of a typical drinker, and perceived vulnerability are elevated.

Food Insecurity and Substance Use Among Young Adult College Students in the United States

BACKGROUND

Food insecurity is prevalent among college students in the United States and has been associated with substance use. We sought to provide updated prevalence estimates and associations between food insecurity and a broad range of substances during the SARS-CoV-2 pandemic.

METHODS

Using cross-sectional data from the Health Minds Study (N = 94,722; September 2020-June 2021), we used multivariable logistic regression to examine associations between food insecurity and several substances, adjusting for age, gender, race/ethnicity, hours worked, and residence. We then added a block of adjustments consisting of mental health factors (depression, anxiety, loneliness, financial stress).

RESULTS

Food insecurity was associated with significantly greater odds of having used most individual substances, including greater odds of binge drinking (adjusted odds ratio [aOR], 1.21; 95% confidence interval [CI], 1.13-1.30), cigarette use (aOR, 1.91; 95% CI, 1.73-2.10), vaping (aOR, 1.74; 95% CI, 1.62-1.87), and a range of illicit or prescription drugs (using any illicit/prescription drug; aOR, 1.43; 95% CI, 1.32-1.55) These associations attenuated and many lost significance after adjusting for mental health factors.

CONCLUSIONS

This study found evidence to suggest that food insecurity is related to substance use in a large sample of young adult college students in the United States, calling for targeted interventions.

Alcohol norms and alcohol intake among high school students

AIMS

To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents.

METHODS

This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents.

RESULTS

The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents.

CONCLUSIONS

Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Taking alcohol from one's parents' home without permission as a risk factor for greater alcohol and marijuana use during the transition into college

While adolescents and underage emerging adults typically obtain alcohol from social sources (e.g., parents, friends, parties), taking alcohol from the home without permission is not well understood. The current study investigated plausible individual characteristics associated with taking alcohol from one's parents' home without permission and associations between taking alcohol and drinking, alcohol consequences, and marijuana use. Two cohorts of alcohol-experienced underage emerging adults (N = 562) completed a web-based survey pre-college matriculation. Participants reported sources of alcohol (friend, mother, father, party, took it from home); drinking; consequences; marijuana use (ever and past 30 days); age of alcohol initiation; symptoms of depression, anxiety, and stress; parental modeling of drinking; and demographic information. Results revealed that taking alcohol was significantly associated with several of the measures examined here (e.g., having obtained alcohol from friends, parents, and parties; earlier age of alcohol initiation; parental modeling of alcohol). Having taken alcohol from the home without permission and obtained it from friends were uniquely associated with increased odds of typical weekly drinking, consequences, and marijuana use in the past 30 days when controlling for all other variables assessed in this study (including drinking, in the consequences and marijuana models). Parent-based interventions targeting adolescents and emerging adults should inform parents of the risks associated with taking alcohol from the home and obtaining it from friends. Further, parents should also be informed that supplying their adolescent with alcohol or modeling drinking may increase the likelihood that they take alcohol from their home.

Understanding changes in eating behavior during the transition to university from a self-determination theory perspective: a systematic review

Objective: The objective of this systematic review was to understand how and why eating behavior changes during the transition to university, and interpret findings from a self-determination theory perspective (Ryan & Deci, 2000). Methods: We searched six databases and identified 51 articles with findings involving changes in eating behavior during the transition to university. Results: During this transition, students eat less food, less healthy, and less regularly. These changes are mostly among students who move into a university residence or off-campus housing, with few changes in eating behavior among students who continue living at home. Yet, incoming students with food skills and experience living independently seem less likely to experience these changes. Conclusions: The university context offers challenges to eating healthy. Students' satisfaction of psychological needs may explain observed changes in habits, self-regulation, and motivation.

Adolescent brain maturation and the neuropathological effects of binge drinking: A critical review

Adolescence is a transitional stage marked by continued brain development. This period is accompanied by physical and neurochemical modifications in the shape and function of the hippocampus, prefrontal cortex, and other limbic system structures. Brain maturation during adolescence, which is typically governed by intrinsic factors, can be dramatically altered by environmental influences such as drugs and alcohol. Unlike many other addictive substances, binge drinking is very common and normative among teenagers and young adults. This repeated pattern of excessive alcohol consumption in adolescents has been shown to cause behavioral changes and neurocognitive impairments that include increased anxiety, risky decision-making, and learning deficits, which could lead to the development of alcohol use disorder (AUD). This manuscript highlights factors that lead to adolescent binge drinking, discusses maturational changes that occur in an adolescent's brain, and then evaluates the effect of adolescent alcohol consumption on brain structure, function, and neurocognitive abilities in both human studies and animal models. The impact of gender/sex and COVID-19 are briefly discussed. Understanding the factors that promote the onset of adolescent binge drinking and its undesirable consequences could serve as a catalyst for developing therapeutic agents that would decrease or eradicate the damaging effects of alcohol on an adolescent brain.

Social Anxiety and Alcohol Use and Related Problems among Black Adults: Differential Roles of Motives by Sex

Background: Black individuals who consume alcohol are at risk of experiencing alcohol-related problems. Psycho-sociocultural models of substance use posit that these individuals may continue to drink despite alcohol-related problems to cope with psychological distress. Emerging data indicate that social anxiety is one type of distress that may play an important role in drinking behavior among Black adults. Objectives: Yet despite evidence that drinking to cope varies as a function of sex among predominantly White samples, this is the first known study to test whether socially anxious Black women are similarly at risk for coping motivated drinking and its negative sequelae. Participants were 257 (75% female) Black undergraduates endorsing current alcohol use. Results: Among women and men, social anxiety was significantly related to more alcoholrelated problems and coping-depression and conformity motives. Among women (but not men), social anxiety was also significantly related to more coping-anxiety and greater typical drinking. Serial mediation analyses among women indicated that social anxiety was indirectly related to more alcohol problems via the serial effect of each of the relevant drinking motives (copinganxiety, coping-depression, conformity) and drinking frequency. Among men, social anxiety was indirectly related to alcohol problems via coping-depression and conformity motives. Conclusions/Importance: Findings highlight the importance of considering sex in research on psychosocial vulnerability factors associated with alcohol-related problems among Black adults.

Closing the treatment gap for alcohol use disorders in low- and middle-income countries

The alcohol-attributable disease burden is greater in low- and middle-income countries (LMICs) as compared to high-income countries. Despite the effectiveness of interventions such as health promotion and education, brief interventions, psychological treatments, family-focused interventions, and biomedical treatments, access to evidence-based care for alcohol use disorders (AUDs) in LMICs is limited. This can be explained by poor access to general health and mental health care, limited availability of relevant clinical skills among health care providers, lack of political will and/or financial resources, historical stigma and discrimination against people with AUDs, and poor planning and implementation of policies. Access to care for AUDs in LMICs could be improved through evidence-based strategies such as designing innovative, local and culturally acceptable solutions, health system strengthening by adopting a collaborative stepped care approach, horizontal integration of care into existing models of care (e.g., HIV care), task sharing to optimise limited human resources, working with families of individuals with AUD, and leveraging technology-enabled interventions. Moving ahead, research, policy and practice in LMICs need to focus on evidence-based decision-making, responsiveness to context and culture, working collaboratively with a range of stakeholders to design and implement interventions, identifying upstream social determinants of AUDs, developing and evaluating policy interventions such as increased taxation on alcohol, and developing services for special populations (e.g., adolescents) with AUDs.

Student perceptions of the current drinking culture in three Australian residential colleges: Drinking motives, consequences and recommendations for harm minimisation strategies

INTRODUCTION

Systemic cultural factors related to excessive alcohol consumption have been identified in Australian university residential colleges. In this mixed methods study, we conducted focus groups with student leaders at three Australian residential colleges. We aimed to explore students' perceptions of alcohol use and related consequences in their current college environment and gather feedback from students on the utility of alcohol harm minimisation strategies in this context.

METHODS

In November 2020, 77 student leaders from three colleges participated in focus groups. Each focus group ran for 1.5-2 hours and included three sections: (i) quantitative survey; (ii) semi-structured group interview; and (iii) feedback on a potential alcohol harm minimisation workshop.

RESULTS

The survey revealed that 81% of participants reported drinking hazardously. Thematic analysis of the interview data indicated many students perceived college as a supportive environment regarding students' alcohol use choices (direct peer pressure to drink was uncommon). However, indirect social influence to drink appeared to maintain a 'culture of intoxication'. Specifically, social norms to attend college events (where drinking is implied) and modelling of excessive drinking were key indirect influences on heavy drinking norms. Students were aware and accepting of many alcohol harm minimisation strategies and interested in improving current strategies.

DISCUSSION AND CONCLUSIONS

Despite the supportive college environment described by students, regarding alcohol use choices, a 'culture of intoxication' driven by indirect social influences was evident. Student leaders' interest in increasing the availability of harm minimisation strategies highlights the potential utility of peer-led alcohol interventions in colleges.

The Relationship between Parental Monitoring, Peer Pressure, and Motivations for Responsible Drinking among Italian Adolescents: The Mediating Role of Positive Alcohol Expectancies

This study investigated the associations between parental monitoring, peer pressure, and motivations for responsible drinking, while also taking the mediating role of positive alcohol expectancies into account. The participants were 579 Italian adolescents, aged 14-20 years (M = 16.39 years, SD = 1.27; 55.3% females), involved in a cross-sectional survey. They were administered online self-report questionnaires. Structural equation modeling revealed both direct and indirect positive associations between study variables. Parental monitoring was positively associated, both directly and indirectly, with adolescents' motivations for responsible drinking through the mediation of positive alcohol expectancies; peer pressure was negatively and indirectly associated with adolescents' motivations for responsible drinking, via the mediating role of positive alcohol expectancies. Findings highlighted the importance of environmental factors with regard to motivations for responsible drinking, suggesting the opportunity to implement prevention programs to improve parental monitoring and increase adolescents' skills to manage peer pressure and to develop realistic expectancies about drinking.

Drinking to cope and coping strategies in Deaf/Hard of hearing college students

INTRODUCTION

Deaf and hard of hearing (DHH) students experience unique stressors as a minority linguistic and cultural group that may contribute to problematic substance and alcohol use behavior. Proper coping strategies may be one protective factor to avoid reliance on alcohol as a means to reduce stress.

METHODS

The current study compared the endorsement of coping strategies by DHH students and hearing individuals and their relationship to drinking to cope behavior. Data was collected among DHH (n = 126) and hearing students (n = 349) at a large university.

RESULTS

While these two groups did not differ in their levels of problematic drinking behavior, there were differences observed in drinking to cope motives as well as in the levels of coping styles used. DHH students were found to endorse greater levels of emotion-oriented and task-oriented coping than hearing students. Drinking to cope motivations were also higher for DHH students, particularly those who endorsed greater emotion focused coping.

CONCLUSIONS

Interventions and educational efforts involving coping skills is a potentially important area of focus for the DHH student population. Further implications for understanding drinking behavior in this population are discussed.

Maturing Out: Between- and Within-Persons Changes in Social-Network Drinking, Drinking Identity, and Hazardous Drinking Following College Graduation

Many college students reduce hazardous drinking (HD) following graduation without treatment. Identifying cognitive mechanisms facilitating this "natural" reduction in HD during this transition is crucial. We evaluated drinking identity as a potential mechanism and tested whether within-person changes in one's social network's drinking were linked to within-person changes in drinking identity and subsequent within-person changes in HD. A sample of 422 undergraduates reporting HD was followed from six months before until two years after graduation. Their drinking, drinking identity, and social networks were assessed online. Within-person changes in drinking identity did not mediate the relationship between within-person changes in social network drinking and personal HD, though significant positive between-person associations among all constructs were found. Instead, there was some evidence that within-person changes in drinking identity followed changes in HD, suggesting that drinking identity may function as a marker versus mechanism of "natural" HD reduction during transition out of college.

Anxiety in the Classroom: Only Girls' Anxiety Is Related to Same-Sex Peers' Anxiety

Many teens report experiencing anxiety in school, which can negatively impact their well-being. Considering that adolescents tend to adopt the same behaviors as their classmates with whom they spend, on average, 923 h every year, the current exploratory study (1) assessed whether an association exists between a student’s state anxiety score and his/her classmates’ average trait anxiety scores and (2) examined whether this association differed between boys and girls, as well as between elementary school and high school students. During two consecutive school years, 1044 Canadian students (59% girls) from six elementary schools (aged 10−12) and seven high schools (aged 15−17) completed the State-Trait Anxiety Inventory for Children. Multilevel analyses revealed a same-sex peer effect of classmates’ anxiety in girls only (β = 0.40, p < 0.001). This effect was similar for elementary and high school girls (β = 0.07, p = 0.27). Interestingly, no association was found for boys, same-sex peers (β = 0.11, p = 0.25), or opposite-sex peers (β = −0.01, p = 1.00). Our results suggest that factors related to sex may reinforce anxiety in school settings. Future studies should confirm these results and explore the mechanisms involved in this sex-specific difference.

A Longitudinal Examination of Young People's Gambling Behaviours and Participation in Team Sports

This paper develops and expands upon social identity theory as an explanation for gambling among youth engaged in team sport. Analysing longitudinal data for over 4500 20-year-olds from the Growing Up in Ireland study, reveals that online gambling increased from 2.6 to 9.3% between 17 and 20 years in the cohort, with the increase driven by males. A statistically significant positive association is uncovered between playing team sports and regularly gambling, as well as online gambling behaviour, independent of socio-demographic and other risk factors for males but not for females. The findings provide support for a dose-response like effect for males, where a longer period of participation in team sports is associated with a higher likelihood of engaging in gambling behaviour compared to shorter periods. Implications of the findings for policy and practice are discussed.