Differential utility of three indexes of risky drinking for predicting alcohol problems in college students

Racial/ethnic discrimination, ADH1B*3, and coping-motivated drinking among Black college students

BACKGROUND AND OBJECTIVES

Discrimination due to race and/or ethnicity can be a pervasive stressor for Black college students in the United States beyond general negative life events and has demonstrated associations with adverse health and alcohol outcomes. Genetics may confer individual differences in the risk of drinking to cope with discrimination-related stress. This study tested whether associations of racial/ethnic discrimination with coping drinking motives and alcohol use differ as a function of a well-documented variant in the alcohol dehydrogenase 1B gene (ADH1B*3).

METHODS

Cross-sectional data were obtained from 241 Black students (Mage  = 20.04 [range = 18-53]; 66% female) attending a predominantly White university in the northeastern United States. Participants provided a saliva sample for genotyping and self-reported on their racial/ethnic discrimination experiences, coping drinking motives, and past-month total alcohol quantity.

RESULTS

Path models demonstrated that associations of discrimination with alcohol quantity directly or indirectly through coping drinking motives did not differ as a function of ADH1B*3, after controlling for gender, age, negative life events, and potential confounding interactions of covariates with model predictors. Regardless of ADH1B*3, greater experience of negative life events was associated with higher coping drinking motives, which in turn were associated with greater alcohol quantity. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Findings represent a novel investigation into gene-environment interplay in associations of alcohol use with racial/ethnic discrimination. Findings demonstrate coping-motivated drinking associated with negative life events within Black college drinkers regardless of ADH1B*3. Future research should leverage longitudinal designs to characterize associations of genetics, stressful experiences, and coping-motivated drinking over time.

Drinking patterns of college students with comorbid depression and anxiety symptoms: The moderating role of gender

Students with anxiety or mood issues tend to engage in more problematic drinking, but less is known about those students with co-occurring anxiety and mood symptoms. This study compares rates of weekly alcohol use, hazardous drinking, and alcohol-related negative consequences in a sample of 699 college students with symptoms of comorbid anxiety and depression (35% of the sample) compared to their non-symptomatic drinking peers, as well as the moderating role of gender. We found main effects of gender and comorbidity status such that participants with comorbid symptoms of anxiety and depression or who were male reported higher rates of weekly alcohol use, more hazardous drinking and more alcohol-related negative consequences than their non-symptomatic and female peers. We also found an interaction effect on alcohol-related negative consequences such that male participants with comorbid anxiety and depression reported more alcohol-related negative consequences than all other groups. These findings imply that while any student drinker with both anxiety and depression may be considered at higher risk for problematic drinking behavior, the risk of negative consequences in particular may be highest in the men of that group.

Enhanced Brief Motivational Intervention for College Student Drinkers With ADHD: Goal-Directed Activation as a Mechanism of Change

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.

Alcohol-specific social comparison as a moderator of the norms-behavior association for young adult alcohol use

Research has indicated that individuals high in social comparison orientation (SCO) are more influenced by the behavior and perceived norms of others. However, despite research indicating that behavior is more closely influenced by and modeled on more socially proximal reference groups, most social comparison research to date has utilized global measures of social comparison. As such, research has not examined whether domain-specific (i.e. alcohol-specific social comparisons) and their relation with norms are more predictive of alcohol-related outcomes than global comparisons. As such, the present study aimed to determine whether the previously found relationships between global SCO, descriptive drinking norms and their interaction are still significant when accounting for alcohol-specific SCO and its interaction with descriptive norms in the prediction of drinking willingness and behavior. Results from 355 young adults age 18-20 indicated that the association of alcohol-specific SCO and its interaction with descriptive norms for drinking predicts alcohol-related outcomes (drinking willingness and alcohol consumption), but not alcohol-related negative consequences above and beyond global SCO. Thus, alcohol-specific SCO may be of particular importance when determining for whom normative based preventive interventions may be the most efficacious.

Alcohol family history moderates the association between evening substance-free reinforcement and alcohol problems

Behavioral economic theories of substance abuse posit that deficits in substance-free reward increase risk for substance misuse, but little research has examined potential moderators of this relationship, including dispositional risk factors. Here, we tested the hypothesis that young adult heavy drinkers with family histories of alcohol misuse would show a stronger association specifically between low evening substance-free reinforcement and alcohol problems compared to those without a family history of alcohol misuse. Participants were 317 college students reporting heavy episodic drinking (Mage = 18.8, SD = 1.1, 61% female, 79% White) who completed a questionnaire about engagement and enjoyment in rewarding activities not involving substance use after 7 p.m., along with measures of personal and parental alcohol use/problems. Evening substance-free reinforcement was negatively associated with typical drinking level for women, but not for men. Family history status did not show a significant association with typical alcohol consumption or evening substance-free reinforcement (operationalized as activity participation × enjoyment), but did show a significant association with alcohol problems. Evening substance-free reinforcement was significantly negatively related to alcohol problems for both men and women. However, the presence of a family history of alcohol misuse moderated this relationship, such that only individuals with familial risk for alcohol misuse who reported lower evening substance-free reinforcement evidenced greater alcohol-related problems. These findings suggest that lower evening substance-free reinforcement is associated with alcohol misuse among young adults, and that this association is exacerbated among individuals with familial risk for developing alcohol problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Association between Distress Tolerance and Alcohol Related Problems: The Pathway of Drinking to Cope

Binge drinking (BD) and alcohol related problems (ARP) are highly prevalent among college students. However, current models examining ARP suggest drinking quantity only accounts for a portion of the variance, suggesting other variables contribute to ARP. Distress tolerance (DT), or the ability to withstand negative affect, is associated with alcohol misuse and may be an important mechanism related to ARP. However, studies have reported inconsistent findings on this association, which may be due to the use of only global scores to measure DT rather than specific DT components. Furthermore, the mechanisms underlying this association remain unknown. Drinking to cope with negative affect has been associated with both DT and ARP, suggesting it may be a mechanism explaining the relationship between DT and ARP. The current study examined the association between specific proposed DT components (i.e., tolerance, absorption, appraisal, and regulation) and drinking to cope and ARP in 147 college students who BD. A hierarchical linear regression was performed in order to examine which DT component best predicted ARP. Four follow-up mediation models were then tested to examine whether drinking to cope mediated the relationship between each DT component and ARP. Appraisal of DT was the only DT component that significantly predicted ARP, in the model controlling for drinking quantity and sex differences. Drinking to cope mediated the relationship between ARP and tolerance, absorption, and regulation, but not appraisal of DT. Implications for furthering our understanding of DT and treatment of BD as it relates to DT are explored.

Psychometric assessment of the marijuana adolescent problem inventory

Cannabis is one of the most commonly used psychoactive substances among adolescents in the United States. Adolescent cannabis use has multiple consequences including academic, health, and psychiatric problems. The Marijuana Adolescent Problem Inventory (MAPI) is a 23-item scale adapted from the Rutgers Alcohol Problem Index and used in the current literature to assess cannabis use problem severity. Psychometric testing for the MAPI has yet to be reported. The current investigation assessed the psychometric characteristics of the MAPI with cannabis-using adolescents (n=727) from school and outpatient settings who enrolled in five separate randomized clinical trials focused on treatment of substance use. Findings suggested that the MAPI is internally consistent and reliable. Factor structure analyses suggested that the MAPI measures one latent construct, with no differences in factor structure between the outpatient and school settings, supporting a one-factor model. External validity of the MAPI was also demonstrated as evidenced by significant relations with concurrent diagnosis of cannabis dependence and abuse, longitudinal frequency of cannabis use, and mean times used per day. Overall, this initial test of the psychometric characteristics of the MAPI suggests that it can be considered a reliable and valid measure of problems associated with cannabis use among adolescents. Future work is now needed to replicate these findings by testing the psychometric properties of the MAPI in more diverse samples and developing a short version to be used as a brief assessment tool.

Gender Differences in the Relationships Among Major Depressive Disorder, Heavy Alcohol Use, and Mental Health Treatment Engagement Among College Students

OBJECTIVE

Although major depressive disorder (MDD) and heavy episodic drinking (HED, 4+/5+ drinks in a single sitting for women/men) are common among young adults in college, the relationship between the two remains unclear. This study examined the association between MDD and HED in this population, the effect of gender on this association, and whether comorbid MDD and heavy alcohol use are associated with higher rates of mental health treatment engagement.

METHOD

The study comprised 61,561 (65.3% female) undergraduate students who answered an online survey on depression, alcohol use, and treatment engagement in the past year. Hierarchical linear regressions examined the association between MDD and alcohol use (HED and peak blood alcohol concentration [pBAC]) and whether gender moderated these associations. Logistic regressions were then conducted to examine the influence of MDD, heavy alcohol use, and gender on treatment engagement.

RESULTS

Students with MDD reported more frequent HED and higher pBAC than did students without MDD; this was especially true for female students. Rates of treatment engagement were higher among women than men, among students with MDD than students without MDD, and among female students with HED than women without HED.

CONCLUSIONS

The presence of an association between MDD and heavy alcohol use suggests the need for systematic screenings of both conditions. Low rates of treatment engagement in college students with MDD and heavy alcohol use calls for the development of strategies to engage this high-risk group in treatment.

Compounding risk: An examination of associations between spirituality/religiosity, drinking motives, and alcohol-related ambivalence among heavy drinking young adults

OBJECTIVES

The present study assessed combinations of spirituality/religiosity (S/R), a known protective factor against heavy drinking, with drinking motives, and alcohol-related ambivalence to better understand how these factors interrelate and are associated with drinking and alcohol-related problems.

METHODS

Participants were 241 heavy drinking undergraduate students (81.74% female; Mage=23.48years; SD=5.50) who completed study questionnaires online.

RESULTS

Coping, enhancement, and conformity drinking motives were associated with greater alcohol use and problems, however there were no main effects of either ambivalence or S/R on alcohol outcomes. S/R interacted with ambivalence with respect to drinking and problems. S/R also interacted with conformity drinking motives with respect to drinking and problems. Further, ambivalence interacted with conformity drinking motives regarding problems. Three-way interactions emerged between ambivalence, S/R, and drinking motives (social, coping, and enhancement motives) regarding drinking and problems. Results show that individuals at highest risk for problematic drinking are those who more strongly endorse drinking motives, are low in S/R, and high in ambivalence.

CONCLUSIONS

Findings supported hypotheses and provide support for clusters of individual difference factors that put heavy drinking college students at higher risk for problematic drinking. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduate students.

Different pathways explain alcohol-related problems in female and male college students

OBJECTIVES

Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways.

METHODS

College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs.

RESULTS

Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males.

CONCLUSIONS

Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.

Questioning the validity of the 4+/5+ binge or heavy drinking criterion in college and clinical populations

BACKGROUND AND AIMS

The terms 'binge drinking' and 'heavy drinking' are both operationalized typically as 4+/5+ standard drinks per occasion for women/men, and are used commonly as a proxy for non-problematic (<4/<5) versus problematic (4+/5+) drinking in multiple research contexts. The Food and Drug Administration in the United States recently proposed the 4+/5+ criterion as a primary efficacy end-point in their guidance for trials examining new medications for alcohol use disorders (AUDs). Internationally, similar cut-offs have been proposed, with the European Medicines Agency having identified reductions in the number of heavy drinking days (defined as 40/60 g pure alcohol in women/men) as a primary end-point for efficacy trials with a harm reduction goal.

ANALYSIS AND EVIDENCE

We question the validity of the 4+/5+ cut-off (and other similar cut-offs) on multiple accounts. The 4+/5+ cut-off has not been shown to have unique predictive validity or clinical utility. The cut-off has been created based on retrospective self-reports and its use demonstrates ecological bias. Given strong evidence that the relationship between alcohol consumption and problems related to drinking is at least monotonic, if not linear, there is little existing evidence to support the 4+/5+ cut-off as a valid marker of problematic alcohol use.

CONCLUSIONS

There is little empirical evidence for the 4+/5+ standard drinks per occasion threshold for 'binge' or 'heavy' drinking in indexing treatment efficacy. Further consideration of an appropriate threshold seems to be warranted.

Injunctive Norms and Alcohol Consumption: A Revised Conceptualization

BACKGROUND

Injunctive norms have been found to be important predictors of behaviors in many disciplines with the exception of alcohol research. This exception is likely due to a misconceptualization of injunctive norms for alcohol consumption. To address this, we outline and test a new conceptualization of injunctive norms and personal approval for alcohol consumption. Traditionally, injunctive norms have been assessed using Likert scale ratings of approval perceptions, whereas descriptive norms and individual behaviors are typically measured with behavioral estimates (i.e., number of drinks consumed per week, frequency of drinking). This makes comparisons between these constructs difficult because they are not similar conceptualizations of drinking behaviors. The present research evaluated a new representation of injunctive norms with anchors comparable to descriptive norms measures.

METHODS

A study and a replication were conducted including 2,559 and 1,189 undergraduate students from 3 different universities. Participants reported on their alcohol-related consumption behaviors, personal approval of drinking, and descriptive and injunctive norms. Personal approval and injunctive norms were measured using both traditional measures and a new drink-based measure.

RESULTS

Results from both studies indicated that drink-based injunctive norms were uniquely and positively associated with drinking, whereas traditionally assessed injunctive norms were negatively associated with drinking. Analyses also revealed significant unique associations between drink-based injunctive norms and personal approval when controlling for descriptive norms.

CONCLUSIONS

These findings provide support for a modified conceptualization of personal approval and injunctive norms related to alcohol consumption and, importantly, offer an explanation and practical solution for the small and inconsistent findings related to injunctive norms and drinking in past studies.

A multisite randomized trial of normative feedback for heavy drinking: Social comparison versus social comparison plus correction of normative misperceptions

OBJECTIVE

Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting one's own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; one's own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students.

METHOD

Participants included 623 heavy-drinking students from 3 universities. Assessments occurred at baseline and 3- and 6-months postbaseline.

RESULTS

Primary analyses examined differences across 4 drinking outcomes (drinks per week, total drinks past month, frequency of past month drinking, and negative alcohol-related consequences) at 3- and 6-month follow-ups controlling for the baseline variable. Results revealed significant reductions across all alcohol consumption outcomes at 3 months in both intervention conditions compared to attention-control. Mediation analyses demonstrated significant indirect effects of the intervention on 6-month drinking through changes in perceived norms at 3 months. Moreover, evidence emerged for changes in drinking at 3 months as a mediator of the association between PSCF and 6-month perceived norms.

CONCLUSIONS

The present research suggests PNF may not require explicit consideration of one's perceived norms to be effective and that direct social comparison provides an alternative theoretical mechanism for PNF efficacy.

An experimental test of assessment reactivity within a web-based brief alcohol intervention study for college students

OBJECTIVE

Web-based brief alcohol intervention (WBI) programs have efficacy in a wide range of college students and have been widely disseminated to universities to address heavy alcohol use. In the majority of efficacy studies, web-based research assessments were conducted before the intervention. Web-based research assessments may elicit reactivity, which could inflate estimates of WBI efficacy. The current study tested whether web-based research assessments conducted in combination with a WBI had additive effects on alcohol use outcomes, compared to a WBI only.

METHODS

Undergraduate students (n=856) from universities in the United States and Canada participated in this online study. Eligible individuals were randomized to complete 1) research assessments+WBI or 2) WBI-only. Alcohol consumption, alcohol-related problems, and protective behaviors were assessed at one-month follow up.

RESULTS

Multiple regression using 20 multiply imputed datasets indicated that there were no significant differences at follow up in alcohol use, alcohol-related problems, or protective behaviors used when controlling for variables with theoretical and statistical relevance. A repeated measures analysis of covariance revealed a significant decrease in peak estimated blood alcohol concentration in both groups, but no differential effects by randomized group. There were no significant moderating effects from gender, hazardous alcohol use, or motivation to change drinking.

CONCLUSIONS

Web-based research assessments combined with a web-based alcohol intervention did not inflate estimates of intervention efficacy when measured within-subjects. Our findings suggest universities may be observing intervention effects similar to those cited in efficacy studies, although effectiveness trials are needed.

Prevent the blue, be true to you: Authenticity buffers the negative impact of loneliness on alcohol-related problems, physical symptoms, and depressive and anxiety symptoms

This study investigated authenticity as a moderator of the association between loneliness and depressive symptoms, anxiety, physical symptoms, and alcohol-related problems. It was expected that loneliness and health outcomes would be negatively related and that relationship would be weaker among those higher in authenticity. Significant interactions emerged between authenticity and loneliness for each outcome such that authenticity mitigated the relationship between higher loneliness and negative health outcomes. Results suggest that authenticity may be an underutilized resource for lonely individuals and warrants future investigation. The potential implications are diverse and could be incorporated in college adjustment and health promotion programs.

Emotional Distress, Alcohol Use, and Bidirectional Partner Violence Among Lesbian Women

This study examined the relationship between emotional distress (defined as depression, brooding, and negative affect), alcohol outcomes, and bidirectional intimate partner violence among lesbian women. Results lend support to the self-medication hypothesis, which predicts that lesbian women who experience more emotional distress are more likely to drink to cope, and in turn report more alcohol use, problem drinking, and alcohol-related problems. These alcohol outcomes were, in turn, associated with bidirectional partner violence (BPV). These results offer preliminary evidence that, similar to findings for heterosexual women, emotional distress, alcohol use, and particularly, alcohol-related problems are risk factors for BPV among lesbian women.

Alcohol evaluations and acceptability: examining descriptive and injunctive norms among heavy drinkers

OBJECTIVES

This study assessed descriptive and injunctive norms, evaluations of alcohol consequences, and acceptability of drinking.

METHODS

Participants were 248 heavy-drinking undergraduates (81.05% female; Mage=23.45).

RESULTS

Stronger perceptions of descriptive and injunctive norms for drinking and more positive evaluations of alcohol consequences were positively associated with drinking and the number of drinks considered acceptable. Descriptive and injunctive norms interacted, indicating that injunctive norms were linked with number of acceptable drinks among those with higher descriptive norms. Descriptive norms and evaluations of consequences interacted, indicating that descriptive norms were positively linked with number of acceptable drinks among those with negative evaluations of consequences; however, among those with positive evaluations of consequences, descriptive norms were negatively associated with number of acceptable drinks. Injunctive norms and evaluations of consequences interacted, indicating that injunctive norms were positively associated with number of acceptable drinks, particularly among those with positive evaluations of consequences. A three-way interaction emerged between injunctive and descriptive norms and evaluations of consequences, suggesting that injunctive norms and the number of acceptable drinks were positively associated more strongly among those with negative versus positive evaluations of consequences. Those with higher acceptable drinks also had positive evaluations of consequences and were high in injunctive norms.

CONCLUSIONS

Findings supported hypotheses that norms and evaluations of alcohol consequences would interact with respect to drinking and acceptance of drinking. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduates.

Alcohol Use Disorders: Translational Utility of DSM-IV Liabilities to the DSM-5 System

OBJECTIVES

Young adults have some of the highest rates of problem drinking and alcohol use disorders (AUDs) relative to any other age. However, recent evidence suggests that the DSM-IV hierarchical classification system of AUDs does not validly represent symptoms in the population; instead, it evinces a unitary, dimensional classification scheme. The DSM-5 has been altered to fit this changing, evidence-based conceptualization. Nevertheless, little is understood about the degree to which known risk factors for DSM-IV AUD diagnoses will transfer to the new DSM-5 guidelines in this group of high-risk drinkers. The current study built a coherent model of liabilities for DSM-IV AUDs in young adults and tested for transferability to DSM-5.

METHODS

N = 496 college students (51.10% male) were assessed on a variety of factors related to AUD risk, including demographics, substance use (past 90-days), and drinking motives. Liability models were created using all variables in Structural Equation Modeling to test direct and indirect effects on DSM diagnostic status. The best model under the DSM-IV was chosen based on fit and parsimony. This model was then applied to the DSM-5 system to test for transferability.

RESULTS

The best the fitting model for DSM-IV included direct influences of drug use, quantity-frequency of alcohol consumption, and social and coping drinking motives. Improved model fit was found when the DSM-5 system was the outcome.

CONCLUSIONS

Knowledge of risk factors for AUDs appear to transfer well to the new diagnostic system.

Decisional Balance: Alcohol Decisional Balance Intervention for Heavy Drinking Undergraduates

BACKGROUND

This study evaluated a decisional balance intervention among heavy drinking undergraduates and compared a nonweighted decisional balance proportion (DBP; Collins, Carey, & Otto, 2009) to a participant-weighted DBP with weights based on relative importance of items. We expected: (1) the intervention to decrease drinking compared to control; (2) the weighted intervention to be more effective compared to the nonweighted or control in reducing drinking; and (3) intervention efficacy to be moderated by initial DBP.

METHOD

Participants (N = 162, Mean age = 24.37, SD = 6.81, 27% male) were randomly assigned to an alcohol intervention wherein they were either asked to assign weights of importance to pros and cons (weighted intervention), or not (nonweighted intervention), or to control. Participants completed web-based questionnaires at baseline and again during a one month follow-up assessment.

RESULTS

Consistent with expectations, the nonweighted intervention was associated with reduced follow-up weekly drinking, and the weighted intervention was associated with reductions in drinking frequency. Results further indicated that initial decisional balance did not moderate intervention efficacy.

DISCUSSION

Findings suggest that the decisional balance procedure can reduce drinking but there was not compelling evidence for the addition of weights. This study lays the groundwork for enhancing future interventions by increasing empirical knowledge of the role motivation plays in heavy alcohol use.

Examining the role of abstainer prototype favorability as a mediator of the abstainer-norms-drinking-behavior relationship

Past research has indicated that peer influence is associated with risky health behaviors, such as alcohol and other substance use (e.g., Maxwell, 2002; Santor, Messervey, & Kusumakar, 2000). Specifically, research has indicated that believing that more of one's peers use alcohol predicts more favorable prototypes (risk images) of the typical alcohol user (Litt & Stock, 2011; Teunissen et al., 2014). However, it is unclear if this same relationship would hold when considering abstainer (i.e., people who do not use alcohol) cognitions. The primary goal of the present study was to determine whether normative perceptions of peer abstinence from alcohol predict alcohol consumption and whether this relationship is mediated by abstainer prototypes. Results from 2,095 college students (42% male) indicated that the relation between abstainer norms and drinking behavior was mediated by abstainer prototypes such that believing that more peers abstained from alcohol use predicted more favorable prototypes of the typical alcohol abstainer, which in turn predicted lower alcohol use. Results from this study provide important first steps to delineating the relationship between abstainer cognitions and alcohol use. (PsycINFO Database Record

Drinking identity as a mediator of the relationship between drinking motives and weekly alcohol consumption among heavy drinking undergraduate students

OBJECTIVES

The present study assessed relationships among social, coping, enhancement, and conformity drinking motives and weekly alcohol consumption by considering drinking identity as a mediator of this relationship.

METHODS

Participants were 260 heavy drinking undergraduate students (81% female; Mage=23.45; SD=5.39) who completed a web-based survey.

RESULTS

Consistent with expectations, findings revealed significant direct effects of motives on drinking identity for all four models. Further, significant direct effects emerged for drinking identity on weekly drinking. Results partially supported predictions that motives would have direct effects on drinks per week; total effects of motives on drinking emerged for all models but direct effects of motives on weekly drinking emerged for only enhancement motives. There were significant indirect effects of motives on weekly drinking through drinking identity for all four models.

CONCLUSIONS

The findings supported the hypotheses that drinking identity would mediate the relationship between drinking motives and alcohol consumption. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduate students.

Tears in your beer: Gender differences in coping drinking motives, depressive symptoms and drinking

This study evaluates associations between coping drinking motives (CDM; drinking to regulate negative affect), depressive symptoms, and drinking behavior and extends the literature by also taking into account gender differences. Two hundred forty-three college students (Mean age = 22.93, SD = 6.29, 82% female) participated. Based on previous research, we expected that CDM would be positively associated with drinking and problems, particularly among those higher in depressive symptoms, as individuals experiencing higher levels of negative affect (i.e. depressive symptoms) and who drink to cope are likely to drink more and experience more alcohol-related problems. Lastly, based on established gender differences, we expected that CDM would be positively associated with drinking and problems, especially among females higher in depressive symptoms. Unexpectedly, findings suggested that CDMs were positively related to peak drinking, especially among those lower in depressive symptoms. Results further revealed a significant three-way interaction between CDM, depressive symptoms, and gender when predicting alcohol-related problems and drinking frequency. Specifically, we found that CDM were more strongly associated with problems among women who were lower in depressive symptoms; whereas CDM were more strongly associated with problems among men who were higher in depressive symptoms. These findings offer a more comprehensive depiction of the relationship between depressive symptoms, CDM, and drinking behavior by taking into account the importance of gender differences. These results provide additional support for considering gender when designing and implementing alcohol intervention strategies.

Proximal and distal social influence on alcohol consumption and marijuana use among middle school adolescents

OBJECTIVES

This study assesses the independent and combined effects of (1) perceived peer norms, (2) best friend use, and (3) being in the presence of others who use on middle school adolescents' consumption of marijuana and alcohol, and how the effects of these sources of social influence evolve over time as youth progress through middle school.

METHODS

The analytic sample consisted of 11,667 adolescents (50% female; >65% Hispanic) in 6th, 7th or 8th grade from 16 middle schools across three school districts in Southern California. Participants were assessed at 5 time points from 2008 to 2011.

RESULTS

All sources of social influence were predictive of alcohol and marijuana consumption. As youth grew older, spending time with other adolescents who drink increased adolescents' likelihood of drinking alcohol, whereas perceived norms became less influential. Furthermore, as adolescents spent more time around other youths who drink, the predictive value of perceived norms on alcohol consumption decreased. Similarly, as youth grew older, the influence of best friend's use and spending time with other adolescents who use marijuana remain stable, whereas perceived norms became less influential.

CONCLUSION

Findings suggest that perceived peer norms may be more influential in early adolescence; whereas proximal social determinants (e.g., being in the presence of other peers who consume) become more influential as youth enter middle adolescence. Prevention programs should continue to address misperception of norms with younger adolescents to decrease the chances of initiation, but also utilize strategies such as refusal skills and alternate coping mechanisms for older adolescents.

Interactions among drinking identity, gender and decisional balance in predicting alcohol use and problems among college students

BACKGROUND

The aim of the present study was to test promising constructs (decisional balance and drinking identity) and their interaction with gender as predictors of risky college drinking. We expected that, consistent with previous work, drinking identity would be positively associated with alcohol consumption and problems. We further expected that drinking identity would be more strongly related to outcomes among individuals scoring low in decisional balance. Additionally, we expect the relationship between drinking identity and alcohol behavior to vary as a function of decisional balance.

METHODS

Participants included 329 undergraduates (M=23.11; SD=5.63; 74.47% female) who met heavy drinking criteria (defined as women who consumed 4 or more drinks per occasion and men who consumed 5 or more drinks per occasion) and completed an online survey comprised of self-report measures.

RESULTS

Decisional balance was negatively correlated with both drinking and problems, which partially supported expectations. As expected, drinking identity was positively correlated with drinking and problems. A two-way interaction emerged between drinking identity and decisional balance regarding problems, indicating that drinking identity was associated with more problems, especially among those lower in decisional balance. A three-way interaction between drinking identity, decisional balance, and gender emerged regarding problems such that drinking identity was associated with more problems for those lower in decisional balance and this effect was stronger among men.

DISCUSSION

Findings lend support to the perspective that decisional balance, drinking identity, and gender are all influential factors that are associated with the experience of alcohol problems.

Spring break versus spring broken: predictive utility of spring break alcohol intentions and willingness at varying levels of extremity

Within the domain of risk-related behavior, many times the decision to engage is not a product of premeditation or intention. The prototype willingness model was created to capture and explain the unintended element of risk behavior. The present study aimed to evaluate the importance of willingness versus intention, two important constructs within the prototype willingness model, in relation to spring break drinking behavior when assessed at both high and low extremities. College undergraduates (N = 275) completed questionnaires prior to spring break regarding their anticipated spring break activities. Willingness and intention were assessed for different levels of risk. Specifically, participants indicated the extent to which they intended to (a) get drunk and (b) drink enough to black out or pass out; and the extent to which they were willing to (a) get drunk and (b) drink enough to black out or pass out. When classes resumed following spring break, the students indicated the extent to which they actually (a) got drunk and (b) drank enough to black out or pass out. Results demonstrated that when the health-related risk was lower (i.e., getting drunk), intention was a stronger predictor of behavior than was willingness. However, as the level of risk increased (i.e., getting drunk enough to black out or pass out), willingness more strongly predicted behavior. The present study suggests that willingness and intentions differentially predict spring break alcohol-related behavior depending on the extremity of behavior in question. Implications regarding alcohol interventions are discussed.

Self-control as a moderator of the relationship between drinking identity and alcohol use

This study evaluated self-control in the relationship between drinking identity and drinking. We expected those higher in drinking identity would drink more than those lower in drinking identity, particularly if low in self-control. Data were collected in 2012 via an online survey (N = 690 undergraduates, M age = 22.87, SD = 5.37, 82.50% female) at an urban university. An interaction emerged between self-control and drinking identity; self-control was negatively associated with drinking among individuals low in drinking identity, but positively associated with drinking among those high in drinking identity. Implications and future directions are discussed. This research was unfunded.

Association among different measures of alcohol use across adolescence and emerging adulthood

BACKGROUND AND AIMS

The use of alterative alcohol indices in developmental research may generate conflicting findings in the literature. This study examined the longitudinal associations among four indices of alcohol involvement from ages 15 to 25 years and examined their concurrent associations with alcohol-related problems in emerging adulthood.

DESIGN

Data are from the Victoria Healthy Youth Survey, a five-wave multi-cohort study conducted biennially in Victoria, Canada between 2003 and 2011.

SETTING AND PARTICIPANTS

This study included a subsample of 637 randomly recruited Canadian adolescents, aged 15-25 years.

MEASUREMENTS

Four indices of alcohol use were compared using multivariate piecewise growth modeling: frequency, usual quantity, heavy episodic drinking and volume.

FINDINGS

All indices increased on average from ages 15 to 21, peaked at approximately age 21, and gradually declined from ages 21 to 25. Levels of use at age 21 were highly correlated across indices (r = 0.63-0.94, P < 0.001), but correlations among rates of change varied between pairs of indices. Heavy episodic drinking and volume had the strongest correlations over time (r = 0.64-0.81, P < 0.001) and accounted for the greatest variance in alcohol use disorder symptoms (R(2)  = 0.35) and social and health consequences (R(2)  = 16) in emerging adulthood. Frequency and quantity had the weakest associations during adolescence (r = 0.49, P = 0.001) and were uncorrelated during emerging adulthood (r = 0.23, P = 0.09).

CONCLUSIONS

Among Canadian youth aged 15-25 years, measures of heavy episodic drinking and volume are the most strongly correlated over time and account for greater variance in alcohol-related problems in emerging adulthood than either frequency or quantity alone.

The influence of individualism and drinking identity on alcohol problems

This study evaluated the interactive association between individualism and drinking identity predicting alcohol use and problems. Seven hundred and ten undergraduates (Mean age =22.84, SD = 5.31, 83.1% female) completed study materials. We expected that drinking identity and individualism would positively correlate with drinking variables. We further expected that individualism would moderate the association between drinking identity and drinking such that the relationship between drinking identity and alcohol outcomes would be positively associated, particularly among those high in individualism. Our findings supported our hypotheses. These findings better explain the relationship between drinking identity, individualism, and alcohol use. Furthermore, this research encourages the consideration of individual factors and personality characteristics in order to develop culturally tailored materials to maximize intervention efficacy across cultures.

I think I can't: drink refusal self-efficacy as a mediator of the relationship between self-reported drinking identity and alcohol use

This study examined the relationship between self-reported drinking identity (SRDI), defined as how closely individuals believe drinking is a crucial aspect of their identity (Conner, Warren, Close, & Sparks, 1999), and alcohol use by considering drink-refusal self-efficacy (DRSE) as a potential mediator. Based on previous findings, we expected that SRDI would be negatively associated with DRSE and positively associated with drinking, and that DRSE would be negatively linked with drinking. Further, we expected that DRSE would mediate the association between SRDI and drinking. Participants included 1069 undergraduate students (M age=22.93years, SD=6.29, 76.25% female) from a large southern university who completed computer-based study materials. Gender was associated with SRDI, each of the DRSE subscales, and drinking, indicating that males report greater SRDI, lower DRSE, and increased alcohol consumption. Consistent with expectations, SRDI was negatively linked with DRSE and positively linked with drinking. DRSE subscales were negatively associated with drinking. Further, four measurement models for latent variables were tested for SRDI and each of the three DRSE subscales. Results showed that the emotional relief and social subscales of DRSE mediated the association between SRDI and drinking, however this mediating relationship did not emerge for the opportunistic subscale. Implications of these results are discussed.

Drink refusal self-efficacy and implicit drinking identity: an evaluation of moderators of the relationship between self-awareness and drinking behavior

This study evaluated the roles of drink refusal self-efficacy (DRSE), implicit drinking identity, and self-awareness in drinking. Self-awareness (assessed by public and private self-consciousness), DRSE, and implicit drinking identity (measured via an implicit association test; IAT) were expected to interact in predicting self-reported drinking. This research was designed to consider mixed findings related to self-awareness and drinking. Hypotheses were: 1) alcohol-related outcomes would be negatively associated with self-awareness; 2) implicit drinking identity would moderate the association between self-awareness and alcohol consumption; and 3) this association would depend on whether participants were higher or lower in drink refusal self-efficacy. Participants included 218 undergraduate students. Results revealed that drinking behavior was not associated with self-awareness but was positively associated with implicit drinking identity. Of the four drinking variables (peak drinking, drinking frequency, drinks per week, and alcohol-related problems), only alcohol-related problems were positively associated with self-awareness. Furthermore, a significant two-way interaction emerged between private (but not public) self-consciousness and drinking identity to predict drinking. Consistent with expectations, three-way interactions emerged between self-awareness, implicit drinking identity, and DRSE in predicting drinking. For participants low in DRSE: 1) high implicit drinking identity was associated with greater drinking frequency when private self-consciousness was low; and 2) high implicit drinking identity was associated with greater drinks per week and peak drinks when public self-consciousness was low. This suggests that alcohol-related IATs may be useful tools in predicting drinking, particularly among those low in self-awareness and DRSE.

Benefit finding as a moderator of the relationship between spirituality/religiosity and drinking

This study evaluated benefit finding as a moderator of the relationship between spiritual and religious attitudes and drinking. Previous research indicates that undergraduates who drink heavily experience negative alcohol-related consequences. Literature also suggests that spirituality and religiosity (S/R) are protective against heavy drinking (e.g., Yonker, Schnabelrauch, & DeHaan, 2012) and that finding meaning, which is conceptually related to benefit finding, is negatively associated with alcohol use (e.g., Wells, 2010). Seven hundred undergraduate students completed the study materials including measures of drinking, benefit finding, and S/R. Based on previous research, we expected that S/R and benefit finding would be negatively associated with drinking. Furthermore, we expected that benefit finding would moderate the association between S/R and drinking, such that S/R would be more negatively associated with drinking among those higher in benefit finding. Consistent with expectations, a negative association between S/R and drinking was present, and was stronger among those high in benefit finding. These findings extend previous research by demonstrating that the protective effect of S/R on drinking appears to be particularly true among those who find benefit following stressful experiences. This study extends previous research showing that S/R is negatively associated with drinking by evaluating benefit finding (measured via the Post-Traumatic Growth Inventory; Tedeschi & Calhoun, 1996) as a potential moderator of the relationship between S/R and drinking. This study contributes to the alcohol literature seeking to understand and identify individual factors in drinking and determine how S/R and benefit finding relate to drinking.

Pre-college matriculation risk profiles and alcohol consumption patterns during the first semesters of college

Excessive alcohol consumption represents a significant concern on U.S. college campuses, and there is a need to identify students who may be at risk for engaging in risky alcohol use. The current study examined how variables measured prior to college matriculation, specifically alcohol-related decision-making variables drawn from the Theory of Reasoned Action (i.e., alcohol expectancies, attitudes, and normative beliefs), were associated with patterns of alcohol use prior to and throughout the first semesters of college. Participants were 392 undergraduate students (56% female) from a large Northeastern U.S. university. Decision-making variables were assessed prior to college matriculation, and alcohol use was measured with five assessments before and throughout freshman and sophomore semesters. Latent profile analysis was used to identify types of students with distinct patterns of decision-making variables. These decision-making profiles were subsequently linked to distinct patterns of alcohol use using latent transition analysis. Four distinct decision-making profiles were found and were labeled "Anti-Drinking," "Unfavorable," "Mixed," and "Risky." Five drinking patterns were observed and included participants who reported consistently low, moderate, or high rates of alcohol use. Two patterns described low or non-drinking at the pre-college baseline with drinking escalation during the measurement period. Students' likelihood of following the various drinking patterns varied according to their decision-making. Findings suggest the early identification of at-risk students may be improved by assessing decision-making variables in addition to alcohol use. The findings also have implications for the design of early identification assessments to identify at-risk college students and for the targeting of alcohol prevention efforts to students based on their alcohol-related attitudes and beliefs.

Implicit drinking identity: Drinker+me associations predict college student drinking consistently

Predicting hazardous drinking in college students continues to be a serious priority. Emerging evidence suggests that implicit measures may offer additional insight in predicting unique variance in alcohol outcomes. Implicit drinking identity, in particular, may be a powerful predictor of alcohol use. The current study examined the predictive validity of three alcohol-related associations (e.g., drinking identity, alcohol approach, and alcohol cope) using adaptations of the Implicit Association Test (IAT) in a sample of 243 undergraduates. Confirming previous findings, drinking identity associations were the most consistent predictor of alcohol consumption and alcohol problems. They were the only associations that were unique predictors of alcohol use after controlling for other implicit associations. In comparison, alcohol cope and alcohol approach associations were weak but consistent predictors of alcohol consumption and alcohol problems. Although positively correlated with all drinking outcomes, neither set of associations predicted unique variance in the drinking outcomes when all implicit associations were included in the same model. Collectively, these results extend previous findings that implicit drinking identity may be a powerful tool for predicting alcohol outcomes and a potential target for clinical intervention and prevention efforts.

Are restrained eaters accurate monitors of their intoxication? Results from a field experiment

Brief interventions encourage college students to eat more before drinking to prevent harm (Dimeff et al., 1999), although many women decrease their caloric intake (Giles et al., 2009) and the number of eating episodes (Luce et al., 2012) prior to drinking alcohol. Participants were 37 undergraduate women (24.3% Caucasian) who were recruited from a local bar district in the Midwest. This study examined whether changes in eating after intending to drink interacted with dietary restraint to predict accuracy of one's intoxication. Results indicated that changes in eating significantly moderated the relationship between dietary restraint and accuracy of one's intoxication level. After eating more food before intending to drink, women higher in restraint were more likely to overestimate their intoxication than women lower in restraint. There were no differences between women with high levels and low levels of dietary restraint in the accuracy of their intoxication after eating less food before intending to drink. Future research would benefit from examining interoceptive awareness as a possible mechanism involved in this relationship.

Social comparison as a moderator of the association between perceived norms and alcohol use and negative consequences among college students

OBJECTIVE

The present study aimed to extend previous research examining the relationships among perceived drinking norms, alcohol use, and related negative consequences by examining the moderating influence of social comparison orientation.

METHOD

A sample of 481 college students (44% male) completed a Web-based survey that assessed perceptions of drinking behavior, social comparison orientation, and alcohol use.

RESULTS

The results suggested that social comparison orientation moderated the norm-behavior relationship such that the association between perceived drinking norms and alcohol-related negative consequences was stronger for those higher in social comparison. Results also showed that there was no moderation effect for alcohol consumption as the dependent variable.

CONCLUSIONS

The findings of the present study are potentially important when developing efficacious alcohol prevention and intervention programs at colleges and universities and in considering more complex models of social influences on drinking.

Social anxiety among young adult drinkers: the role of perceived norms and drinking motives

The aim of the study was to examine the separate and combined influence of perceived norms, negative reinforcement drinking motives, and social anxiety on alcohol outcomes. Participants (N = 250) completed measures of injunctive norms, social anxiety, drinking motives, alcohol use, and alcohol-related problems. Data collection occurred in 2010. When examined separately, motives emerged as a stronger predictor of alcohol outcomes over norms. When tested jointly, findings suggest that for drinkers higher in social anxiety, normative perceptions are relevant and to such a degree that norms actually supersede their motivation to drink to conform. Implications and limitations are discussed.

Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.

Alcohol use and negative consequences among active duty military personnel

AIMS

An examination of alcohol use patterns in the active duty military to determine the relations of drinking levels and self-reported negative outcomes.

DESIGN

A population-based cross-sectional study design using two-stage complex sampling methodology.

SETTING

Paper and pencil surveys were administered anonymously in groups at 64 U.S. military installations worldwide.

PARTICIPANTS

Randomly selected active duty members (28,546) at major military installations representing the total active force, with the exception of recruits, cadets, and incarcerated personnel.

MEASURES

Personnel were classified into five drinking levels ranging from abstainer to heavy drinker based on quantity and frequency of alcohol intake. Negative outcomes were measured as self-reported serious consequences of alcohol use and alcohol-related productivity loss. Risk for other alcohol related problems was assessed by the Alcohol Use Disorders Identification Test (AUDIT).

FINDINGS

Alcohol negative outcomes showed a curvilinear dose-response relationship with drinking levels. Higher levels of drinking were associated with higher rates of alcohol problems, but problem rates were notably higher for heavy drinkers. Heavy alcohol users showed nearly three times the rate of self-reported serious consequences and over twice the rate of self-reported productivity loss than moderate/heavy drinkers. Heavy drinkers also had the highest risk for alcohol problems on the AUDIT. One fifth of military personnel were heavy drinkers and were most likely aged 18 to 35.

CONCLUSIONS

Prevention and clinical interventions should include a major focus on heavy drinkers. Commanders and peers should be trained in recognizing signs of heavy alcohol use and in approaching heavy alcohol users in a way that will foster positive attitudes as opposed to defensiveness and stigma.

Handedness and drinking behaviour

OBJECTIVES

A number of papers have investigated whether there is an association between handedness and alcohol consumption hypothesizing that alcoholism may be a consequence of atypical cerebral lateralization or a response to the stress involved in being a minority in a right-handed world. Research to date has mostly used small clinical samples, some without a comparison group. This paper exams this issue using a large population-based random sample.

DESIGN

A large multi-country data set of nationally representative samples of the non-institutional population aged 50 years and older from 12 European countries was used (N= 27,428). methods: Logistic regression was used to model the frequency with which individuals self-report the frequency of alcohol consumption. A series of models with differing numbers of potential confounders are estimated. The predictors of frequent and infrequent drinking are investigated separately.

RESULTS

After controlling for a number of confounders it is shown that left-handers do drink more often. However, this is due to them being less likely to drink rarely (less than once a month) or not at all.

CONCLUSIONS

The evidence suggests that while there is an association between left-handedness and frequency of alcohol consumption there is no reason to believe that it is associated with excessive alcohol consumption or risky drinking.

Identifying factors that increase the likelihood for alcohol-induced blackouts in the prepartying context

The present study examined risk factors related to "blacking out" (e.g., temporary periods of memory loss during drinking) during preparty drinking events (i.e., pregaming, predrinking). Participants were students from two universities on the West Coast who reported past month prepartying (N = 2,546) in online surveys administered in the fall of 2008. Among these students, 25% (n = 636) reported blacking out during at least one occasion in which they prepartied in the past month. A logistic regression model underscored that Greek student affiliation, family history of alcohol abuse, frequency of prepartying, and both playing drinking games and consuming shots of liquor while prepartying increased the likelihood of blacking out. Limitations and implications for future research and collegiate prevention strategies are discussed.

Factors Associated With General and Sexual Alcohol-Related Consequences: An Examination of College Students Studying Abroad

This study contributes to the scarce research on U.S. college students studying abroad by documenting general and sexual negative alcohol-related risks and factors associated with such risk. The manner of drinking (quantity vs. frequency), predeparture expectations surrounding alcohol use while abroad, culture-related social anxiety, and perceived disparity between home and host cultures differentially predicted consequences abroad. The findings include important implications for student affairs professionals in developing study abroad-specific interventions and resources to maintain student well-being while abroad.

The intersection of violence, substance use, depression, and STDs: testing of a syndemic pattern among patients attending an urban STD clinic

OBJECTIVES

High rates of psychosocial and health problems have been identified among patients attending sexually transmitted disease (STD) clinics, who are disproportionately urban, have low income, and are racial/ethnic minorities. This study sought to determine whether these problems co-occurred and whether they indicated the presence of a syndemic.

METHODS

Patients (N = 1557, 46% female, 64% African American) attending an urban STD clinic completed a computerized survey assessing childhood sexual abuse (CSA), depressive symptoms, binge drinking, marijuana use, intimate partner violence (IPV), and sexual risk behavior. Medical records were reviewed to determine incident STD diagnosis.

RESULTS

The psychosocial and health problems were interrelated. Endorsing more psychosocial problems was associated with a greater likelihood of having multiple sexual partners and STD diagnosis. Interactions between CSA and marijuana use and between CSA and IPV predicted STD diagnosis.

CONCLUSIONS

Numerous psychosocial and health problems co-occur among urban STD clinic patients. There was some evidence of a syngergistic relationship (i.e., a syndemic) between these conditions, resulting in worsened sexual health outcomes. Health care needs to be multidisciplinary to address the multiple psychosocial and health problems faced by STD clinic patients. Research needs to identify factors that may underlie these comorbid conditions.

Examining the relationship between typical drinking behavior and 21st birthday drinking behavior among college students: implications for event-specific prevention

AIMS

The purpose of this research was to: (i) compare 21st birthday drinking with typical drinking; (ii) assess the prevalence of negative consequences and risk behaviors experienced during the 21st birthday week; and (iii) examine the role of typical drinking and 21st birthday drinking in explaining 21st birthday week negative consequences and risk behaviors.

SETTING AND PARTICIPANTS

Participants (n = 306; 50% male) included college students turning 21 at a Midwestern public university in the United States.

DESIGN AND MEASUREMENT

Approximately 1 week prior to their 21st birthday, students completed measures of typical past 3-month alcohol consumption via a web-based survey. Following their birthday, students (n = 296; 50% male) completed measures of 21st birthday week drinking as well as negative consequences and risk behaviors.

FINDINGS

Findings indicated that students consumed considerably larger amounts of alcohol during the week of their 21st birthdays in comparison to typical weekly consumption. Additionally, students experienced a variety of negative consequences and risk behaviors during the week of their 21st birthday, including hangovers, vomiting and not remembering part of the previous evening. Negative binomial regression results indicated that those most likely to experience more negative consequences and risk behaviors associated with 21st birthday drinking were those who consumed heavy amounts of alcohol the week of their birthday, but who did not typically drink excessively.

CONCLUSIONS

Findings underscore the need to develop event-specific prevention approaches for occasions associated with extreme drinking and provide direction for considering who may be at greatest risk for problems associated with celebratory drinking.

Projected alcohol dose influences on the activation of alcohol expectancies in college drinkers

BACKGROUND

Alcohol expectancies have been linked to drinking behavior in college students, and vary according to a number of factors, including projected dose of alcohol. Research using Multidimensional Scaling (MDS) suggests that drinking may be influenced by activation of differing expectancy dimensions in memory, yet studies have not examined expectancy activation according to projected alcohol doses.

METHODS

The present study used Individual Differences Scaling (INDSCAL) to map expectancy networks of college students (n = 334) who imagined varied drinking at high and low alcohol doses. Expectancy activation was modeled by dose, as well as by gender and by drinking patterns (typical quantity, blood alcohol content, heavy episodic drinking, and alcohol consequences). Expectancies were organized along positive-negative and arousal-sedation dimensions. Anticipation of a high dose of alcohol was associated with greater emphasis on the arousal-sedation dimension, whereas anticipation of a lower dose was associated with greater emphasis on the positive-negative dimension.

RESULTS

Across heavy, medium, and light drinkers, expectancy dimensions were most distinguishable at higher doses; activation patterns were more similar across drinking groups at lighter doses. Modest evidence for the influence of gender on activation patterns was observed. Findings were consistent across alcohol involvement indices.

CONCLUSIONS

These data suggest that both dimensionality and context should be considered in the refinement of interventions designed to alter expectancies in order to decrease hazardous drinking.

Heavy episodic drinking: determining the predictive utility of five or more drinks

Although the heavy episodic drinking (HED) measure of 5+ drinks (sometimes 4+ for women) is used extensively, there is no empirical basis for the designation of 5 drinks as the threshold (vs. another threshold that may perform equally). The present study sought to determine the threshold for HED that maximally predicts proximal and distal adverse-drinking-related outcomes. Participants included 115 young adults (57% female; 96% Caucasian) who partook in an 8-week Internet survey that assessed daily drinking as well as next-day hangover; 10 months later, adverse outcomes (problem drinking, alcohol-related problems, maximum number of drinks, and drug use) were surveyed. Thresholds were computed, with a range from 1+ drinks to 15+ drinks, and outcomes were predicted from each threshold. Findings for hangover measures showed relatively good convergence across multiple indicators, with greatest prediction occurring at a threshold of 10+ drinks per occasion. Different thresholds were observed for long-term outcomes, with higher thresholds indicative of outcomes with greater severity. Although alternatives to HED, such as subjective effects and blood alcohol concentration, can indicate risky drinking, a threshold measure of HED may have advantages in terms of prevention and of intervention efforts.

Predicting functional outcomes among college drinkers: reliability and predictive validity of the Young Adult Alcohol Consequences Questionnaire

Heavy drinking and associated consequences are widespread among U.S. college students. Recently, Read et al. (Read, J. P., Kahler, C. W., Strong, D., & Colder, C. R. (2006). Development and preliminary validation of the Young Adult Alcohol Consequences Questionnaire. Journal of Studies on Alcohol, 67, 169-178) developed the Young Adult Alcohol Consequences Questionnaire (YAACQ) to assess the broad range of consequences that may result from heavy drinking in the college milieu. In the present study, we sought to add to the psychometric validation of this measure by employing a prospective design to examine the test-retest reliability, concurrent validity, and predictive validity of the YAACQ. We also sought to examine the utility of the YAACQ administered early in the semester in the prediction of functional outcomes later in the semester, including the persistence of heavy drinking, and academic functioning. Ninety-two college students (48 females) completed a self-report assessment battery during the first weeks of the Fall semester, and approximately one week later. Additionally, 64 subjects (37 females) participated at an optional third time point at the end of the semester. Overall, the YAACQ demonstrated strong internal consistency, test-retest reliability, and concurrent and predictive validity. YAACQ scores also were predictive of both drinking frequency, and "binge" drinking frequency. YAACQ total scores at baseline were an early indicator of academic performance later in the semester, with greater number of total consequences experienced being negatively associated with end-of-semester grade point average. Specific YAACQ subscale scores (Impaired Control, Dependence Symptoms, Blackout Drinking) showed unique prediction of persistent drinking and academic outcomes.

Are social norms the best predictor of outcomes among heavy-drinking college students?

OBJECTIVE

This research was designed to evaluate the relative contribution of social norms, demographics, drinking motives, and alcohol expectancies in predicting alcohol consumption and related problems among heavy-drinking college students.

METHOD

Participants included 818 (57.6% women) first-year undergraduates who reported at least one heavy-drinking episode in the previous month. In addition to providing demographic information (gender and fraternity/sorority membership) participants completed Web-based assessments of social norms (perceived descriptive norms regarding typical student drinking, injunctive norms regarding friends' and parents' approval), motives (social, enhancement, coping, and conformity), and expectancies and evaluations of positive and negative alcohol effects.

RESULTS

Regression results indicated that descriptive and injunctive norms were among the best predictors of college student drinking. With respect to alcohol problems, results indicated that coping motives accounted for the largest proportion of unique variance. Finally, results revealed that alcohol consumption mediated the relationships between predictors and problems for social norms, whereas coping motives, negative expectancies, and evaluation of negative effects were directly associated with alcohol problems despite having relatively weak or null unique associations with consumption.

CONCLUSIONS

The results of this study substantiate social norms as being among the best predictors of alcohol consumption in this population and suggest that drinking to cope is a better predictor of problems. The findings are discussed in terms of practical prevention and treatment implications.

Outcomes of a technology-based social norms intervention to deter alcohol use in freshman residence halls

OBJECTIVE

The authors tested a prototype intervention designed to deter alcohol use in residence halls.

PARTICIPANTS

Approximately 384 freshmen participated in the study over a 2-year period.

METHODS

The authors devised a feedback method that assessed residents' blood alcohol concentration (BAC) at night and allowed the readings to be retrieved the next day via the Web. Residents in an intervention hall received their BAC readings as well as normative feedback. In a comparison hall, residents could retrieve only the BAC readings.

RESULTS

The authors found statistically significant hall differences, but they were small in size and not meaningful.

CONCLUSIONS

Qualitative findings suggest the intervention had an overall positive impact, but the actions of a subgroup of rebellious drinkers might have obscured the effect. Social norms interventions could provoke some episodes of excessive drinking in students who find these messages objectionable. More research is needed to evaluate delayed BAC feedback.