Recent alcohol-induced blackouts among heavy drinking college students: A qualitative examination of intentions, willingness, and social context

Projected alcohol demand in college students with heavy drinking

Measures of the relative reinforcing value of alcohol (i.e., alcohol demand) are associated with concurrent and future rates of alcohol use. Given that college-age young adults may fail to predict escalation of substance use, the present project explores the novel construct of projected future demand by college students who engage in heavy drinking and whether it can predict future alcohol use. During an initial session, participants completed a standard alcohol purchase task, a projected alcohol purchase task (i.e., "three months from now"), and measures of past-month alcohol consumption and associated risk. During a follow-up session 3 months later, participants completed another standard alcohol purchase task and measures of consumption and risk. We found that college students (n = 40) projected increases in demand for 3 months in the future but did not exhibit subsequent changes in demand. In addition, measures of projected future demand were associated with subsequent alcohol use. However, when baseline alcohol use and risk were included as additional predictors, projected demand was not a unique predictor of future alcohol use. The current study signals the potential of novel measures of projected demand, which when contrasted with measures of current demand, may lend predictive utility on subsequent trajectories of alcohol use.

Serious harm reduction protective behavioral strategies reduce consequences associated with alcohol-induced blackouts in college students

OBJECTIVE

Alcohol-induced blackouts (AIBs) have been associated with increased alcohol-related consequences. Serious harm reduction (SHR) protective behavioral strategies may reduce consequences when students are drinking heavily. We examined whether SHR weakened the relationship between AIBs and a) total consequences and b) serious consequences (e.g., sexual assault) only.

METHODS

Students were eligible if they were aged 18-22  years, in their second or third year of college, reported drinking 4 + drinks on a typical Friday or Saturday, experienced ≥ 1 AIB in the past semester, owned an iPhone, and were willing to wear a sensor for 3  days each weekend. Students (N = 79, 55.7 % female, 86.1 % White, Mage = 20.1) wore sensors and completed daily diaries over four consecutive weekends (852 total surveys; 89.9 % completion rate). Linear multilevel models were conducted to test for moderating effects of SHR.

RESULTS

SHR weakened the association between AIBs and total consequences. At low (-1 SD) SHR, days with an AIB had an additional 1.46 consequences compared to days without an AIB, on average. At high (+1 SD) SHR, days with an AIB had an additional 0.94 consequences compared to days without an AIB, on average. SHR did not change the association between AIBs and serious consequences.

CONCLUSIONS

Students experienced approximately 50% more consequences on nights when they had an AIB and used below average numbers of SHR compared to nights when they had an AIB and used above average numbers of SHR. These findings suggest that student drinking interventions should include SHR to reduce harm associated with drinking and AIBs.

Associations among sexual assault history, alcohol use, blackouts, and blackout intentions among college women

Background: Links between alcohol-induced blackouts and sexual assault (SA) are understudied. We tested whether: (1) history of blackouts, past 30-day blackouts, and past 30-day blackout intentions would be higher among women with histories of SA relative to women without; (2) baseline history of blackouts, past 30-day blackouts, and blackout intentions would predict an increase in SA severity (i.e., a continuous variable that considers SA tactic type and assault frequency) at a one-year follow-up. Methods: 1721 undergraduate women completed a baseline survey and 313 completed the follow-up. Results: Women with SA history had 2.10 higher odds of history of blackouts, 1.47 higher odds of past 30-day blackout during "one" drinking episode, 1.78 higher odds of blackout during a "few" drinking episodes, 3.21 higher odds of blackout during "most/all" drinking episodes, and 1.54 higher odds of blackout intentions in the last 30-days. Longitudinally, history of blackouts and past 30-day blackouts at baseline were associated with an increase in SA severity at follow-up, when peak drinks were not controlled. Conclusion: Longitudinal findings provide some evidence that lifetime history of blackouts and past 30-day blackouts are significant predictors of an increase in SA severity at follow-up and therefore an essential target for interventions.

Contextualizing linguistic acculturation and alcohol use among Hispanic college students in the social digital environment

OBJECTIVES

Linguistic acculturation is a predictor of alcohol use among Hispanic college students, but existing linguistic acculturation measures do not capture language use in the social digital context (e.g., social media). Guided by erosion theory and past empirical findings, this study operationalized two dimensions of social digital linguistic acculturation (SDLA) and examined the interactive effects of SDLA with immigration generation-a demographic proxy for acculturation-in relation to alcohol use intentions and behaviors.

METHOD

Online questionnaires were completed by 246 Hispanic college students in central Texas between the ages of 18 and 29 (Mage = 21.0, SD = 2.4; 82.1% female) who reported current alcohol use. Measures included two dimensions of SDLA (SDLA-English and SDLA-Spanish) with items developed for this study and supported by exploratory factor analysis, immigration generation as a demographic proxy for acculturation, and three alcohol outcomes (intentions to use alcohol, alcohol consumption, and binge drinking). We specified three regression models in which immigration generation moderated the pathways between SDLA-English and SDLA-Spanish and each alcohol outcome.

RESULTS

Contrary to hypotheses, lower rather than higher SDLA-English was related to greater intentions to use alcohol, greater alcohol consumption, and more frequent binge drinking when immigration generation was higher rather than lower. More aligned with expectations, lower SDLA-Spanish was related to more frequent binge drinking when immigration generation was higher.

CONCLUSIONS

The link between SDLA and alcohol engagement is nuanced. This study's findings may be partially explained by acculturative stress in the context of social digital engagement, warranting further exploration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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

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

A Dual-Process Decision-Making Model Examining the Longitudinal Associations Between Alcohol-Induced Blackouts and Alcohol Use Disorder Risk Among College Student Drinkers

OBJECTIVE

The purpose of this study was to use a dual-process decision-making model to examine the longitudinal associations between alcohol-induced blackouts (blackouts) and alcohol use disorder (AUD) risk symptoms among college student drinkers.

METHOD

Undergraduate drinkers (N = 2,024; 56% female; 87% White; 5% Hispanic) at a large northeastern university completed online surveys each semester during their first (Time [T] 1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). Path analyses were examined testing the longitudinal associations between T1 willingness to experience a blackout, T1 intentions to avoid a blackout, T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms. Hypotheses 1 and 2 tested the associations between T1 willingness, T1 intentions, T2-T8 drinking, and T2-T8 blackouts. Hypothesis 3 tested the associations between T2-T8 drinking, T2-T8 blackouts, and T8 AUD risk symptoms.

RESULTS

Students experienced an average of 8 (SD = 8) blackouts during college. Approximately 1,514 (88.8%) participants reported experiencing 1 of 8 AUD risk symptoms. T1 willingness was positively associated with T2-T8 blackouts. T2-T8 drinking and T2-T8 blackouts were positively associated with T8 AUD risk symptoms. T1 willingness significantly indirectly affected T8 AUD risk symptoms through its association with T2-T8 blackouts.

CONCLUSIONS

Results estimated that, on average, college student drinkers experienced eight blackouts across 4 years of college, and 88% of participants reported experiencing at least one symptom of AUD in the last semester of college. Willingness to experience a blackout influenced students' AUD risk symptoms through the number of blackouts they experienced throughout college.