Identifying At-Risk College Student Drinkers With the AUDIT-US: A Receiver Operating Characteristic Curve Analysis

Hazardous alcohol use, drinking motives and COVID-19-related anxiety in college students

OBJECTIVE

This study examined the associations of anxiety and drinking motives with hazardous and binge alcohol use among young adults.

PARTICIPANTS

We recruited young adults (N = 182, mean age 25) between November 2020 and December 2020.

METHODS

Linear regressions were used to evaluate relationships among hazardous alcohol use (US Alcohol Use Disorders Identification Test-C [USAUDIT-C]), binge drinking (Alcohol Intake Questionnaire [AIQ]), PROMIS-Anxiety, COVID-19 related anxiety (CAS), and the drinking to cope with depression and anxiety subscales of the Modified Drinking Motives Questionnaire.

RESULTS

Sixty-two percent of participants reported hazardous drinking (USAUDIT-C score > 4). PROMIS Anxiety and CAS scores were 63.7 and 1.0, respectively. Scores were positively associated with drinking patterns. However, the drinking to cope with depression motive significantly mediated these associations.

CONCLUSIONS

After the onset of the pandemic, hazardous and binge drinking patterns among young adults were associated with drinking to cope with depression rather than anxiety.

Personality and Alcohol Use across College: Examining Context-Dependent Pathways toward Alcohol Problems

BACKGROUND

College life is characterized by marked increases in alcohol consumption. Extraversion and neuroticism are associated with alcohol use problems in college and throughout adulthood, each with alcohol use patterns consistent with an externalizing and internalizing pathway respectively. Students higher in extraversion drink more frequently and consume more alcohol, while neuroticism is paradoxically not consistently associated with elevated alcohol use.

OBJECTIVE

This study examined whether students higher in neuroticism may drink the day before stressors, namely tests and assignment deadlines.

METHOD

Multilevel generalized linear models were performed using data from a longitudinal study of first-time, first-year undergraduates assessing alcohol use across four years of college, with daily diary bursts each semester.

RESULTS

Students higher in extraversion had heavier alcohol use and greater alcohol use problems in their fourth year of college. Neuroticism was not associated with drinking behaviors or with drinking before a test or assignment, but was associated with greater fourth year alcohol problems. Students lower in extraversion who reduced heavy drinking the day before academic events had fewer alcohol use problems at the fourth year of college relative to students higher in extraversion.

CONCLUSIONS

Students higher in extraversion appear to exhibit a continuity of established alcohol use patterns from adolescence, predisposing them to a more hazardous trajectory of college alcohol use. Characteristics of low extraversion may afford some protection from alcohol-positive college culture. High neuroticism appears associated with a hazardous trajectory of college alcohol use, but continued research into situational factors of alcohol use in high neuroticism is warranted.

Risk factors for hazardous drinking in university students from South Africa and Belgium: a cross-cultural comparison study

Background

Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use.

Objectives

To determine whether or not there was a difference in hazardous drinking between Belgian and South African university students and to establish the risk factors that contribute to hazardous drinking in university students (calculated using the AUDIT-C) from a developing country (South Africa) and a developed country (Belgium).

Methods

An online survey assessing hazardous drinking among university students in South Africa (University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp, UoA) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). Risk factors in males and females for hazardous drinking were explored using multivariate logistic regression analysis.

Results

In total, 499 students were included in the study (250 UoA and 249 UKZN students). A significant higher amount of male (94.8%) as well as female (92.4%) UoA students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) UKZN students (p<0.001). Additionally, a significant higher amount of UoA students were hazardous drinkers, compared to the UKZN students (p<0.001). Multivaiate analysis showed that male UoA students were almost 6 times more likely to be hazardous drinkers than male UKZN students (OR=5.611, p=0.005). Female UoA students were more than twice as likely to be hazardous drinkers than female UKZN students (OR=2.371, p=0.016).

Conclusion

This study found a significant difference in hazardous drinking between Belgian and South African university students.

Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension

The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n = 1523 Slovak university students). Descriptive, regression, and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9), and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, while in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.

Screening for alcohol use disorders in college student drinkers with the AUDIT and the USAUDIT: a receiver operating characteristic curve analysis

Background: The Alcohol Use Disorders Identification Test (AUDIT) and its consumption subscale (AUDIT-C) are international gold standard screeners for identifying at-risk drinkers. Items have been modified to reflect United States low-risk drinking guidelines in the USAUDIT and USAUDIT-C, which also perform well in identifying at-risk drinkers. The USAUDIT may also be used to screen for potential AUD, an important first step to identify individuals needing diagnostic testing and treatment referrals. Objectives: The present study sought to evaluate the sensitivity and specificity of each measure in predicting potential AUDs via diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition in a college sample. Methods: Participants were 382 college student drinkers (Mage = 20.2, SD = 1.5; 68.7% female) who completed online surveys assessing alcohol use, at-risk drinking, and AUD symptom endorsement. Receiver operating curves provide optimal cutoff scores for each measure in overall, male, and female samples. Results: Results indicated the AUDIT and USAUDIT are equally superior in detecting potential AUD in the current sample. Recommended cutoff scores for detecting likely AUD with the USAUDIT are 12 for males (sensitivity = 62.0%, specificity = 86.6%) and 8 for females (sensitivity = 65.3%, specificity = 87.7%). Conclusions: Whereas prior work supports the USAUDIT-C in detecting at-risk drinking, the current study supports the AUDIT and USAUDIT in detecting potential AUD. Based on prior work, and in an effort to be consistent with standard US drinking guidelines, we recommend using the USAUDIT in screening and brief interventions across college campuses.

College Alcohol Beliefs and Alcohol Outcomes: The Mediating Effects of Alcohol Protective Behavioral Strategies

The present study examined the mediating role of alcohol protective behavioral strategies (i.e. serious harm reduction [PBS-SHR], manner of drinking [PBS-MOD], stopping/limiting drinking [PBS-SLD]) on the relationships between college alcohol beliefs and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences) in an attempt to replicate recent findings in the early stages of college alcohol belief and PBS research. Methods: Participants were 625 traditional age undergraduate college students (M = 19.00, SD = 1.72; 63.7% White; 80.7% female) recruited from a southeastern United States university who reported past 30-day alcohol consumption. All participants completed measures of college alcohol beliefs, alcohol PBS use, hazardous drinking, and alcohol-related negative consequences through an online survey. Results: Higher college alcohol beliefs were associated with greater hazardous drinking and alcohol-related negative consequences. Further, PBS-MOD mediated the positive relationship college alcohol beliefs had with hazardous drinking, such that higher college alcohol beliefs predicted less PBS-MOD use which was associated with greater hazardous drinking. Discussion: These findings provide further evidence to support previous findings highlighting the additional protective value of certain alcohol PBS especially for college students with high college alcohol beliefs.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students

College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. Purpose: This study evaluated the mediating role of coping styles (i.e. problem-solving and avoidance coping) on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences [ARNC]). Methods: A national sample of 672 traditional age (i.e. 18-25 years old; M = 22.35, SD = 1.97) college students who reported alcohol consumption in the past month were recruited via Amazon's Mechanical Turk website. Participants were 55.1% male and 60.9% White and completed measures of PTSD symptoms, coping styles, hazardous drinking, and ARNC. Results: Problem-solving coping mediated the positive relationship between PTSD symptoms and hazardous drinking such that PTSD symptoms were negatively associated with problem-solving coping, which was negatively associated with hazardous drinking. Avoidance coping mediated the positive relationship between PTSD symptoms and ARNC through a positive association between PTSD symptoms and avoidance coping. Conclusions: These novel findings highlight the importance of adaptive coping styles as a protective factor for college students experiencing co-occurring PTSD symptoms and harmful alcohol use.