A group-administered Timeline Followback assessment of alcohol use

Regulatory Focus and Substance Use in Adolescents: Protective Effects of Prevention Orientation

Substance use is a major risk factor for negative health and functioning outcomes among middle schoolers. The purpose of this study was to assess whether individual differences in the adolescents' goal orientation are associated with elevated or attenuated risk for substance use. Regulatory focus theory stipulates that individuals vary in their strength of orientation toward promotion goals ("making good things happen") and prevention goals ("keeping bad things from happening"). Objectives: We sought to examine the association between individual differences in regulatory focus and adolescents' reports of their own and their friends' substance use. Methods: Participants were 241 seventh grade students who completed measures of regulatory focus (promotion and prevention orientation), self-reported substance use, perceived substance use habits of peers, and demographics. Logistic regression models were used to examine adjusted odds of lifetime tobacco use, alcohol use, and marijuana use for both participants' own use and their reports of friends' use. Results: Prevention orientation was associated with lower odds of all self-reported lifetime substance use outcomes (tobacco, alcohol, and marijuana). Prevention orientation was also associated with lower odds of reporting all types of substance use among friends. Promotion orientation was not associated with any self-reported substance use outcome, and was only associated with higher odds of reporting lifetime alcohol use among friends. Conclusions: These findings underscore the importance of regulatory focus as it relates to adolescent substance use. Future research may seek to incorporate regulatory focus within interventions intended to prevent or delay initiation of substance use in adolescents.

The Role of Social Media Content on Solitary Drinking Among Korean Adults

This study aims to provide explanations for how exposure to social media content on solitary drinking influences the frequency and quantity of solitary drinking, and posting about solitary drinking on social networking sites (SNS). An online survey was conducted with 506 Korean adults who had consumed alcohol at least once while alone in the previous year. The study showed the following results: First, exposure to social media content related to solitary drinking was positively associated with both descriptive norms and negative alcohol expectancies, both of which increased solitary drinking and posting on SNS. Second, although social media content influenced injunctive norm perceptions, injunctive norms did not influence solitary drinking or posting on SNS. Findings suggest that correcting descriptive norms on solitary drinking may be an appropriate intervention for solitary alcohol users in Korea.

Evaluation of the psychometric properties of self-reported measures of alcohol consumption: a COSMIN systematic review

PURPOSE

To review studies about the reliability and validity of self-reported alcohol consumption measures among adults, an area which needs updating to reflect current research.

METHODS

Databases (PUBMED (1966-present), MEDLINE (1946-present), EMBASE (1947-present), Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1937-present), PsycINFO (1887-present) and Social Science Citation Index (1976-present)) were searched systematically for studies from inception to 11th August 2017. Pairs of independent reviewers screened study titles, abstracts and full texts with high agreement and a third author resolved disagreements. A comprehensive quality assessment was conducted of the reported psychometric properties of measures of alcohol consumption using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) to derive ratings of poor, fair, good or excellent for each checklist item relating to each psychometric property.

RESULTS

Twenty-eight studies met inclusion criteria and, collectively, they investigated twenty-one short-term recall measures, fourteen quantity-frequency measures and eleven graduated-frequency measures. All measures demonstrated adequate/good test-retest reliability and convergent validity. Quantity-frequency measures demonstrated adequate/good criterion validity; graduated-frequency and short-term recall measures demonstrated adequate/good divergent validity. Quantity-frequency measures and short-term recall measures demonstrated adequate/good hypothesis validity; short-term recall measures demonstrated adequate construct validity. Methodological quality varied within and between studies.

CONCLUSIONS

It was difficult to discern conclusively which measure was the most reliable and valid given that no study assessed all psychometric properties and the included studies varied in the psychometric properties that they selected to assess. However, when the results from the range of studies were considered and summed, they tended to indicate that the quantity-frequency measure compared to the other two measures performed best in psychometric terms and, therefore, it is likely to produce the most reliable and valid assessment of alcohol consumption in population surveys.

Lifetime influences for cannabis cessation in male incarcerated indigenous australians

INTRODUCTION

Urban non-indigenous populations report life events (marriages, employment) as influences for self-initiated cannabis cessation. However, this hasn't been investigated in remote indigenous populations with different social paradigms.

METHODS

We investigate cannabis use, harms, and poly-substance misuse in 101 consenting male incarcerated indigenous Australians. Interviews applied quantitative and qualitative questions assessing demographic characteristics, criminal history, drug use, the Marijuana Problems Inventory (MPI), and cannabis-cessation influences. Comparisons used Chi Square, Analysis of Variance, and Nvivo software.

RESULTS

Cannabis use groups (current users, ex-users, and never users) were demographically similar except that current users reported more juvenile legal problems, younger school departure, and lower school achievement (p < 0.05). Mean cannabis consumption was 12.3 cones/day. Incarceration and family responsibilities were the strongest cessation influences. Employment responsibilities and negative self-image were rarely cited as influences.

DISCUSSION

High cannabis use, with its associated problems, is concerning. These identified influences indicate incarceration should be used for substance reduction programs, plus post-release follow-up. Community-based programs focusing on positive influences, such as family responsibilities and social cohesion, may be successful within indigenous populations with strong kinship responsibilities, rather than programs that focus solely on substance harms.

Negative Affect, Alcohol Consumption, and Female-to-Male Intimate Partner Violence: A Daily Diary Investigation

While research suggests that both negative affect and alcohol use are related to the risk of intimate partner violence (IPV) in male samples, less is known about the status of these risk factors in female samples. Forty-three college-age females who reported a recent history of IPV perpetration submitted six weeks of on-line daily reports pertaining to their levels of negative affect, alcohol consumption habits, and the occurrence of both male-to-female (MFPV) and female-to-male IPV (FMPV). Results indicated that negative affect significantly predicted increases in the daily risk of FMPV. MFPV also significantly predicted FMPV risk. Alcohol consumption failed to predict FMPV perpetration on both levels of analysis. Results are discussed in terms of prevailing models of alcohol use, negative affect, and IPV.

Alcohol expectancies, perceived norms, and drinking behavior among college students: examining the reciprocal determinism hypothesis

Social learning mechanisms, such as descriptive norms for drinking behavior (norms) and positive alcohol expectancies (PAEs), play a major role in college student alcohol use. According to the principle of reciprocal determinism (Bandura, 1977), norms and PAEs should be reciprocally associated with alcohol use, each influencing one another over time. However, the nature of these prospective relationships for college students is in need of further investigation. This study provided the first examination of the unique reciprocal associations among norms, PAEs, and drinking together in a single model. PAEs become more stable with age, whereas norms are likely to be more dynamic upon college entry. Thus, we hypothesized that alcohol use would show stronger reciprocal associations with norms than with PAEs for college students. Students (N = 557; 67% women) completed online measures of PAEs, norms, and quantity and frequency of alcohol use in September of their first (T1), second (T2), and third (T3) years of college. Reciprocal associations were analyzed using a cross-lagged panel design. PAEs had unidirectional influences on frequency and quantity of alcohol use, with no prospective effects from alcohol use to PAEs. Reciprocal associations were observed between norms and alcohol use, but only for quantity and not for frequency. Specifically, drinking quantity prospectively predicted quantity norms and quantity norms prospectively predicted drinking quantity. This effect was observed across both years in the model. These findings support the reciprocal determinism hypothesis for norms but not for PAEs in college students and may help to inform norm-based interventions.

Concurrent validity of an online version of the Timeline Followback assessment

The Timeline Followback (TLFB) interview has been used extensively in the assessment of alcohol and other substance use. While this methodology has been validated in multiple formats for multiple behaviors, to date no systematic comparisons have been conducted between the traditional interview format and online versions. The present research employed a randomized within-subjects design to compare interview versus online-based TLFB assessments of alcohol and marijuana use among 102 college students. Participants were randomly assigned to receive either the online version first or the in-person interview format first. Participants subsequently completed the second format within 3 days. While we expected few overall differences between formats, we hypothesized that differences might emerge to the extent that participants are more comfortable and willing to answer honestly in an online format, which provides a degree of anonymity. Results were consistent with expectations in suggesting relatively few differences between the online version and the in-person version. Participants did report feeling more comfortable in completing the online version. Moreover, greater discomfort during the in-person assessment was associated with reporting more past-month marijuana use on the online assessment, but reported discomfort did not moderate differences between formats in reported alcohol consumption.

Reducing Alcohol Risk in Adjudicated Male College Students: Further Validation of a Group Motivational Enhancement Intervention

This study examined the effectiveness of a single-session group motivational enhancement alcohol intervention on adjudicated male college students. Over two sequential academic years, 230 students sanctioned by the university for alcohol-related infractions attended a 60- to 75-minute group intervention. The intervention consisted of a timeline followback, social norms education, decisional balance for behavioral change, blood alcohol content (BAC) information, expectancy challenge, and generation of behavioral goals. Participants were followed weekly for three months and showed reductions in drinking (29%) and alcohol-related consequences (32%) at three-month follow-up. The intervention was successful in reducing drinking for both first-year students and upperclassmen, with reductions appearing to be a function of the intervention and not the citation itself. Furthermore, a post hoc control condition revealed that those participants randomly assigned to the intervention group condition reduced drinking (19%) and alcohol-related consequences (44%) more than participants in the control condition over one month. These results provide continued evidence of the effectiveness of group motivational enhancement interventions with adjudicated male college students.

Early Adolescent Romantic Partner Status, Peer Standing, and Problem Behaviors

This study examined associations among early adolescent romantic relationships, peer standing, problem behaviors, and gender as a moderator of these associations, in a sample of 320 seventh-grade students. Popular and controversial status youth were more likely to have a romantic partner, whereas neglected status youth were less likely to have a romantic partner. Similarly, youth perceived as conventional and unconventional leaders were also more likely to have a romantic partner than were non-leaders. Youth who had a romantic partner drank more alcohol and were more aggressive than were youth who did not have a romantic partner. Among those youth who had romantic partners, those who reported having more deviance-prone partners were themselves more likely to use alcohol and to be more aggressive, and those who engaged in deviant behavior with their partners used more alcohol. However, these associations varied somewhat by gender. These findings underscore the salience of early romantic partner relationships in the adjustment of early adolescents.

Readiness to change drinking behavior in female college students

OBJECTIVE

Motivational interviewing (MI) therapies are effective in reducing high-risk drinking in college populations. Although research supports efficacy of MI prevention strategies in reducing alcohol use, there are little data examining readiness to change (RTC), the underlying theoretical model of MI interventions. The purpose of the present study was to explore RTC variability and drinking behavior and whether MI increases RTC in an intervention group compared with controls.

METHOD

Two-hundred eighty-five first-year female college students participated in the study. Present analyses focused on those students who consumed alcohol in the month before the study (n = 182). RTC was measured using the Readiness to Change Ruler.

RESULTS

Analyses were conducted using hierarchical linear modeling. There was significant variability in RTC: 71.86% of variance in RTC was between-person differences, and 28.14% was within-person differences. Higher RTC was associated with lower intentions to drink and future drinking behavior. However, in weeks in which students drank more, they experienced a decrease in RTC. Based on the significant cross-level interaction, the intervention group had significantly higher RTC than controls.

CONCLUSIONS

These results provided partial support for our hypotheses. The overall theoretical construct of RTC varies both across and within individuals. These results also offer support for the utility of MI-based prevention strategies in increasing RTC within individuals. However, we did not consistently find that these changes related to drinking changes. Findings provide support for both the construct of RTC and utility of MI interventions in changing these beliefs in female college students.

Preventing risky drinking in first-year college women: further validation of a female-specific motivational-enhancement group intervention

OBJECTIVE

Female college students have increased their alcohol consumption rates. The current study sought to replicate the effectiveness of a female-specific motivational-enhancement group intervention and extended previous work by adding a 6-month follow-up. The intervention included several motivational-enhancement components delivered in a group setting and included a group discussion of female-specific reasons for drinking.

METHOD

Participants were 285 first-year college women. Data collection consisted of an online pre-intervention questionnaire, 10 weeks of online follow-up assessment, and a 6-month online follow-up. Using a randomized design, participants chose a group session, blind to treatment status. Held during the first weeks of the first semester, 159 participants received the intervention and 126 participants received an assessment-only control.

RESULTS

Using a repeated-measures analysis of covariance, intervention participants consumed significantly less than control participants on drinks per week (F = 11.86, 1/252 df, p < .001), maximum drinks (F = 11.90, 1/252 df, p < .001), and heavy episodic drinking events (F = 20.14, 1/252 df, p < .001) across 10 weeks of follow-up. However, these effects did not persist at the 6-month follow-up. Moderation effects were found for social motives on all drinking variables, such that the intervention was most effective for those women with higher social motives for drinking.

CONCLUSIONS

Efficacy was found for a female-specific motivational group intervention in creating less risky drinking patterns among first-year women, especially women with social motives for drinking. The effect dissipated by the second semester, suggesting the need for maintenance or booster sessions.

Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women

This study examined whether a self-reported family history of alcohol abuse (FH+) moderated the effects of a female-specific group motivational enhancement intervention with first-year college women. First-year college women (N=287) completed an initial questionnaire and attended an intervention (n=161) or control (n=126) group session, of which 118 reported FH+. Repeated measures ANCOVA models were estimated to investigate whether the effectiveness of the intervention varied as a function of one's reported family history of alcohol abuse. Results revealed that family history of alcohol abuse moderated intervention efficacy. Although the intervention was effective in producing less risky drinking relative to controls, among those participants who received the intervention, FH+ women drank less across five weeks of follow-up than FH- women. The current findings provide preliminary support for the differential effectiveness of motivational enhancement interventions with FH+ women.

Early adolescents' social standing in peer groups: behavioral correlates of stability and change

Sociometric nominations, social cognitive maps, and self-report questionnaires were completed in consecutive years by 327 students (56% girls) followed longitudinally from grade 7 to grade 8 to examine the stability of social standing in peer groups and correlates of changes in social standing. Social preference, perceived popularity, network centrality, and leadership were moderately stable from grade 7 to grade 8. Alcohol use and relational aggression in grade 7 predicted changes in social preference and centrality, respectively, between grade 7 and grade 8, but these effects were moderated by gender and ethnicity. Changes in social standing from grade 7 to grade 8 were unrelated to grade 8 physical aggression, relational aggression, and alcohol use after controlling for the grade 7 corollaries of these behaviors. Results are discussed in terms of their implications for understanding links between social standing and problem behaviors during adolescence.

Changes in Drinking Patterns Across the Transition to College Among First-Year College Males

Few studies examine changes in drinking behavior during the transition from high school to college. Using a sample of 239 first-year males, we hypothesized that participants would increase drinking from pre-college to the first month of college. Results reveal a general trend toward increased drinking upon entering college. Caucasians increased drinking more than non-Caucasians. Social expectancies of alcohol moderated increases in drinking behavior. These findings indicate that differential changes in drinking behavior occur among incoming college males. Interventions with college students need to address both preventing heavy consumption and alcohol-related problems in pre-college light drinkers and in reducing these behaviors among pre-college heavy drinkers.

The differential impact of relational health on alcohol consumption and consequences in first year college women

The Relational Health Indices (RHI) is a relatively new measure that assesses the strength of relationships. It has been found that relational health has a protective factor for women, such that it enhances positive experiences and limits negative ones. The current study is the first to use the RHI to examine the effect of relational health on alcohol consumption and alcohol consequences. First year college women were given questionnaires assessing relational health, drinking motives, and alcohol use in their first few months at a mid-sized, private university. Due to the social nature of college settings, it was predicted that relational health would moderate the relationship between motives and alcohol consumption. Further, due to the protective factor of relational health, it was predicted that relational health would attenuate the relationship between drinking and negative consequences. These hypotheses were supported. Relational health, moderated the relationship between both social and coping drinking motives and drinking, such that women with strong relational health towards their peers and community who also had high social and coping motives, drank more than those with weaker relationships. Paradoxically, relational health also moderated the relationship between drinking and consequences such that heavy drinking women with strong relational health experienced fewer negative consequences than women with weaker relational health. Results indicate that although relational health is associated with an increase in alcohol consumption, it may also serve as a protective factor for alcohol-related negative consequences. Future research and interventions may seek to de-link the relational health-drinking connection in the college student environment.

A self-administered Timeline Followback to measure variations in underage drinkers' alcohol intake and binge drinking

Underage drinkers typically have not developed regular patterns of drinking and so are likely to exhibit situational variation in alcohol intake, including binge drinking. Information about such variation is not well captured by quantity/frequency (QF) measures, which require that drinkers blend information over time to derive a representative estimate of "typical" drinking. The Timeline Followback (TLFB) method is designed to retrospectively capture situational variations in drinking during a specific period of time. We compared our newly-developed Self-administered TLFB (STLFB) measure to a QF measure for reporting alcohol intake. Our sample of 429 (men=204; women=225) underage (i.e., age 18-20 years) drinkers completed the two drinking measures and reported on alcohol problems. The STLFB and QF measures converged in assessing typical daily intake, but the STLFB provided more information about situational variations in alcohol use and better identification of regular versus intermittent binge drinkers. Regular binge drinkers reported more alcohol problems. The STLFB is an easy-to-administer measure of variations in alcohol intake, which can be useful for understanding drinking behavior.

A group Motivational Interviewing intervention reduces drinking and alcohol-related negative consequences in adjudicated college women

College students who violate campus alcohol policies (adjudicated students) are at high risk for experiencing negative alcohol-related consequences and for undermining campus life. Further, college women may be especially at-risk due to differential intoxication effects and sexual consequences experienced mainly by female students. Research on interventions for adjudicated students, especially adjudicated females, has been limited. One hundred and fifteen college women who received a sanction for violating campus alcohol policies participated in the study. The two-hour group intervention focused on female-specific reasons for drinking and included decisional balance, goal setting and other exercises. Participants completed follow-up surveys for 12 weeks following the intervention and answered questions regarding alcohol consumption and alcohol-related negative consequences. Findings support the use of an MI-based intervention to reduce both alcohol consumption and consequences among adjudicated females. Specifically, alcohol use was reduced by 29.9% and negative consequences were reduced by 35.87% from pre-intervention to 3-month follow up. Further, the intervention appeared to successfully initiate change in the heaviest drinkers, as women who drank at risky levels reduced alcohol consumption to a greater extent than women who drank at moderate levels.

Reasons for drinking in the college student context: the differential role and risk of the social motivator

OBJECTIVE

The present study examines the relationships among reasons for drinking, alcohol consumption, and alcohol-related consequences in two college-aged samples. Personal motivators such as mood enhancement and coping (tension reduction) have consistently been shown to predict problematic alcohol use, but because of the salient nature of social drinking in college, we hypothesized that social reasons for drinking would be most frequently endorsed and, in turn, predict negative consequences.

METHOD

T w o distinct samples--119 co-ed adjudicated students sanctioned by the university for violating campus alcohol policy and 106 co-ed volunteer students--completed measures assessing alcohol consumption, reasons for drinking, and consequences. Differential effects between genders were examined.

RESULTS

Social camaraderie (SC) was the most frequently endorsed reason for drinking. Regression analyses controlling for previous drinking revealed that social reasons for drinking predicted alcohol-related problems among female students in both samples. Additionally, SC was significantly correlated with every drinking measure and problem measure at 1 month for females in both the adjudicated and the volunteer groups. Total drinks, drinking days, and heavy episodic drinking events correlated with SC for males in the adjudicated sample.

CONCLUSIONS

For females, these results suggest a relationship between social reasons for drinking and alcohol-related consequences, which previous research has not identified. More research is needed to explore females' reasons for drinking, accompanying problems, and the underlying psychosocial traits associated with these reasons.

A campus-based motivational enhancement group intervention reduces problematic drinking in freshmen male college students

The current study employs an adaptation to Motivational Interviewing (AMI) group intervention with freshmen male undergraduates. The program follows suggestions of the National Institute on Alcohol Abuse and Alcoholism for effective interventions with problematic college student drinking, and combines several empirically validated strategies to prevent drinking problems throughout college. All participants reduced drinking and alcohol-related problems; heavier drinkers and those experiencing the most alcohol-related problems reduced drinking most. Additionally, freshmen who completed the intervention were less likely than their non-intervention freshmen male peers to commit alcohol-related violations of campus policies. In addition to the reductions in problematic drinking, the group AMI has advantages over individual formats because larger numbers of students can benefit with comparable expenditures of time and effort.

Classifying risky-drinking college students: another look at the two-week drinker-type categorization

OBJECTIVE

The present study examined the effectiveness of the 2-week period currently used in the categorization of heavy episodic drinking among college students. Two-week drinker-type labels included the following: nonbinge drinker, binge drinker, and frequent binge drinker.

METHOD

Three samples of college student drinkers (104 volunteers, 283 adjudicated students, and 238 freshmen male students) completed the 3-month Timeline Followback assessment of drinking. Drinking behavior during the last 2 weeks of the month before the study was compared with drinking behavior during the first 2 weeks of the same month to compare behavior and resulting labels during both 2- week periods.

RESULTS

Inconsistencies existed in drinker-type labels during the first 2 weeks of the month and the last 2 weeks of the month for all three samples. Between 40% and 50% of participants in the three samples were classified as a different drinker type across the month. Nonbinge drinkers experienced a wide range of alcohol-related problems, and much variation existed among the frequent-binge-drinker label.

CONCLUSIONS

The results suggest that the current definition needs to be modified to accurately identify risky-drinking college students. Expanding the assessment window past 2 weeks of behavior, as well as developing different classification schemes, might categorize risky drinkers more accurately.

Comparing electronic-keypad responses to paper-and-pencil questionnaires in group assessments of alcohol consumption and related attitudes

Electronic versions of questionnaires have the potential to improve research and interventions in the addictions. Administering questionnaires electronically to groups, however, has proven difficult without a multitude of computers, but gathering data electronically from a group could make for easy assessment and quick feedback. Using a sample of 107 college students, we examined the validity of wireless keypad survey responses by comparing them to traditional paper-and-pencil questionnaires. The two formats led to almost identical responses that did not differ significantly from each other (all effect sizes less than g=.15) and high correlations between formats. The wireless, handheld keypad procedure appears to generate data that are as valid as questionnaire responses and permit rapid feedback to groups, as well as easy, human error-free data entry for analysis.

Peer standing and substance use in early-adolescent grade-level networks: a short-term longitudinal study

Two competing hypotheses were tested concerning the associations between current alcohol and cigarette use and measures of individual, group and network peer standing in an ethnically-diverse sample of 156 male and female adolescents sampled at two time points in the seventh grade. Findings lent greater support to the person hypothesis, with early regular substance users enjoying elevated standing amongst their peers and maintaining this standing regardless of their maintenance of or desistance from current use later in the school year. In the fall semester, users (n=20, 13%) had greater social impact, were described by their peers as more popular, and were more central to the peer network than abstainers (i.e., those who did not report current use).Conversely, in the spring semester, there were no differences between users (n=22, 13%) and abstainers in peer ratings of popularity or social impact. Notably, the spring semester users group retained fewer than half of the users from the fall semester. Further, students who had reported current use in the fall, as a group, retained their positions of elevated peer standing in the spring, compared to all other students, and continued to be rated by their peers as more popular and as having greater social impact. We discuss the findings in terms of the benefit of employing simultaneous systemic and individual measures of peer standing or group prominence, which in the case of peer-based prevention programs, can help clarify the truly influential from the "pretenders" in the case of diffusion of risk-related behaviors.

A within-subjects validation of a group-administered timeline followback for alcohol use

OBJECTIVE

The current study uses a within-subjects randomized design with the Timeline Followback (TLFB) method administered in groups or to individuals to determine the equivalence of these methods.

METHOD

One hundred and four male and female college students who reported drinking at least once in the past 3 months completed the TLFB during a one-on-one interview, as well as in a group setting days apart. The two administrations were counterbalanced among the participants. Drinking variables assessed were drinking days, average drinks, total drinks, and maximum drinks consumed both during a 3-month (90 days) and a 1-month (30 days) period.

RESULTS

Repeated measures analyses revealed no differences within subjects between the individual TLFB and the group TLFB on any of the four assessed drinking variables in the past 3 months and the past 1 month. Pearson's correlation coefficients revealed strong and significant correlations between the two administration styles. Heavy episodic drinking behavior was similar across administration styles as well. No differences between administration styles were consistent regardless of which administration was received first.

CONCLUSIONS

The study suggests that the group TLFB yields similarly accurate results to the previously validated individual TLFB. The group-administered TLFB could be used in clinical and research settings as an efficient means of collecting information from large numbers of individuals.