Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations.

Nocturnal hypoglycemia is associated with next day cognitive performance in adults with type 1 diabetes: Pilot data from the GluCog study

OBJECTIVE

 Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated.

METHODS

 This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured via mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition.

RESULTS

 Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality.

CONCLUSIONS

 These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D.

Stress Monitoring in Free-Living Environments

Stress monitoring is an important area of research with significant implications for individuals' physical and mental health. We present a data-driven approach for stress detection based on convolutional neural networks while addressing the problems of the best sensor channel and the lack of knowledge about stress episodes. Our work is the first to present an analysis of stress-related sensor data collected in real-world conditions from individuals diagnosed with Alcohol Use Disorder (AUD) and undergoing treatment to abstain from alcohol. We developed polynomial-time sensor channel selection algorithms to determine the best sensor modality for a machine learning task. We model the time variation in stress labels expressed by the participants as the subjective effects of stress. We addressed the subjective nature of stress by determining the optimal input length around stress events with an iterative search algorithm. We found the skin conductance modality to be most indicative of stress, and the segment length of 60 seconds around user-reported stress labels resulted in top stress detection performance. We used both majority undersampling and minority oversampling to balance our dataset. With majority undersampling, the binary stress classification model achieved an average accuracy of 99% and an f1-score of 0.99 on the training and test sets after 5-fold cross-validation. With minority oversampling, the performance on the test set dropped to an average accuracy of 76.25% and an f1-score of 0.68, highlighting the challenges of working with real-world datasets.

Using ecological momentary assessments of negative affect and craving during residential opioid use disorder treatment to predict patients' relapse to substance use

BACKGROUND

Negative affect (NA) and craving are often independently examined as precipitators of relapse among individuals with substance use disorders, including opioid use disorder (OUD). Recent ecological momentary assessment (EMA) research has revealed that NA and craving frequently co-occur within individuals. Yet we know little about the general patterns of, and variability in, within-person associations between NA and craving, as well as whether the nature and degree of within-person NA-craving coupling predicts post-treatment time-to-relapse.

METHODS

Seventy-three patients (77 % male, Mage = 30.10, Range = 19-61) in residential treatment for OUD took part in a 12-day, 4× daily smartphone-based EMA study. Linear mixed-effects models tested within-person, day-level associations between self-reported NA and craving during treatment. The study used Person-specific slopes (i.e., average within-person NA-craving coupling for each participant) estimated from the mixed-effects model in survival analyses with Cox proportional hazards regression models to determine if between-person differences in the within-person coupling predicted post-treatment time-to-relapse (operationalized as the return to problematic use of any substance except tobacco), and whether this prediction was similar across patients' average levels of NA and craving intensity. The study monitored relapse through a combination of hair samples and reports from patients or alternative contacts via a voice response system twice a month for up to 120 days or more following discharge.

RESULTS

Among the 61 participants with time-to-relapse data, those with stronger positive within-person NA-craving coupling on average during residential OUD treatment had a lower hazard of relapsing (slower time to relapse) post-treatment than participants with weaker NA-craving slopes. The significant association held after controlling for interindividual differences in age, sex, and average levels of NA and craving intensity. Average NA and craving intensity did not moderate the association between NA-craving coupling and time-to-relapse.

CONCLUSIONS

Interindividual differences in average within-person, day-level NA-craving coupling during residential treatment predict OUD patients' post-treatment time-to-relapse.

An Ecological Momentary Assessment of College Women's Decisions to Use Protective Behavioral Strategies

Protective behavioral strategies (PBS) have been associated with reduced risk for sexual assault victimization in college women. Sexual assault risk reduction programs have had limited success increasing PBS use, particularly among heavy drinkers, suggesting a need for additional research on the malleable predictors of PBS use. Whereas longitudinal studies show women's decisions to use PBS can be both planned and reactive, little is known about the decision-making processes that affect PBS use on drinking days, when sexual assault risk may be elevated. The current study used ecological momentary assessment to examine variability in the associations between decision-making and PBS use within and across drinking days in first-semester college women. Participants (56 female drinkers) completed a 14-day protocol with three daily measures of intentions and willingness to use PBS, and once-daily diaries of PBS use. Multilevel models examined between-day and within-day effects of intentions and willingness to use PBS with regards to sexual assault PBS (e.g., communicating sexual boundaries) and drinking PBS (e.g., limiting alcohol consumption), respectively. On days when sexual assault PBS willingness increased throughout the day, women tended to use more sexual assault PBS. This association was strongest among women who were typically less willing to use these PBS. Among women who were the least willing to use drinking PBS, their drinking PBS use decreased on days when they reported increased willingness to use them. Decisions to use sexual assault and drinking PBS on drinking days were qualified by women's typical levels of willingness to use the different PBS. This suggests the need for a multi-faceted intervention strategy that targets both typical and event-level risk. Individual-level alcohol and sexual assault risk reduction approaches could be enhanced with event-level PBS messaging and evaluation.

Variations in acceptability of heavy alcohol use and gender double standards across drinking cultures. A U.S.A. - Italy study

Focus group data from 92 youths from Italy and the U.S.A. indicate that Italians and Americans differ in perceived threshold of acceptability of drinking to excess. Youth from the U.S.A. were more accepting of intoxication than Italian youth, reflecting features of each respective dominant drinking culture. Alcohol gender double standards existed in both countries and were conceptually connected to sexuality. However, the social construction behind such connections differed across the two groups: focusing on harms to the woman in the U.S.A. and the respectability of her social group in Italy.

Examining the time-varying association of negative affect and covariates with craving during treatment for prescription opioid dependence with two types of mixed models

Opioid use disorders are chronic and relapse is common. Both negative affect and craving have been suggested antecedents of relapse and have been shown to demonstrate within- and between-person variability, as well as association with each other. The present study extends previous research by examining the covariation of negative affect and craving both within-day and at the person-level during 12 days of treatment among opioid-dependent patients. Ecological momentary assessment (EMA) data were collected from 73 participants starting between 10 and 14 days after admission to an inpatient treatment facility. These data were analyzed using multivariate multilevel models and time-varying effect models. Results demonstrated strong association between negative affect and craving. Within-day, negative affect and craving were most associated in the early afternoon. At the person-level, association between negative affect and craving declined during the first week of data collection. Following this initial decline in association, negative affect and craving increasingly covaried during days 8-12 of data collection. To our knowledge, this is the first study to report a lagged increase in the association between negative affect and craving among patients during inpatient treatment for opioid dependence. Implications for research and treatment providers are discussed.

Examining the time-varying association of negative affect and covariates with craving during treatment for prescription opioid dependence with two types of mixed models

Opioid use disorders are chronic and relapse is common. Both negative affect and craving have been suggested antecedents of relapse and have been shown to demonstrate within- and between-person variability, as well as association with each other. The present study extends previous research by examining the covariation of negative affect and craving both within-day and at the person-level during 12 days of treatment among opioid-dependent patients. Ecological momentary assessment (EMA) data were collected from 73 participants starting between 10 and 14 days after admission to an inpatient treatment facility. These data were analyzed using multivariate multilevel models and time-varying effect models. Results demonstrated strong association between negative affect and craving. Within-day, negative affect and craving were most associated in the early afternoon. At the person-level, association between negative affect and craving declined during the first week of data collection. Following this initial decline in association, negative affect and craving increasingly covaried during days 8-12 of data collection. To our knowledge, this is the first study to report a lagged increase in the association between negative affect and craving among patients during inpatient treatment for opioid dependence. Implications for research and treatment providers are discussed.

The intergenerational transmission of harsh parenting, substance use, and emotional distress: Impact on the third-generation child

The current study evaluated the intergenerational transmission of harsh parenting, substance use, and emotional distress across generations and the association with child aggression. The study included 218 Generation 1 (G1) mothers and fathers, their adolescent (Generation 2; G2) who participated from middle adolescence through adulthood, and the 3rd-generation (G3) child between ages 3-5 years and 6-10 years. G1 behavior was examined when G2 was 16 and 18 years old; G2 alcohol problems and marijuana use were assessed when G2 was 19 and 21 years old. G2 emotional distress and harsh parenting were examined when the G3 child was between 3 and 5 years old. Finally, G3 aggression was assessed between 6 and 10 years old. Results showed continuity of G1 behavior when G2 was in adolescence to G2 behavior in adulthood. G1 alcohol problems and G1 harsh parenting were both associated with G3 aggression through G2 alcohol problems, G2 emotional distress, and G2 harsh parenting. Results suggest that G1 problem behavior as experienced by G2 adolescents in the family of origin plays an important role in G2 alcohol problems in emerging adulthood, which leads to G2 emotional distress and G2 harsh parenting in adulthood, which is related to G3 aggression in the early elementary school years. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Short- and Long-Term Effects of Cannabis on Headache and Migraine

Use of cannabis to alleviate headache and migraine is relatively common, yet research on its effectiveness remains sparse. We sought to determine whether inhalation of cannabis decreases headache and migraine ratings as well as whether gender, type of cannabis (concentrate vs flower), delta-9-tetrahydrocannabinol, cannabidiol, or dose contribute to changes in these ratings. Finally, we explored evidence for tolerance to these effects. Archival data were obtained from Strainprint, a medical cannabis app that allows patients to track symptoms before and after using different strains and doses of cannabis. Latent change score models and multilevel models were used to analyze data from 12,293 sessions where cannabis was used to treat headache and 7,441 sessions where cannabis was used to treat migraine. There were significant reductions in headache and migraine ratings after cannabis use. Men reported larger reductions in headache than women and use of concentrates was associated with larger reductions in headache than flower. Further, there was evidence of tolerance to these effects. PERSPECTIVE: Inhaled cannabis reduces self-reported headache and migraine severity by approximately 50%. However, its effectiveness appears to diminish across time and patients appear to use larger doses across time, suggesting tolerance to these effects may develop with continued use.

Examining the Roles of Heavy Episodic Drinking, Drinking Venues, and Sociosexuality in College Men's Sexual Aggression

OBJECTIVE

College men's alcohol consumption is positively associated with sexual aggression perpetration, yet men's drinking does not typically predict later sexual assault after accounting for risk factors, such as impersonal sexuality. In the present study, we tested an indirect effects model whereby college men's impersonal sex orientation and heavy episodic drinking (HED) were hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).

METHOD

Freshman males (N = 1,043) were recruited to participate in a five-semester study. Key measures included the Sociosexuality Index as a measure of impersonal sex attitudes and behaviors, frequency of HED, and frequency of attending drinking venues (parties, bars). The dichotomous outcome measure was based on the Sexual Strategies Survey, a measure of tactics used to convince a female partner to have sex. Structural equation modeling was used to examine whether sociosexuality attitudes, sociosexuality behaviors, and HED (all measured at Wave 1) would have direct and indirect effects on use of Wave 5 sexual aggression tactics, through effects on Wave 3 venue attendance.

RESULTS

The model supported the hypothesized indirect effects of sociosexuality and HED via men's subsequent drinking venue attendance and was preferred over alternative models.

CONCLUSIONS

College men who more frequently attended drinking "hot spots" were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault. Findings also help to explicate the mechanism underlying the robust role of impersonal sex orientation in sexual aggression.

A Mixed Methods Cross-Cultural Study to Compare Youth Drinking Cultures in Italy and the USA

AIMS

To compare the drinking cultures of youth in the USA and in Italy.

METHOD

Sequential explanatory mixed method design. Phase 1: Multigroup latent class analysis was used to identify subgroups of drinkers from samples of 424 (61.3% female) Italian and 323 American college students (57.3% female). Phase 2: Focus group interviews with 41 Italian and 47 American youth were used to collect narratives on features of the two drinking cultures.

RESULTS

Four partially invariant subgroups of drinkers were found. Most participants (>75%) in both countries concentrated drinking during weekends. Overall, US drinkers displayed greater probabilities to report risky drinking behaviors and experience negative consequences as compared to comparable subgroups of Italian drinkers. Discrepancies in terms of socialisation processes during childhood (i.e. permissiveness) and underlying cultural assumptions with regard to alcohol consumption (i.e. purposes of alcohol use) may explain differences in how alcohol is used in the two countries.

CONCLUSIONS

Findings suggest that there are crucial differences in societal schema of beliefs, informal social norms, practices, and values attached to alcoholic beverages across the USA and Italy. These results demonstrate the need for culturally tailored alcohol preventive interventions and clinical practice targeted to young people that capitalise on such differences.

Do Party Schools Report Higher Rates of Violence Against Women in Their Clery Data? A Latent Class Analysis

The current study examined violent crimes against women among 1,384 four-year private and public college campuses using Clery Act data from 2014-2016 (i.e., rape, domestic and dating violence, stalking, and fondling). Latent class analysis (LCA) was used to identify five types of campuses: smaller (22%), liberal arts (25%), satellite (16%), private (19%), and party schools (18%). Smaller schools reported the lowest rates of violence against women (VAW), whereas private schools had significantly higher reported rapes. These findings have important implications for the types of campuses seem to be abiding by Clery law and reporting crimes that involve VAW.

An Examination of Parental Permissiveness of Alcohol Use and Monitoring, and Their Association with Emerging Adult Drinking Outcomes Across College

BACKGROUND

Studies have shown that parents have a significant influence on emerging adult college students' drinking during the first year of college. Limited research has been conducted to address the question of whether parenting later in college continues to matter in a similar manner. The current study utilized a prospective design to identify associations between parental permissiveness toward alcohol use and monitoring behaviors and student drinking outcomes during the first and fourth years of college.

METHODS

Participants (N = 1,429) at 3 large public universities completed surveys during the fall semesters of their first (T1) and fourth years (T2) (84.3% retention). The study employed a saturated autoregressive cross-lag model to examine associations between parental permissiveness of college student alcohol use, parental monitoring, student drinking, and consequences at T1 and T2, controlling for peer norms, sex, and campus.

RESULTS

Examination of the association between parenting and student drinking outcomes revealed: (i) parental permissiveness was positively associated with drinking at T1 and again at T2; (ii) parental permissiveness had indirect effects on consequences via the effects on drinking at both times. Specifically, a 1-unit increase in parental permissiveness at T1 resulted in students experiencing 4 to 5 more consequences as a result of their drinking; (iii) parental permissiveness was not directly associated with monitoring at T1 or T2; and (iv) parental monitoring was significantly associated with drinking at T1 but not T2.

CONCLUSIONS

The findings provide evidence for the continued importance of parenting in the fourth year of college and parents expressing low permissiveness toward student drinking may be beneficial to reducing risky drinking even as students turn 21.

Examining the Roles of Heavy Episodic Drinking, Drinking Venues, and Sociosexuality in College Men's Sexual Aggression

OBJECTIVE

College men's alcohol consumption is positively associated with sexual aggression perpetration, yet men's drinking does not typically predict later sexual assault after accounting for risk factors, such as impersonal sexuality. In the present study, we tested an indirect effects model whereby college men's impersonal sex orientation and heavy episodic drinking (HED) were hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).

METHOD

Freshman males (N = 1,043) were recruited to participate in a five-semester study. Key measures included the Sociosexuality Index as a measure of impersonal sex attitudes and behaviors, frequency of HED, and frequency of attending drinking venues (parties, bars). The dichotomous outcome measure was based on the Sexual Strategies Survey, a measure of tactics used to convince a female partner to have sex. Structural equation modeling was used to examine whether sociosexuality attitudes, sociosexuality behaviors, and HED (all measured at Wave 1) would have direct and indirect effects on use of Wave 5 sexual aggression tactics, through effects on Wave 3 venue attendance.

RESULTS

The model supported the hypothesized indirect effects of sociosexuality and HED via men's subsequent drinking venue attendance and was preferred over alternative models.

CONCLUSIONS

College men who more frequently attended drinking "hot spots" were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault. Findings also help to explicate the mechanism underlying the robust role of impersonal sex orientation in sexual aggression.

Patterns of Alcohol Use in Italian Emerging Adults: A Latent Class Analysis Study

Aims

The goals of the current study were to identify latent classes of alcohol users among Italian emerging adults (18-33 years), examine differences in the class solution based on socio-demographic characteristics, and examine whether differences exist across classes in experiencing different types of alcohol-related negative consequences.

Methods

Participants (N = 5955; 62.72% female; mean age 27.19 years) were drawn from a pre-recruited Web panel designed to be representative of the Italian young adults (18-33 years) population. Latent class analysis (LCA) was used to identify common patterns of alcohol use.

Results

Four classes of drinking patterns were identified: (a) Current Nondrinkers (15%); (b) Weekend Non-Risky Drinkers (51%); (c) Weekend Risky Drinkers (20%); and (d) Daily Drinkers (13%). The number and type of classes did not differ across several demographic variables, although proportions within classes varied by sex, age, occupation status and geographic area. Weekend Risky Drinkers experienced the greatest number of alcohol-related negative consequences.

Conclusions

The great majority of the sample displayed drinking patterns with relatively infrequent involvement in risky drinking. Preventive interventions should, instead, target those who drink alcohol on weekends only, but show the greatest negative consequences.

Short Summary

Four classes of drinking patterns were identified in a large representative sample of Italian young adults. The great majority of the sample displayed drinking patterns with relatively little involvement in risky drinking, though those misusing alcohol at weekends were at greatest risk to experience alcohol-related negative consequences.

The Effects of Mothers' Protective Parenting and Alcohol Use on Emerging Adults' Alcohol Use: Testing Indirect Effects Through Prototype Favorability Among African American Youth

BACKGROUND

We examined how mothers' protective parenting and alcohol use influenced changes in offspring's heavy drinking among a sample of African American youth. The conceptual model also tested indirect effects of mothers' behaviors, through changes in the youths' social images (i.e., prototypes) of heavy drinkers, derived from the prototype willingness (PW) model.

METHODS

Participants were 686 emerging adults (55% female) from the Family and Community Health Study (FACHS), an ongoing prospective study of African American families. Three waves of FACHS data were used as follows: T3 during 10th grade (M age = 16.3 years), T4 shortly after high school (M age = 19.4 years), and T5 3 years later (M age = 22.1 years). Mothers' self-reports of protective parenting and alcohol use were assessed at T4. Two separate path models tested the study hypotheses. The first model specified direct and indirect effects of mothers' protective parenting and alcohol use. The second model added interaction terms between the protective parenting behaviors and mothers' alcohol use. The analyses were first conducted using the full sample and then repeated separately for female and male participants.

RESULTS

Maternal alcohol use had a positive and direct effect on offspring's alcohol use. Mothers' endorsement of alcohol-related rules inhibited normative increases in the favorability of the offspring's social image of heavy drinkers (prototype) while her warmth was positively related to these increases. Maternal alcohol use amplified the positive association between mothers' warmth and the daughters' increased drinking. For sons, maternal alcohol use increased the positive association between alcohol-related rules and increased prototype favorability.

CONCLUSIONS

Results indicated clear gender differences in how mothers' behaviors influence her offspring's alcohol use during the transition to emerging adulthood. Interventions that target culturally specific risk and protective factors within the family environment are needed to reduce health disparities among this vulnerable population of youth.

Alcohol Consumption and Use of Sexual Assault and Drinking Protective Behavioral Strategies: A Diary Study

Heavy drinking is a risk factor for sexual assault. Although protective behavioral strategies (PBS) tend to be associated with reduced alcohol consumption, there are studies showing differential benefits for using these strategies. The current study extended the research on PBS and drinking by examining daily associations between alcohol consumption and sexual assault PBS (e.g., letting others know one's whereabouts) versus stopping or limiting drinking PBS (e.g., planning to stop drinking at a predetermined time) and manner of drinking PBS (e.g., avoiding mixing alcohol types). Women who are heavy episodic drinkers attending a northeastern university (N = 69) completed 14 daily reports of alcohol consumption and PBS use. Using multilevel modeling, we examined associations between alcohol consumption and PBS types across days and PBS users. Alcohol consumption increased with greater use of sexual assault PBS and decreased with greater use of stopping or limiting drinking and manner of drinking PBS. Findings suggest differential benefits for specific PBS. Clinicians, teachers, and parents can provide a menu of options for reducing sexual assault risk by encouraging women to use sexual assault and drinking PBS together.

A Web-Based Intervention to Reduce Indoor Tanning Motivations in Adolescents: a Randomized Controlled Trial

Youthful indoor tanning as few as ten sessions can increase the risk of melanoma by two to four times with each additional session adding another 2 % to the risk. Recent research estimates that indoor tanning can be linked to approximately 450,000 cases of skin cancer annually in the USA, Europe, and Australia. Despite these risks, indoor tanning remains popular with adolescents. This study tested the efficacy of a web-based skin cancer prevention intervention designed to reduce indoor tanning motivations in adolescent females. A nationally representative sample of 443 female teens was enrolled from an online panel into a two-arm, parallel group design, randomized controlled trial. Treatment participants received an appearance-focused intervention grounded in established health behavior change models. Controls viewed a teen alcohol prevention website. Outcome variables included willingness and intentions to indoor tan, willingness to sunless tan, and measures of indoor tanning attitudes and beliefs. The intervention decreased willingness and intentions to indoor tan and increased sunless tanning willingness relative to controls. We also examined indirect mechanisms of change through intervening variables (e.g., indoor tanning attitudes, norms, positive and negative expectancies) using the product of coefficient approach. The web-based intervention demonstrated efficacy in changing adolescent indoor tanning motivations and improving their orientation toward healthier alternatives. Results from the intervening variable analyses give guidance to future adolescent skin cancer prevention interventions.

Does Alcohol Contribute to College Men's Sexual Assault Perpetration? Between- and Within-Person Effects Over Five Semesters

OBJECTIVE

The current longitudinal study was designed to consider the time-varying effects of men's heavy episodic drinking (HED) and drinking setting attendance on college sexual assault perpetration.

METHOD

Freshman men (N = 992) were recruited in their first semester and completed online measures at the end of their first five semesters. Using multilevel models, we examined whether men with higher frequency HED (or party or bar attendance) were more likely to perpetrate sexual assault (between-person, Level 2 effect) and whether sexual assault perpetration was more likely in semesters in which HED (or party or bar attendance) was higher than each individual's average (within-person, Level 1 effect).

RESULTS

The between-person effect of HED on sexual assault was not significant after accounting for the between-person effects of antisocial behavior, impersonal sex orientation, and low self-control. The within-person effect of HED on sexual assault perpetration was not significant. However, models substituting frequency of party attendance or bar attendance revealed both between- and within-person effects. The odds of sexual assault were increased for men with higher bar and party attendance than the sample as a whole, and in semesters in which party or bar attendance was higher than their own average. Supplemental analyses suggested that these drinking setting effects were explained by hookups, with sexual assault perpetration more likely in semesters in which the number of hookups exceeded one's own average.

CONCLUSIONS

Findings point toward the importance of drinking contexts, rather than drinking per se, as predictors of college men's sexual assault perpetration.

Cognitions about infant sleep: Interparental differences, trajectories across the first year, and coparenting quality

This study examined mothers' and fathers' beliefs about responding to infant night wakings across the first year of life, changes in those beliefs, and how individual maternal and paternal beliefs and interparental discrepancy in beliefs about responding to infant night wakings related to parents' perceptions of coparenting quality. Participants were 167 mothers and 155 fathers who reported on their own beliefs about responding to infant night wakings and perceptions of coparenting quality when infants were 1, 3, 6, 9, and 12 months old. As predicted, mothers endorsed stronger beliefs about responding more immediately to infant night wakings than fathers, but for both parents these beliefs declined over the first year. Troubled beliefs about responding to infant night wakings predicted worse coparenting quality. In addition, the discrepancy between mothers' and fathers' beliefs predicted coparenting quality such that a larger discrepancy in parents' beliefs about responding to infant night wakings significantly predicted poorer perceptions of coparenting, particularly in the early months, but only when mothers endorsed stronger beliefs than fathers. Results emphasize the importance of communication and concordance in nighttime parenting practices for aspects of parents' coparenting relationship. Future research should consider the importance of examining domain-specific parenting practices and cognitions as well as interparental discrepancies when assessing coparenting quality. (PsycINFO Database Record

Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs

OBJECTIVE

Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD.

METHOD

Participants (n=68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD=2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving.

RESULTS

Greater cravings were observed on days of lower than usual sleep quality (γ₁₀=-0.10, p=0.003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA.

CONCLUSIONS

Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders.

An Examination of the Relationship Between Consequence-Specific Normative Belief Patterns and Alcohol-Related Consequences Among College Students

BACKGROUND

Research has previously identified a high-risk subgroup of college students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). The purpose of this study was to examine the association between consequence-specific normative influences and experiencing multiple and repeated drinking-related consequences using a person-centered approach. Normative subgroups were identified using latent profile analysis (LPA), which were then used to predict MRC group status at 6-month follow-up.

METHODS

First-year college student drinkers (N = 2,024) at a large northeastern university completed online surveys during the fall and spring semesters of their freshman year. Retention was high with 92% of invited participants completing T2, of which the MRC group accounted for 27%.

RESULTS

Three student profiles were identified from LPA on T1 data: Nonpermissive Parents (77%), Positive Peer and Parent Norms (21%), and Permissive Parents (3%). Logistic regression revealed that both the Positive Peer and Parent Norms and Permissive Parents profiles had significantly higher odds of MRC group membership at follow-up (1.81 and 2.78 times greater, respectively).

CONCLUSIONS

The results suggest value in prevention efforts that include normative beliefs about alcohol-related consequences. Further, parental norms in particular have the potential to enhance interventions, especially through direct communication of disapproval for experiencing consequences.

A Dual-Process Examination of Alcohol-Related Consequences Among First-Year College Students

OBJECTIVE

Despite showing reductions in college student drinking, interventions have shown some inconsistency in their ability to successfully decrease consequences. With the goal of improving prevention efforts, the purpose of this study was to examine the role of consequence-specific constructs, in addition to drinking, that influence students' experiences with alcohol-related problems. The study examined how drinking and protective behaviors mediated the relationships between students' willingness to experience consequences, intentions to avoid them, and four categories of alcohol-related problems (physiological, social, sexual, and academic).

METHOD

First-year college student drinkers (n = 2,024) at a large northeastern university completed surveys during the fall and spring of their freshman year.

RESULTS

As expected, different patterns of associations emerged for physiological and nonphysiological consequences. When physiological consequences (e.g., hangover, vomiting) were examined, drinking significantly mediated the effect of willingness on the consequences. Drinking-specific protective behaviors indirectly influenced consequences through drinking behaviors whereas general protective behaviors did not. When nonphysiological (e.g., social, sexual, academic) consequences were examined, drinking and general protective behaviors emerged as significant mediators of the effects of willingness and intentions on the consequences, whereas drinking-specific protective behaviors did not.

CONCLUSIONS

The results suggest that prevention efforts (e.g., personalized feedback) could be tailored to address specific types of protective behaviors as well as specific types of consequences frequently experienced by college students.

Who Will Experience the Most Alcohol Problems in College? The Roles of Middle and High School Drinking Tendencies

BACKGROUND

Previous work examining college drinking tendencies has identified a disproportionately small (20%), but uniquely high-risk group of students who experience nearly 50% of the reported alcohol-related consequences (i.e., the multiple repeated consequences, or MRC, group). With the goal of reducing drinking-related consequences later in college, this study sought to identify potential MRC group members in their first semester by examining: (i) early-risk subgroups based on analysis of early-risk screening constructs (e.g., age of drinking onset, middle school alcohol exposure, high school drinking, and consequences); and (ii) their association with MRC criteria early in the first semester of college.

METHODS

A random sample of 2,021 first-year college student drinkers (56% female) completed a web-based drinking survey in their first semester on campus.

RESULTS

Latent class analysis revealed 4 early-risk subgroups: (i) an early-onset risk group who endorsed early age of drinking onset and engaged in heavy middle and high school drinking (10%); (ii) a late-onset risk group who engaged in weekend drinking and drunkenness and experienced 6 or more unique consequences as seniors in high school (32%); (iii) an early-onset limited risk group who only endorsed early age of onset and middle school drinking (3%); and (iv) a minimal risk group who did not engage in any early-risk behaviors (55%). Members of both the early- and late-onset risk groups had significantly higher odds of MRC membership in their first semester of college (9.85 and 6.79 greater, respectively).

CONCLUSIONS

Results suggest age of onset, middle and high school drinking and drunkenness, and frequency of unique consequences could be particularly useful in brief screening tools. Further, findings support early screening and prevention efforts for MRC membership prior to college matriculation.

Do students use contextual protective behaviors to reduce alcohol-related sexual risk? Examination of a dual-process decision-making model

Recent studies suggest drinking protective behaviors (DPBs) and contextual protective behaviors (CPBs) can uniquely reduce alcohol-related sexual risk in college students. Few studies have examined CPBs independently, and even fewer have utilized theory to examine modifiable psychosocial predictors of students' decisions to use CPBs. The current study used a prospective design to examine (a) rational and reactive pathways and psychosocial constructs predictive of CPB use and (b) how gender might moderate these influences in a sample of college students. Students (n = 508) completed Web-based baseline (mid-Spring semester) and 1- and 6-month follow-up assessments of CPB use; psychosocial constructs (expectancies, normative beliefs, attitudes, and self-concept); and rational and reactive pathways (intentions and willingness). Regression was used to examine rational and reactive influences as proximal predictors of CPB use at the 6-month follow-up. Subsequent path analyses examined the effects of psychosocial constructs, as distal predictors of CPB use, mediated through the rational and reactive pathways. Both rational (intentions to use CPB) and reactive (willingness to use CPB) influences were significantly associated with increased CPB use. The examined distal predictors were found to effect CPB use differentially through the rational and reactive pathways. Gender did not significantly moderate any relationships within in the model. Findings suggest potential entry points for increasing CPB use that include both rational and reactive pathways. Overall, this study demonstrates the mechanisms underlying how to increase the use of CPBs in programs designed to reduce alcohol-related sexual consequences and victimization.

Examination of a dual-process model predicting riding with drinking drivers

BACKGROUND

Nearly 1 in 5 of the fatalities in alcohol-related crashes are passengers. Few studies have utilized theory to examine modifiable psychosocial predictors of individuals' tendencies to be a passenger in a vehicle operated by a driver who has consumed alcohol. This study used a prospective design to test a dual-process model featuring reasoned and reactive psychological influences and psychosocial constructs as predictors of riding with drinking drivers (RWDD) in a sample of individuals aged 18 to 21.

METHODS

College students (N = 508) completed web-based questionnaires assessing RWDD, psychosocial constructs (attitudes, expectancies, and norms), and reasoned and reactive influences (intentions and willingness) at baseline (the middle of the spring semester) and again 1 and 6 months later. Regression was used to analyze reasoned and reactive influences as proximal predictors of RWDD at the 6-month follow-up. Subsequent analyses examined the relationship between the psychosocial constructs as distal predictors of RWDD and the mediation effects of reasoned and reactive influences.

RESULTS

Both reasoned and reactive influences predicted RWDD, while only the reactive influence had a significant unique effect. Reactive influences significantly mediated the effects of peer norms, attitudes, and drinking influences on RWDD. Nearly all effects were constant across gender except parental norms (significant for females).

CONCLUSIONS

Findings highlight that the important precursors of RWDD were reactive influences, attitudes, and peer and parent norms. These findings suggest several intervention methods, specifically normative feedback interventions, parent-based interventions, and brief motivational interviewing, may be particularly beneficial in reducing RWDD.

How much does one more drink matter? Examining effects of event-level alcohol use and previous sexual victimization on sex-related consequences

OBJECTIVE

The first semester of college has been associated with increased drinking and sexual risk. However, it remains unclear why some drinking occasions result in experiencing negative sexual consequences whereas others do not. The current study used a diary-based approach to assess the event-level effect of alcohol use and previous adult/adolescent sexual victimization (PSV) on experiencing negative sex-related consequences in first-year college women.

METHOD

Participants (N=120) provided repeated measures of weekend drinking and sex-related consequences on the Friday and Saturday nights of six different weekends over the course of their first semester, resulting in 12 measured drinking occasions. A multilevel model was used to assess both between- and within-person effects of alcohol use and between-person effects of PSV on the likelihood of experiencing negative alcohol-related sexual consequences.

RESULTS

Findings revealed an important within-person association, such that every drink consumed above one's mean was associated with a 13% increase in the likelihood of experiencing negative consequences. In addition, PSV had a significant main effect on experiencing negative sex-related consequences. Individuals with PSV experienced nearly 2.5 times more sexual consequences than individuals without PSV.

CONCLUSIONS

These results yield important implications for prevention, particularly with respect to limiting "above average" alcohol consumption among women with a history of sexual victimization.

Optimizing timing and dosage: does parent type moderate the effects of variations of a parent-based intervention to reduce college student drinking?

Research on parent-based interventions (PBIs) to reduce college student drinking has explored the optimal timing of delivery and dosage. The present study extended this work by examining the effectiveness of three different PBI conditions on student drinking outcomes as a function of parenting types and students' pre-college drinking patterns. Four hypotheses were evaluated (early intervention, increased dosage, invariant, and treatment matching risk). A random sample of 1,900 college students and their parents was randomized to four conditions: (1) pre-college matriculation, (2) pre-college matriculation plus booster, (3) post-college matriculation, or (4) control, and was assessed at baseline (summer prior to college) and 5-month follow-up. Baseline parent type was assessed using latent profile analysis (positive, pro-alcohol, positive, anti-alcohol, negative mother, and negative father). Student drinking patterns were classified at baseline and follow-up and included: non-drinker, weekend light drinker, weekend heavy episodic drinker, and heavy drinker. Consistent with the treatment matching risk hypothesis, results indicated parent type moderated the effects of intervention condition such that receiving the intervention prior to college was associated with lower likelihood of being in a higher-risk drinking pattern at follow-up for students with positive, anti-alcohol, or negative father parent types. The findings are discussed with respect to optimal delivery and dosage of parent-based interventions for college student drinking.

Moderating effects of positive parenting and maternal alcohol use on emerging adults' alcohol use: does living at home matter?

Positive parenting behaviors and parental modeling of alcohol use are consistent predictors of offspring's alcohol use. Recent research extends these findings to emerging adult children and confirms continued parental influence beyond adolescence. This paper examines how maternal warmth and supervision moderate the effects of mother's heavy alcohol use on their offspring's alcohol use among a sample of non-college-attending emerging adults. Three-way interactions were used to examine if these moderating effects differed between emerging adults who lived at home and those with other living arrangements. Separate analyses within gender were used to further examine these associations. Participants were 245 emerging adults between ages 18 and 22 years with no post-secondary education (59% female) who were selected from a national probability-based internet panel. Path analyses indicated that, regardless of living arrangements, male emerging adults who were more likely to witness their mother getting drunk were themselves more likely to engage in risky drinking. However, among female emerging adults, similarity between mothers' and daughters' drunkenness was strongest among participants who resided with their family and also reported low levels of maternal warmth. This study extends previous research by indicating that the effects of maternal modeling of heavy alcohol use on emerging adults' heavy alcohol use depend upon several factors, including the gender of the child and the family context. Implications of the study findings are discussed in terms of expanding the scope of a parent-based intervention (PBI) to all emerging adults, including those who do not attend colleges or universities.

Are certain college students prone to experiencing excessive alcohol-related consequences? Predicting membership in a high-risk subgroup using pre-college profiles

OBJECTIVE

Previous research identified a high-risk subgroup of students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). Although they consist of 20% of the population and account for nearly 50% of the consequences, the MRC group has not been the focus of etiological or prevention research. The present study identified pre-college profiles of psychosocial and behavioral characteristics and examined the association between these profiles and membership in the MRC group.

METHOD

The sample consisted of 370 first-year college students (57% female) recruited in the summer before college. Participants reported on typical drinking, alcohol-related risky and protective drinking behaviors, alcohol beliefs, descriptive and injunctive norms, and alcohol-related consequences at three time points over 15 months.

RESULTS

Latent profile analysis identified four baseline student profiles: extreme-consequence drinkers, high-risk drinkers, protective drinkers, and nondrinkers. Logistic regression revealed that, when the high-risk drinkers were used as the reference group, both the protective drinkers and the nondrinkers were significantly less likely to be members of the MRC group, whereas the extreme-consequence drinkers were at increased odds of being in the MRC group, even after first-year drinking was controlled for. Student profiles and previously identified parental profiles both had unique main effects on MRC group membership, but there was no significant interaction between parental and student profiles.

CONCLUSIONS

Findings suggest ways that brief interventions can be tailored for students and parents in relation to the MRC group.

How estimation of drinking influences alcohol-related consequences across the first year of college

BACKGROUND

This study examined how well students estimate their overall drinker type and the relation between the accuracy of this estimation with alcohol-related consequences. The study also explored the association between psychosocial alcohol variables and underestimation or overestimation of drinker type.

METHODS

College students (n = 1,895) completed questionnaires at baseline (precollege matriculation) assessing self-reported drinker types (SI), protective and risky drinking behaviors, drinking expectancies, attitudes, and norms. Postbaseline assessment occurred during the fall semester sophomore year and included the number and type of alcohol consequences experienced during the previous year. Students' SIs were coded as accurate, overestimated, or underestimated relative to their empirically derived latent class analytic drinker class. The association between drinker type accuracy and consequences and membership in the high-risk Multiple and Repeated Consequence group was assessed, as was the relationship between the psychosocial alcohol variables and accuracy.

RESULTS

Eighteen percent of students underestimated and 10% overestimated their drinker type. Students who under- or overestimated their drinker type reported experiencing more consequences, even after controlling for drinking. Increases in positive alcohol expectancies, protective and risky drinking behaviors, and descriptive peer norms were positively associated with underestimation of drinker type. Only protective and risky drinking behaviors were associated with overestimation.

CONCLUSIONS

This study underscores the importance of accurate estimation of drinker type and the risk of experiencing alcohol consequences. Future research and intervention strategies are discussed.

Thursday drinking and academic load among college women

OBJECTIVE

Research indicates that alcohol consumption by college students fluctuates across the semester, with consumption changing because of social events and calendar holidays. In addition, some research indicates that Thursday alcohol consumption is a function of Friday course schedule. Students with courses after 10 a.m. or not at all on Friday are more likely to consume alcohol on Thursday nights. Furthermore, college women are increasingly consuming alcohol at higher levels and comprise a larger portion of college students in comparison with their male counterparts. The current study was aimed at examining patterns of Thursday night alcohol consumption and academic load among female college students.

METHOD

College students (N = 383, 100% female) participated in a 10-week paper- and web-based survey on alcohol consumption. After completion of the study, academic records of the participants were retrieved for objective measures of academic load.

RESULTS

Patterns of Thursday alcohol consumption relate to timing and difficulty of the first course on Friday. However, patterns of Thursday alcohol consumption were not related to other aspects of academic load (e.g., number of academic credits, fall semester grade-point average, cumulative grade-point average, other Friday courses).

CONCLUSIONS

It seems that female students who are more likely to consume alcohol on Thursday night have made academic scheduling decisions to allow for this experience. These decisions seem to not adversely affect their grade-point average. Findings suggest that changes to the academic calendar to curb alcohol consumption warrant further investigation.

Identifying theoretical predictors of risky alcohol use among noncollege emerging adults

OBJECTIVE

Studies show that emerging adults who do not obtain postsecondary education are at greater risk for developing alcohol use disorders later in life relative to their college-attending peers. Research examining constructs amenable to change within this population is necessary to inform intervention efforts. Thus, the current study aimed to identify psychosocial correlates of risky alcohol use for noncollege emerging adults. A secondary goal was to examine whether gender moderated the relationships between the psychosocial constructs and alcohol use.

METHOD

Participants were a nationally representative sample of noncollege emerging adults (18-22 years old) who reported using alcohol in the past year, recruited through an established Internet panel (N = 209; 125 women). A path model was used to examine the relationship between theoretically derived constructs (expectancies, attitudes, normative beliefs) and risky (peak) drinking. A second model examined a multigroup solution to assess moderating effects of gender.

RESULTS

The full-sample model revealed significant associations between attitudes toward drinking and risky drinking. The model assessing gender differences revealed association between normative beliefs and drinking for women but not men, whereas attitudes were significantly associated with risky drinking for both men and women.

CONCLUSIONS

Findings highlight the importance of attitudes and, for women, descriptive norms in the etiology of risky drinking among noncollege emerging adults, which emphasizes their potential utility in the development and adaptation of interventions for this at-risk population.

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.

Patterns of alcohol use and related consequences in non-college-attending emerging adults

OBJECTIVE

Among emerging adults, those who do not attain postsecondary education are at highest risk for experiencing longterm problems related to alcohol use, including alcohol dependence. The purpose of the current study was to identify latent classes of alcohol users among non-college-attending youth and examine correlates of class membership.

METHOD

Screening criteria were used to select emerging adults between ages 18 and 22 years with no postsecondary education (N = 264) from a prerecruited probability-based Web panel. Latent class analysis (LCA) was used to identify common patterns of alcohol use. Grouping variables and demographic variables were added to the LCA model, and rates of alcohol-related consequences across the LCA classes were compared.

RESULTS

Four classes of drinking patterns were identified: (a) current nondrinkers (34%), (b) weekend light drinkers (38%), (c) weekend risky drinkers (23%), and (d) daily drinkers (5%). Class membership was associated with early onset of alcohol use (age 14 or younger), marital status, employment status, and urban residency (area populated by 50,000 or more people). The number of latent classes did not differ across sex and legal drinking age status, although proportions of subjects within classes varied by age. Weekend risky drinkers were most likely to report sickness and feelings of guilt because of drinking, whereas daily drinkers were most likely to report getting into fights, driving a car after drinking, and missing work.

CONCLUSIONS

Similar to college samples of emerging adults, most of this noncollege sample belonged to latent classes defined by rare or moderate alcohol use. Nevertheless, nearly a quarter of the sample reported high-risk drinking behaviors, and a small number reported drinking alcohol on a daily basis. Both of these classes were at elevated risk for experiencing a number of alcohol-related consequences.

Evaluation of timing and dosage of a parent-based intervention to minimize college students' alcohol consumption

OBJECTIVE

The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories.

METHOD

First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration <.08) were used in a latent transition analysis (LTA) to examine a stage-sequential model of drinking. LTA models with dummy-coded intervention variables were used to examine the effects of the intervention conditions on changes in drinking patterns.

RESULTS

Results indicated that four patterns of drinking were present at all waves: (a) nondrinkers, (b) weekend light drinkers, (c) weekend heavy episodic drinkers, and (d) heavy drinkers. Results indicated that the PCM condition was most effective at influencing baseline heavy drinkers' transition out of this pattern to lower risk patterns at first follow-up, whereas the ACM condition was not effective at preventing drinking escalation for baseline nondrinkers at first follow-up. No decay of effects was observed at long-term follow-up for the PCM condition. Finally, the results also indicated that increased dosage of the parental intervention was not significantly associated with either reduction or escalation of use.

CONCLUSIONS

The results underscore the value of pre-college parental interventions and targeted efforts to reduce high-risk drinking among college students.

Moderation of a parent-based intervention on transitions in drinking: examining the role of normative perceptions and attitudes among high- and low-risk first-year college students

BACKGROUND

Parent-based interventions (PBIs) are an effective strategy to reduce problematic drinking among first-year college students. The current study examined the extent to which student-based characteristics, derived from the Theory of Planned Behavior, moderated 3 PBI conditions: (i) prior to college matriculation (PCM); (ii) PCM with a booster during the fall semester; and (iii) after college matriculation. The moderator variables included injunctive and descriptive peer norms about alcohol use and attitudes toward alcohol use.

METHODS

Using data from a randomized control trial delivered to 1,900 incoming college students, we examined differential treatment effects within 4 types of baseline student drinkers: (i) nondrinkers; (ii) weekend light drinkers (WLD); (iii) weekend heavy episodic drinkers; and (iv) heavy drinkers. The outcome variable was based on the transitions in drinking that occurred between the summer prior to college enrollment and the end of the first fall semester and distinguished between students who transitioned to 1 of the 2 risky drinking classes.

RESULTS

The results indicated that injunctive norms (but not descriptive norms or attitudes) moderated the differential effects of the PBI with strongest effects for students whose parents received the booster. Differential effects also depended on baseline drinking class and were most pronounced among WLDs who were deemed "high-risk" in terms of injunctive peer norms.

CONCLUSIONS

Parental influence can remain strong for young adults who are transitioning to college environments, even among students with relatively high peer influence to drink alcohol. Thus, the PBI represents an effective tool to prevent escalation of alcohol use during the first year of college, when risk is highest and patterns of alcohol use are established.

Examining the relationship between alcohol-energy drink risk profiles and high-risk drinking behaviors

BACKGROUND

The mixing of alcohol and energy drinks (AMEDs) is a trend among college students associated with higher rates of heavy episodic drinking and negative alcohol-related consequences. The goals of this study were to take a person-centered approach to identify distinct risk profiles of college students based on AMED-specific constructs (expectancies, attitudes, and norms) and examine longitudinal associations between AMED use, drinking, and consequences.

METHODS

A random sample of incoming freshmen (n = 387, 59% female) completed measures of AMED use, AMED-specific expectancies, attitudes, and normative beliefs, and drinking quantity and alcohol-related consequences. Data were collected at 2 occasions: spring semester of freshmen year and fall semester of sophomore year.

RESULTS

Latent profile analysis identified 4 subgroups of individuals: occasional AMED, anti-AMED, pro-AMED, and strong peer influence. Individuals in the pro-AMED group reported the most AMED use, drinking, and consequences. There was a unique association between profile membership and AMED use, even after controlling for drinking.

CONCLUSIONS

Findings highlighted the importance of AMED-specific expectancies, attitudes, and norms. The unique association between AMED risk profiles and AMED use suggests AMED use is a distinct behavior that could be targeted by AMED-specific messages included in existing brief interventions for alcohol use.

Latent Class Analysis of college women's Thursday drinking

College students drink in consistent patterns over the course of the academic semester and year (Beets et al., 2009; Del Boca et al., 2004). However, it is unclear if there are naturally occurring groups of female Thursday drinkers who display their own unique patterns of drinking across the semester. In a fall semester 10-week mixed online- and paper-based study of college female drinking, classes of Thursday drinkers were identified using Repeated Measures Latent Class Analysis. The 424 participants were recruited via flyers and advertisements in the student newspaper. It was determined that three latent classes provided optimal fit to the data: 1. Unlikely to report Thursday drinking; 2. Normal probability of Thursday drinkers; and 3. High probability of Thursday drinkers. The proportion of students within the latent classes differed across academic year in school. Seniors were least likely to be in the Unlikely group, and juniors and seniors were not in the Normal group. An additional analysis indicated that women in a sorority were four times more likely to be in the Normal or High groups compared to the Unlikely group. A final set of analyses indicated that women who enrolled in Friday morning classes were more likely to be in the Unlikely or Normal groups compared to the High group. Results indicated that the Unlikely group consumed significantly less alcohol at baseline, had lower levels of negative alcohol-related consequences prior to and during the study, and drank less on the weekends (Friday and Saturday). Female students who report drinking on Thursdays tend to be older, to be part of sororities, to have later classes or no classes on Friday, and to experience more negative alcohol-related consequences. Female students whose "weekends" start early are high-risk drinkers and might be targeted for future prevention and intervention efforts.

A multidomain approach to understanding risk for underage drinking: converging evidence from 5 data sets

OBJECTIVES

We examined the independent and combined influence of major risk and protective factors on youths' alcohol use.

METHODS

Five large data sets provided similar measures of alcohol use and risk or protective factors. We carried out analyses within each data set, separately for boys and girls in 8th and 10th grades. We included interaction and curvilinear predictive terms in final models if results were robust across data sets. We combined results using meta-analytic techniques.

RESULTS

Individual, family, and peer risk factors and a community protective factor moderately predicted youths' alcohol use. Family and school protective factors did not predict alcohol use when combined with other factors. Youths' antisocial attitudes were more strongly associated with alcohol use for those also reporting higher levels of peer or community risk. For certain risk factors, the association with alcohol use varied across different risk levels.

CONCLUSIONS

Efforts toward reducing youths' alcohol use should be based on robust estimates of the relative influence of risk and protective factors across adolescent environment domains. Public health advocates should focus on context (e.g., community factors) as a strategy for curbing underage alcohol use.

The community epidemiology of underage drinking: variation across communities in relations of risk to alcohol use

To test the assumption embedded in state-of-the-art, community assessment and decision-making regarding prevention of underage drinking: that there is minimal variation in the way that risk and protective factors (RPF) are associated with underage drinking across communities. Three large datasets provided the same measures of adolescent alcohol use and RPFs. Multilevel ordered-logistic regression models were carried out separately for each dataset and separately for males and females in 8th and 10th grades, testing random slopes for each RPF index. Predicted school-level coefficients were derived from these models, representing the association between RPFs and alcohol use. The variation in associations between RPFs and alcohol use across schools was greatest for antisocial peer risk and community protection; the lowest variation across schools was found for family cohesion and individual antisocial behavior. Ranges in predicted coefficients indicate large differences across schools for many RPFs. Bivariate correlations indicated that school-level associations vary across RPFs in expected directions. Policy makers should recognize that the magnitude of associations between RPFs and adolescent alcohol use vary considerably across communities, and that such variability is greater for certain RPFs than others. These findings have implications for policies regarding how prevention resources are targeted within and across communities.

Do peers' parents matter? A new link between positive parenting and adolescent substance use

OBJECTIVE

Although studies have demonstrated that an adolescent's parents and friends both influence adolescent substance use, it is not known whether the parenting experienced by one's friends also affects one's own use. Drawing on conceptions of shared parenting and the tenets of coercion theory, we investigated the extent to which three domains of parenting behaviors (parental knowledge, inductive reasoning, and consistent discipline) influenced the alcohol, cigarette, and marijuana use of not only their own adolescent children but also of members of their adolescents' friendship groups.

METHOD

Analyses of friendship nominations within each of two successive ninth-grade cohorts in 27 Iowa and Pennsylvania schools (N = 7,439 students, 53.6% female) were used to identify 897 friendship groups. Hierarchical logistic regression models were used to examine prospective associations between 9th-grade friendship group-level parenting behaviors and adolescent self-reported alcohol, cigarette, and marijuana use in 10th grade.

RESULTS

Adolescent substance use in 10th grade was significantly related to parenting behaviors of friends' parents, after controlling for adolescents' reports of their own substance use and their own parents' behaviors at the 9th grade level. These associations were particularly strong for parents' knowledge about their children and use of inconsistent discipline strategies. Significant interaction effects indicated that these relationships were strongest when adolescents received positive parenting at home. Some, but not all, of the main effects of friends' parents' parenting became nonsignificant after friends' substance use in ninth grade was included in the model.

CONCLUSIONS

The findings suggest that the parenting style in adolescents' friends' homes plays an important role in determining adolescent substance use. Implications of the joint contribution of parents and peers for prevention and intervention are discussed.

Predicting alcohol use across adolescence: relative strength of individual, family, peer, and contextual risk and protective factors

The current study examined developmental changes in the relative influence of risk and protective factors (RPFs) across individual, family, peer, school, and community domains on adolescent alcohol use. Using longitudinal data from two independent samples, multivariate cross-lagged models were used to estimate the unique influence of each RPF on subsequent changes in recent alcohol use between early to late adolescence. The results supported the hypothesis that the influence of Individual Risk would increase during this developmental period. However, less consistent evidence was found concerning developmental changes among the other domains. Whereas the influence arising from Family Protection diminished during adolescence, the influence of Family Risk, School Protection, and Community Protection did not vary. The influence of Peer Risk showed a nonlinear pattern across adolescence, peaking during the middle adolescent years. The results of this study support a developmental approach to adolescent alcohol use and emphasize the need for prevention strategies that account for these developmental changes.

Transitions in first-year college student drinking behaviors: does pre-college drinking moderate the effects of parent- and peer-based intervention components?

This study used Latent Transition Analysis (LTA) to examine a stage-sequential model of alcohol use among a sample of high-risk matriculating college students (N=1,275). Measures of alcohol use were collected via web-administered surveys during the summer before entering college and followed-up during the fall semester of college. Seven indicators of alcohol use were used in the LTA models, including temporal measures of typical drinking throughout the week. The results indicated that four latent statuses characterized patterns of drinking at both times, though the proportion of students in each status changed during the transition to college: (a) nondrinkers; (b) weekend nonbingers; (c) weekend bingers; and (d) heavy drinkers. Heavy drinkers were distinguished by heavy episodic drinking (HED), and increased likelihood of drinking throughout the week, especially on Thursdays. Covariates were added to the LTA model to examine the main and interaction effects of parent- and peer-based intervention components. Results indicated that participants in the parent and peer conditions were least likely to transition to the heavy drinkers status. Results also indicated that the parent condition was most effective at preventing baseline nondrinkers from transitioning to heavy drinkers whereas the peer condition was most effective at preventing escalation of use among weekend nonbingers. The results underscore the value of considering multiple dimensions of alcohol use within a person-centered approach. Differential treatment effects were found across baseline drinking class, suggesting the benefit for tailored intervention programs to reduce high-risk drinking among college students.

Is more better? Outcome and dose of a universal drug prevention effectiveness trial

Two evidence-based interventions, Life Skills Training and TimeWise, were combined in an effectiveness trial. Participants were predominately African American youth (N = 715; M (age) = 12). The study authors provide an empirical demonstration of the implications of incorporating dosage information in intervention outcome analyses. Study results showed no program-related benefits for drug use. Results indicated intervention-related benefits for assertiveness and anxiety management skills and drug use intentions as well as a reduction in detrimental leisure motivations. High program exposure and lesson coverage tended to be connected to intervention benefits. Study findings also documented ways that dosage information provides insight into interventions and their effects.

Perceived discrimination as a risk factor for Latina/o youth's substance use: do parent- and peer-based communication and relationship resources act as protective factors?

Based on general strain theory, it was hypothesized that as Latina/o youth experience perceived discrimination, they are more likely to develop acculturation stress and, in turn, more likely to use substances. Two additional hypotheses were set forth to examine how parent- and peer-based communication, relationship, and norm resources may function as buffers, thereby decreasing the likelihood that strained youth will use substances. Latina/o youth (N = 728) from 23 schools in Phoenix, AZ, completed surveys at three waves over 2 years. Structural equation modeling (SEM) results supported the first hypothesis. Yet, contrary to the second hypothesis, neither parent nor peer resources were significant moderators. Implications are discussed for theory and parent- and peer-based prevention research directed at perceived discrimination, acculturation stress, and substance use.

Applying general strain theory to examine perceived discrimination's indirect relation to Mexican-heritage youth's alcohol, cigarette, and marijuana use

Latent growth curve modeling was used to test four hypotheses. First, this study hypothesized that acculturation-related variables (e.g., Mexican-heritage youth's country of origin, time spent in the U.S., and language preference with family and friends) would be associated with initial levels of perceived discrimination. Guided by general strain theory (GST), this study then posed a second hypothesis: Initial levels of perceived discrimination would be indirectly related to initial levels of substance use through initial levels of acculturation stress. Third, this study hypothesized that changes in perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. As a fourth hypothesis, it was postulated that initial levels of perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. Mexican-heritage youth (N = 1,106) from 29 schools in Phoenix, AZ completed surveys at six waves from 5th through 8th grades. In partial support of the first hypothesis, more time spent in the U.S. and speaking English with friends were associated with lower levels of perceived discrimination. The second hypothesis was not supported. Initial levels of perceived discrimination were positively associated with initial levels of acculturation stress; however, this association was not found between initial levels of acculturation stress and substance use. The third and fourth hypotheses were supported, which buttressed predictions derived from GST. Both initial levels and increases in perceived discrimination were indirectly related to increases in substance use through increases in acculturation stress.

Does individual risk moderate the effect of contextual-level protective factors? A latent class analysis of substance use

The current study investigated how individual risk factors interact with social contextual-level protective factors to predict problematic substance use among a sample of 12th-grade students (n = 8,879, 53% female). Results suggested six latent classes of substance use: (1) Non-Users; (2) Alcohol Experimenters; (3) Alcohol, Tobacco, and Other Drug (ATOD) Experimenters; (4) Current Smokers; (5) Binge Drinkers; and (6) Heavy Users. Binary logistic regression models provided evidence that individual risk, family, school, and community protective factors were associated with membership in the substance use latent classes. However, the significance of interaction terms suggested that these protective influences differed according to the level of individual risk. Adolescents with high levels of individual risk benefited less from a positive family or neighborhood context than adolescents with low levels of individual risk. These findings suggest that the individual risk factors may undermine the protective effect of parental supervision, discipline, and other family factors, as well as protective aspects of cohesive neighborhoods, among these adolescents. Multi-component and adaptive intervention efforts that account for different levels of ATOD use involvement, as well as distinct profiles of risk and protection, are likely to be most effective in preventing problematic substance use.