College binge drinking in the 1990s: a continuing problem. Results of the Harvard School of Public Health 1999 College Alcohol Study

Estimates and influences of reflective opposite-sex norms on alcohol use among a high-risk sample of college students: exploring Greek-affiliation and gender effects

Reflective opposite sex norms are behavior that an individual believes the opposite sex prefers them to do. The current study extends research on this recently introduced construct by examining estimates and influences of reflective norms on drinking in a large high-risk heterosexual sample of male and female college students from two universities. Both gender and Greek-affiliation served as potential statistical moderators of the reflective norms and drinking relationship. All participants (N=1790; 57% female) answered questions regarding the amount of alcohol they believe members of the opposite sex would like their opposite sex friends, dates, and sexual partners to drink. Participants also answered questions regarding their actual preferences for drinking levels in each of these three relationship categories. Overall, women overestimated how much men prefer their female friends and potential sexual partners to drink, whereas men overestimated how much women prefer their sexual partners to drink. Greek-affiliated males demonstrated higher reflective norms than non-Greek males across all relationship categories, and for dating partners, only Greek-affiliated males misperceived women's actual preferences. Among women however, there were no differences between reflective norm estimates or the degree of misperception as a function of Greek status. Most importantly, over and above perceived same-sex social norms, higher perceived reflective norms tended to account for greater variance in alcohol consumption for Greeks (vs. non-Greeks) and males (vs. females), particularly within the friend and sexual partner contexts. The findings highlight that potential benefits might arise if existing normative feedback interventions were augmented with reflective normative feedback designed to target the discrepancy between perceived and actual drinking preferences of the opposite sex.

An examination of depressive symptoms and drinking patterns in first year college students

Depression and alcohol use are often found in college students, particularly during their first year. The current study assessed the interrelationship of alcohol use and specific depression symptoms. A large sample (n = 869) of first year students were invited to participate via the Internet. Results indicated that specific depression symptoms correlated with alcohol consumption. Self-reported heavy, problem drinkers experienced significantly higher Beck Depression Inventory scores than all other groups. Our findings highlight the importance of screening for both alcohol use and depressed mood in college students.

An exploratory model of substance use among Asian American women: the role of depression, coping, peer use and Asian values

This study explored the relationship among Asian values, depressive symptoms, perceived peer substance use, coping strategies, and substance use among 167 Asian American college women. More than 66% of the women in our sample scored higher than the clinical cutoff score on the Center of Epidemiological Depression Scale. Three path analyses examining illicit drugs, alcohol use, and binge drinking indicated that perceived peer use was the most robust predictor of substance use. Depressive symptoms were positively associated with illicit drug use and alcohol consumption but were not related to binge drinking. Asian values and coping strategies were not predictive of substance use. Additional analysis revealed that avoidant coping was a strong predictor of depressive symptoms.

The epidemiology of alcohol consumption and misuse among Chinese college students

AIMS

To understand alcohol-related risk behaviours among Chinese college students.

METHODS

As part of the first China National Youth Risk Behaviour Survey, undertaken in 2009, 52,150 students at 119 colleges were randomly sampled. Information was obtained from self-administered questionnaires.

RESULTS

Prevalences were: lifetime drinkers 80.8%, current drinkers 49.3% (drank alcohol in past 30 days) and binge drinkers 23.5% ('binge drinkers' reporting at least five alcoholic drinks on a single occasion at least six times during the past 30 days). Multinomial logistic analysis revealed the contribution of sociodemographic factors to three high-risk drinking behaviours: odds ratio (95% confidence interval) = 3.64 (2.69-4.60) with frequent drinking; 3.27 (1.82-4.72) with binge drinking; and 5.48 (3.20-7.77) with heavy binge drinking. These three rates were greater among males than females, in the Western more than the Eastern region, among students living off-campus and among those whose mothers had higher education. Heavy drinking was linked to lower academic self-rating.

CONCLUSION

There is a trend towards risky drinking among Chinese college students. Measures such as a minimum drinking age, advertisement restrictions, taxation, drunk-driving penalties and campaigns to heighten public awareness of alcohol-related health risks should be instituted in order to improve the situation on college campuses where alcohol abuse is particularly prevalent.

Ethnicity specific norms and alcohol consumption among Hispanic/Latino/a and Caucasian students

Previous research has shown that social norms are among the strongest predictors of college student drinking and that normative misperceptions of more similar groups' drinking behavior may be more influential on individual drinking than those groups perceived to be more different. However, limited research has explored the moderating role of ethnicity in this context. The current study examined the differential impact that Hispanic/Latino/a and Caucasian students' normative perceptions of both typical and same-ethnicity college students' drinking behavior had on their own drinking. Participants (N=5,369 students; 60.4% female; 81.4% Caucasian; mean age 19.9 years) from two colleges completed web-based surveys assessing their alcohol consumption, and their perceptions of the drinking behaviors of both the typical college student and the typical same race/ethnicity college student at their campus. Results demonstrated that perceived norms were significantly associated with likelihood of drinking regardless of race or ethnicity specificity, but that Hispanics/Latinos/as typically had weaker relationships between ethnicity-specific norms and drinking than general student norms and drinking. The opposite was true for Caucasians such that the relationship between same-race norms and drinking was stronger than the relationship between general student norms and drinking. Further, Hispanic/Latino/a students with high perceived norms were less likely to have consumed any alcohol than Caucasians with similar normative beliefs. Further, a campus site interaction suggests that the size of the minority population on campus relative to other students may influence the relationship between norms and drinking. Implications and targets for future investigation are discussed.

Substance use in college students with ADHD

OBJECTIVE

The college years represent a developmental transition during which the initiation and escalation of heavy drinking set the stage for lifelong difficulties with alcohol and other drugs. Evidence from studies of adolescents and young adults with ADHD suggests that college students with the disorder may be uniquely vulnerable to alcohol- and drug-related problems. However, no studies have examined substance use in college students with ADHD.

METHOD

Tobacco, alcohol, illicit drug use, and associated impairment were examined in 91 college students with (n = 53) and without (n = 38) ADHD.

RESULTS

ADHD was associated with increased frequency of tobacco use, higher rates of dangerous or hazardous patterns of alcohol use, and higher levels of impairment related to marijuana and nonmarijuana illicit drug use, independent of conduct disorder history.

CONCLUSION

These findings suggest that college students with ADHD may be at elevated risk for problematic patterns of substance use.

Prevention for college students who suffer alcohol-induced blackouts could deter high-cost emergency department visits

Fifty percent of college students who drink report alcohol-induced blackouts, and alcohol abusers in general put a heavy burden on the medical care system. Using data drawn from a randomized, controlled alcohol intervention trial at five university sites, our study quantified the costs of visits to emergency departments by college students who experienced blackouts from drinking alcohol. Of 954 students in the study, 52 percent of males and 50 percent of females at the outset of the study had experienced an alcohol-induced blackout in the past year. Of 404 emergency department visits among the study participants over a two-year observation period, about one in eight were associated with blackout drinking. Injuries ranged from broken bones to head and brain injuries requiring computed tomography. We calculate that on a large university campus having more than 40,000 students, blackout-associated emergency department visit costs would range from $469,000 to $546,000 per year. We conclude that blackouts are a strong predictor of emergency department visits for college drinkers and that prevention efforts aimed at students with a history of blackouts might reduce injuries and emergency department costs.

An exploratory cluster randomised trial of a university halls of residence based social norms intervention in Wales, UK

Background

Excessive alcohol consumption amongst university students has received increasing attention. A social norms approach to reducing drinking behaviours has met with some success in the USA. Such an approach is based on the assumption that student's perceptions of the norms of their peers are highly influential, but that these perceptions are often incorrect. Social norms interventions therefore aim to correct these inaccurate perceptions, and in turn, to change behaviours. However, UK studies are scarce and it is increasingly recognised that social norm interventions need to be supported by socio ecological approaches that address the wider determinants of behaviour.

Objectives

To describe the research design for an exploratory trial examining the acceptability, hypothesised process of change and implementation of a social norm marketing campaign designed to correct misperceptions of normative alcohol use and reduce levels of misuse, implemented alongside a university wide alcohol harm reduction toolkit. It also assesses the feasibility of a potential large scale effectiveness trial by providing key trial design parameters including randomisation, recruitment and retention, contamination, data collection methods, outcome measures and intracluster correlations.

Methods/design

The study adopts an exploratory cluster randomised controlled trial design with halls of residence as the unit of allocation, and a nested mixed methods process evaluation. Four Welsh (UK) universities participated in the study, with residence hall managers consenting to implementation of the trial in 50 university owned campus based halls of residence. Consenting halls were randomised to either a phased multi channel social norm marketing campaign addressing normative discrepancies (n = 25 intervention) or normal practice (n = 25 control). The primary outcome is alcohol consumption (units per week) measured using the Daily Drinking Questionnaire. Secondary outcomes assess frequency of alcohol consumption, higher risk drinking, alcohol related problems and change in perceptions of alcohol-related descriptive and injunctive norms. Data will be collected for all 50 halls at 4 months follow up through a cross-sectional on line and postal survey of approximately 4000 first year students. The process evaluation will explore the acceptability and implementation of the social norms intervention and toolkit and hypothesised process of change including awareness, receptivity and normative changes.

Discussion

Exploratory trials such as this are essential to inform future definitive trials by providing crucial methodological parameters and guidance on designing and implementing optimum interventions.

Trial registration number

ISRCTN: ISRCTN48556384

Prospective protective effect of parents on peer influences and college alcohol involvement

This prospective study used a conceptually based risk and protective framework to investigate whether parental influences exert a protective effect on the robust association between peer influences and college alcohol involvement. Participants were incoming freshmen in the control condition of a randomized clinical trial, N = 256, 57.0% female, baseline age: M = 18.36 years (SD = 0.41). Participants completed telephone surveys in the summer before matriculation (baseline) and in the spring of the freshman (10-month) and sophomore years (22-month) with 85.6% retention at 22-months. Latent growth models were estimated for heavy episodic drinking and alcohol-related consequences. Descriptive norms and social modeling among peers were positively associated with initial heavy drinking and consequences; parental drinking permissiveness was positively associated with initial heavy drinking. Greater social modeling among peers was associated with less growth in consequences. Parental monitoring was not significantly associated with alcohol involvement. Prematriculation social modeling exhibited a weaker positive association with initial heavy drinking and consequences at low prematriculation parental drinking permissiveness compared to high. Similarly, prematriculation descriptive norms exhibited a weaker positive association with initial heavy drinking at low prematriculation parental drinking permissiveness compared to high. Prematriculation descriptive norms were not significantly associated with growth in heavy drinking at low parental drinking permissiveness; in contrast, higher prematriculation descriptive norms were associated with less growth in heavy drinking at high parental drinking permissiveness. Findings provide support for a protective parental influence on peer-alcohol relations extending into college. Parental drinking permissiveness may be an important target for parent-based interventions.

Alcohol-induced memory blackouts as an indicator of injury risk among college drinkers

BACKGROUND

An alcohol-induced memory blackout represents an amnesia to recall events but does not involve a loss of consciousness. Memory blackouts are a common occurrence among college drinkers, but it is not clear if a history of memory blackouts is predictive of future alcohol-related injury above and beyond the risk associated with heavy drinking episodes.

OBJECTIVE

To determine whether baseline memory blackouts can prospectively identify college students with alcohol-related injury in the next 24 months after controlling for heavy drinking days.

METHODS

Data were analysed from the College Health Intervention Project Study (CHIPS), a randomised controlled trial of screening and brief physician intervention for problem alcohol use among 796 undergraduate and 158 graduate students at four university sites in the USA and one in Canada, conducted from 2004 to 2009. Multivariate analyses used generalised estimating equations with the logit link.

RESULTS

The overall 24-month alcohol-related injury rate was 25.6%, with no significant difference between men and women (p=0.51). Alcohol-induced memory blackouts at baseline exhibited a significant dose-response on odds of alcohol-related injury during follow-up, increasing from 1.57 (95% CI 1.13 to 2.19) for subjects reporting 1-2 memory blackouts at baseline to 2.64 (95% CI 1.65 to 4.21) for students acknowledging 6+ memory blackouts at baseline. The link between memory blackouts and injury was mediated by younger age, prior alcohol-related injury, heavy drinking, and sensation-seeking disposition.

CONCLUSIONS

Memory blackouts are a significant predictor of future alcohol-related injury among college drinkers after adjusting for heavy drinking episodes.

Descriptive drinking norms: For whom does reference group matter?

OBJECTIVE

Perceived descriptive drinking norms often differ from actual norms and are positively related to personal consumption. However, it is not clear how normative perceptions vary with specificity of the reference group. Are drinking norms more accurate and more closely related to drinking behavior as reference group specificity increases? Do these relationships vary as a function of participant demographics? The present study examined the relationship between perceived descriptive norms and drinking behavior by ethnicity (Asian or White), sex, and fraternity/sorority status.

METHOD

Participants were 2,699 (58% female) White (75%) or Asian (25%) undergraduates from two universities who reported their own alcohol use and perceived descriptive norms for eight reference groups: "typical student"; same sex, ethnicity, or fraternity/sorority status; and all combinations of these three factors.

RESULTS

Participants generally reported the highest perceived norms for the most distal reference group (typical student), with perceptions becoming more accurate as individuals' similarity to the reference group increased. Despite increased accuracy, participants perceived that all reference groups drank more than was actually the case. Across specific subgroups (fraternity/sorority members and men) different patterns emerged. Fraternity/sorority members reliably reported higher estimates of drinking for reference groups that included fraternity/ sorority status, and, to a lesser extent, men reported higher estimates for reference groups that included men.

CONCLUSIONS

The results suggest that interventions targeting normative misperceptions may need to provide feedback based on participant demography or group membership. Although reference group-specific feedback may be important for some subgroups, typical student feedback provides the largest normative discrepancy for the majority of students.

Drunkorexia: understanding the co-occurrence of alcohol consumption and eating/exercise weight management behaviors

OBJECTIVE

Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective.

PARTICIPANTS

Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment.

METHODS

Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence.

RESULTS

Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model.

CONCLUSIONS

Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol-activity association among college students.

Individual, interpersonal, and institutional level factors associated with the mental health of college students

OBJECTIVE

This study investigates the individual, interpersonal, and institutional level factors that are associated with overall mental health among college students.

PARTICIPANTS

Data are from an online cross-sectional survey of 2,203 students currently enrolled at a large public university.

METHODS

Mental health was ascertained using a subcomponent of the RAND Medical Outcomes Study functioning and well-being measures developed by the RAND corporation. Stepwise regression was used to determine if self-reported measures of individual (ie, coping abilities), interpersonal (ie, intergroup awareness), and institutional (ie, campus climate/tension) level factors were associated with overall mental health, after controlling for demographic characteristics.

RESULTS

The combined effects of both individual and institutional level measures were associated with student mental health. In particular, limited coping abilities and a perceived racially tense campus climate contributed to the psychological distress of college students.

CONCLUSIONS

Simultaneously addressing the individual and institutional level influences on mental health offers the most promising help for students.

The morning after: alcohol misuse and employment problems

Using a rich, recent, and nationally representative longitudinal survey specifically designed to examine alcohol use and associated problems, we investigate the effects of alcohol misuse on a series of understudied and perhaps less common employment problems. Such problems include being fired or laid off from a job, sustained unemployment, and conflicts with a supervisor and/or co-worker. After controlling for time-invariant omitted variables via fixed effects estimation, we find evidence that three measures of alcohol misuse are significantly related to employment problems. The results offer new information on the potential adverse labor market effects of alcohol misuse and shed light on potential mechanisms through which alcohol misuse may impact intensive labor supply and/or wages.

The sexual assault of undergraduate women at historically Black colleges and universities (HBCUs)

Although research has shown that undergraduate women are at high risk for experiencing sexual assault, little research has been conducted with undergraduate women who are attending a historically Black college or university (HBCU). The purpose of this research is to document the prevalence of different types of sexual assault among undergraduate women at HBCUs and make comparisons to data collected from undergraduate women at non-HBCUs. Data on sexual assault victimization were collected from 3,951 undergraduate women at HBCUs using a cross-sectional, web-based survey. These data are compared to data collected from 5,446 undergraduate women at non-HBCUs using the same research methods. Findings indicate that approximately 9.7% of undergraduate women at HBCUs report experiencing a completed sexual assault since entering college. This rate is considerably lower than the comparable rate obtained from undergraduate women at non-HBCUs (13.7%). This difference seems to be associated with differences in alcohol-use frequency. Perhaps undergraduate women at HBCUs drink alcohol much less frequently and are thus less likely to be sexually assaulted when they are incapacitated and unable to provide consent. Alcohol use frequency, while controlling for other factors, seems to have an independent association with the likelihood of an undergraduate woman being sexually assaulted. Implications for the creation and delivery of sexual assault risk reduction and prevention policies and programs are discussed.

Differential prevalence of alcohol use among 2-year and 4-year college students

PURPOSE

To determine whether alcohol use behaviors and alcohol-related consequences differed among students attending two-year versus four-year colleges.

METHODS

Participants (N=13,700) from 7 two-year and 11 four-year colleges completed the 2010 College Student Health Survey. Alcohol use behaviors included past year alcohol use, past month alcohol use, and binge drinking over the past two weeks. Alcohol-related factors included average calculated blood alcohol level and average number of alcohol-related consequences. Cross-sectional mixed-effects regression analyses were conducted to determine if the prevalence of alcohol-related behaviors and consequences differed among two-year and four-year students.

RESULTS

Students attending four-year colleges, particularly males, were more likely to report past year alcohol use, past month alcohol use, and binge drinking, as well as a higher average blood alcohol content and a greater number of alcohol-related consequences than their two-year counterparts (p<0.05). Among female students there were fewer differences between two-year and four-year college students. Many differences remained after adjusting for socio-demographic factors (e.g., age, race/ethnicity), however, with the addition of living situation as a covariate, several of the differences among males were no longer significant.

CONCLUSIONS

Significant differences in alcohol-related behaviors and consequences exist among students attending two-year versus four-year colleges. While the prevalence of alcohol-related behaviors and consequences was lower among two-year college students, they are not a population to be over-looked. The prevalence of alcohol use remains high among both two-year and four-year college students, making it important for researchers to design appropriate interventions for all students regardless of the type of institution being attended.

Progression to problem drinking among Mexican American and White European first-year college students: a multiple group analysis

OBJECTIVE

Problem drinking during college is a well-known phenomenon. However, predictors of progression to problematic drinking, particularly among ethnic minorities such as Mexican Americans, have received limited research attention.

METHOD

The current study compared the rates and predictors of problem drinking progression from the first to the second year of college among four groups: Mexican American men, Mexican American women, White European men, and White European women (N = 215). At baseline, participants were all first-year college students who scored as nonproblem drinkers on the Young Adult Alcohol Problems Screening Test (YAAPST). Participants were classified as progressors or stable nondrinkers/nonproblem drinkers based on YAAPST scores 12 months later. Hypothesized predictors of progression included behavioral undercontrol, negative emotionality, alcohol use expectancies, and cultural orientation (Mexican American sample only). Differences were anticipated between gender and ethnic groups in both progression rates and predictors of progression.

RESULTS

Twenty-nine percent of the sample progressed to problematic drinking; however, no differences emerged by gender or ethnicity. For the full sample, higher behavioral undercontrol and higher negative emotionality significantly predicted progression. Differences in predictors were not found across gender and ethnic subgroups.

CONCLUSIONS

The hypothesis that rates of progression to problem drinking would differ among the four gender and ethnic groups was not supported. Thus, although White European men are most often identified as at high risk for alcohol use problems, the present findings indicate that women and Mexican American students also should be targeted for prevention and/or intervention.

Cerebral effects of binge drinking: respective influences of global alcohol intake and consumption pattern

OBJECTIVE

Binge drinking is a major health concern, but its cerebral correlates are still largely unexplored. We aimed at exploring (1) the cognitive step at which these deficits appear and (2) the respective influence of global alcohol intake and specific binge-drinking consumption pattern on this deficit.

METHODS

On the basis of a screening phase (593 students), 80 participants were selected and distributed in four groups (control non-drinkers, daily drinkers, low and high binge drinkers). Event-related potentials (ERPs) were recorded while performing a simple visual oddball task.

RESULTS

Binge drinking was associated with massive ERP impairments, starting at the perceptive level (P100/N100 and N170/P2) and spreading through the attentional (N2b/P3a) and decisional (P3b) ones. Moreover, these deficits were linked with global alcohol intake and also with the specific binge-drinking consumption pattern.

CONCLUSIONS

Binge drinkers presented early and global ERP deficits, affecting basic and high-level cognitive stages. Moreover, we showed that binge drinking is deleterious for the brain because of alcohol consumption per se, and also because of its specific consumption pattern.

SIGNIFICANCE

The present results show that binge-drinking habits lead to striking brain consequences, particularly because of the repeated alternation between intense intoxications and withdrawal episodes.

Dating Violence and Substance Use in College Students: A Review of the Literature

Dating violence is a serious and prevalent problem among college-aged dating couples. Although substance use has been shown to be associated with dating violence among college students in empirical studies, the use of substances as they relate to dating violence has yet to be systematically reviewed. The purpose of the present manuscript is to review research on dating violence (perpetration and victimization) and substance use (alcohol and drugs). First, theoretical explanations for the association between substances and dating violence are presented. Second, the literature on substance use and dating violence is reviewed. The literature suggests a consistent association between alcohol and dating violence perpetration and victimization, although the association between drug use and dating violence is less clear. Implications of this review for dating violence prevention programming and future research are discussed.

A latent class analysis of DSM-IV alcohol use disorder criteria and binge drinking in undergraduates

BACKGROUND

Adolescent and adult samples have shown that the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) abuse and dependence criteria lie on a continuum of alcohol problem severity, but information on criteria functioning in college students is lacking. Prior factor analyses in a college sample (Beseler et al., 2010) indicated that a 2-factor solution fit the data better than a single-factor solution after a binge drinking criterion was included. The second dimension may indicate a clustering of criteria related to excessive alcohol use in this college sample.

METHODS

The present study was an analysis of data from an anonymous, online survey of undergraduates (N = 361) that included items pertaining to the DSM-IV alcohol use disorder (AUD) diagnostic criteria and binge drinking. Latent class analysis (LCA) was used to determine whether the criteria best fit a categorical model, with and without a binge drinking criterion.

RESULTS

In an LCA including the AUD criteria only, a 3-class solution was the best fit. Binge drinking worsened the fit of the models. The largest class (class 1, n = 217) primarily endorsed tolerance (18.4%); none were alcohol dependent. The middle class (class 2, n = 114) endorsed primarily tolerance (81.6%) and drinking more than intended (74.6%); 34.2% met criteria for dependence. The smallest class (class 3, n = 30) endorsed all criteria with high probabilities (30 to 100%); all met criteria for dependence. Alcohol consumption patterns did not differ significantly between classes 2 and 3. Class 3 was characterized by higher levels on several variables thought to predict risk of alcohol-related problems (e.g., enhancement motives for drinking, impulsivity, and aggression).

CONCLUSIONS

Two classes of heavy-drinking college students were identified, one of which appeared to be at higher risk than the other. The highest risk group may be less likely to "mature out" of high-risk drinking after college.

The reinforcing value of alcohol in a drinking to cope paradigm

BACKGROUND

Alcohol use is often regarded as a means of coping with sadness and distress. The present research was conducted to explore the relation between negative mood and the reinforcing value of alcohol, while clarifying the role of coping motives.

METHODS

Participants with a history of recent alcohol use (N=44; 72% female) attended a laboratory session and were randomly assigned to either a negative (n=22) or a neutral (n=22) mood condition. A manipulation check confirmed that participants in the negative mood condition, but not the neutral mood condition, displayed a significant increase in negative affect. The multiple choice procedure (MCP) was used to measure the reinforcing value of alcohol after the mood manipulation.

RESULTS

Regression models employing the MCP crossover point as the dependent variable and mood condition (neutral or negative) and drinking to cope as predictors indicated that a model with an interaction term accounted for the most variance.

CONCLUSIONS

These results suggest that the relation between mood and the reinforcing value of alcohol is moderated by drinking to cope, and help clarify the conditions under which drinking to cope may lead to negative outcomes.

Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.

Who is really at risk? Identifying risk factors for subthreshold and full syndrome eating disorders in a high-risk sample

BACKGROUND

Numerous longitudinal studies have identified risk factors for the onset of most eating disorders (EDs). Identifying women at highest risk within a high-risk sample would allow for focusing of preventive resources and also suggests different etiologies.

METHOD

A longitudinal cohort study over 3 years in a high-risk sample of 236 college-age women randomized to the control group of a prevention trial for EDs. Potential risk factors and interactions between risk factors were assessed using the methods developed previously. Main outcome measures were time to onset of a subthreshold or full ED.

RESULTS

At the 3-year follow-up, 11.2% of participants had developed a full or partial ED. Seven of 88 potential risk factors could be classified as independent risk factors, seven as proxies, and two as overlapping factors. Critical comments about eating from teacher/coach/siblings and a history of depression were the most potent risk factors. The incidence for participants with either or both of these risk factors was 34.8% (16/46) compared to 4.2% (6/144) for participants without these risk factors, with a sensitivity of 0.75 and a specificity of 0.82.

CONCLUSIONS

Targeting preventive interventions at women with high weight and shape concerns, a history of critical comments about eating weight and shape, and a history of depression may reduce the risk for EDs.

Heavy episodic drinking in early adulthood and outcomes in midlife

OBJECTIVE

This study assessed to what extent drinking patterns of young adults persist into midlife and whether frequent heavy episodic drinking as a young adult is associated with educational attainment, labor market, and health outcomes at midlife.

METHOD

Using the National Longitudinal Survey of Youth 1979, we grouped individuals into three baseline drinking categories using data on the number of occasions they consumed six or more drinks on one occasion from the 1982-1984 surveys. Categories were frequent heavy episodic drinker, occasional heavy episodic drinker, and other drinker/abstainer. We used propensity score matching to compare baseline drinking groups on midlife alcohol consumption, educational attainment, and labor market and health outcomes.

RESULTS

Frequent heavy episodic drinkers substantially reduced alcohol consumption between baseline and follow-up 25 years later. However, they were much more likely to abuse alcohol and be alcohol dependent in 1994 and be heavy episodic drinkers at the 25-year follow-up compared with the other drinking groups. After matching, there was little indication that being in a higher consumption baseline alcohol group was adversely associated with years of schooling completed by middle age, the probability of being employed, earnings conditional on being employed in midlife, and health problems in midlife. Results on the probability of surviving to follow-up were mixed.

CONCLUSIONS

Frequent heavy episodic drinking at ages 17-25 years was associated with higher rates of alcohol dependence and abuse at a 10-year follow-up and alcohol consumption 25 years following baseline but not with other study outcomes at midlife. Lack of differences in outcomes at midlife may be because of decreased heavy episodic drinking among the heaviest baseline drinkers.

Alcohol mixed with energy drinks: consumption patterns and motivations for use in U.S. college students

Binge drinking in college students is widespread and known to cause significant harms and health hazards for the drinker. One factor that may be exacerbating hazardous drinking in young people is the new popular trend of consuming alcohol mixed with energy drinks (AmED). However, rates of AmED use and motivations for AmED consumption in college students have not been well established. In this study, 706 undergraduate college students from a university in the United States participated in a web-based survey that queried self-reported alcohol, energy drink, and AmED use. In addition, motivations for using AmEDs were assessed. The results indicated that for all participants, 81% reported that they have tried at least one energy drink in the past and 36% reported consumption of at least one energy drink in the past 2 weeks. Alcohol consumption patterns were similar to findings from U.S. national surveys of college drinking, as 37% of respondents were classified as binge drinkers and 23% abstained from drinking. In the whole sample (including the alcohol abstainers), 44% reported trying AmED at least once and 9% reported AmED consumption at least once in the past 2 weeks. 78% of respondents agreed with the statement that AmEDs appeal to underage drinkers. When AmED users were asked about various motivations for consuming AmEDs, users reported that they consumed these beverages to get drunk and reduce sedation compared to alcohol alone. In conclusion, the consumption of AmEDs is common in U.S. college students. Motivations for using AmEDs include the reduction of the sedative effects of alcohol, an important interoceptive cue that one should stop drinking.

HPV vaccination among a community sample of young adult women

OBJECTIVES

Despite the high efficacy of the human papillomavirus (HPV) vaccine, uptake has been slow and little data on psychosocial barriers to vaccination exist.

METHODS

A community sample of 428 women enrolled in a longitudinal study of social development in the Seattle WA metropolitan area were interviewed about HPV vaccine status, attitudes, and barriers to HPV vaccination in spring 2008 or 2009 at ∼age 22.

RESULTS

Nineteen percent of women had initiated vaccination, 10% had completed the series, and ∼40% of unvaccinated women intended to get vaccinated. Peer approval was associated with vaccine initiation (adjusted prevalence ratio (APR) 2.1; 95% confidence interval 1.4-3.2) and intention to vaccinate (APR 1.4; 1.1-1.9). Belief the vaccine is <75% effective was associated with less initiation (APR 0.6; 0.4-0.9) or intention to vaccinate (APR 0.5; 0.4-0.7). Vaccine initiation was also less likely among cigarette smokers and illegal drug users, whereas intention to vaccinate was more common among women currently attending school or with >5 lifetime sex partners, but less common among women perceiving low susceptibility to HPV (APR 0.6; 0.5-0.9).

CONCLUSIONS

HPV vaccination uptake was low in this community sample of young adult women. Increasing awareness of susceptibility to HPV and the high efficacy of the vaccine, along with peer interventions to increase acceptability, may be most effective.

Metacognition, emotion, and alcohol dependence in college students: a moderated mediation model

Based on Wells and Matthews' (1994) theory of psychological dysfunction and prior empirical studies, it was hypothesized that negative emotion would mediate the relationship between maladaptive metacognition and alcohol dependence, and maladaptive metacognition would moderate the relationship between negative emotion and alcohol dependence. A sample of 300 British college students completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, and Meta-Cognitions Questionnaire 30. Metacognitive traits, emotions, and alcohol dependence were positively intercorrelated. Moderated mediation modeling indicated that metacognition fosters emotion and moderates the relationship between emotion and alcohol dependence in such a way that emotion and dependence are positively associated for high metacognition and are negatively associated for low metacognition. The implications of the findings are discussed.

Using personalized feedback to reduce alcohol use among hazardous drinking college students: the moderating effect of alcohol-related negative consequences

Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention.

METHODS

One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored ≥8 on the AUDIT participated in this randomized controlled trial for course credit. Participants were assigned to 1 of 4 conditions in this 2 Intervention (Alcohol Feedback vs. Control)×2 Assessment (Motivational Assessment vs. No Motivational Assessment) between-subjects design. Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables.

RESULTS

Controlling for corresponding baseline alcohol measures, hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences. For those who reported more alcohol consequences at baseline, the alcohol intervention resulted in significantly less alcohol use and fewer heavy drinking episodes at follow-up, while no difference was observed between intervention conditions for those with few baseline consequences. Assessment did not moderate intervention effects.

DISCUSSION

These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences.

Alcohol effects on simulated driving in frequent and infrequent binge drinkers

OBJECTIVE

Compared with non‐bingers, binge drinkers are more likely to drive while intoxicated. The extent to which binge frequency impacts confidence in driving and subsequent driving impairment is unknown. This study compared the effects of an experimenter‐delivered alcohol binge on subjective impairment and simulated driving ability in female high‐frequency and low‐frequency bingers.

METHODS

Female drinkers were assigned to high‐frequency (n = 30) or low‐frequency (n = 30) binge groups based on their Alcohol Use Questionnaire responses. At 30‐min intervals within a 2‐h period, participants received either a placebo drink (n = 15 per group) or a 0.2 g/kg dose of alcohol (n = 15 per group; cumulative dose 0.8 g/kg). Self‐reported impairment, driving confidence, and simulated driving were then measured.

RESULTS

Self‐reported confidence in driving was significantly lower after alcohol than after placebo in low‐frequency but not highfrequency bingers. Self‐reported impairment and collisions during simulated driving were significantly greater after alcohol than after placebo in both low‐frequency and high‐frequency bingers.

CONCLUSIONS

The impairing effects of a single alcohol binge on driving ability in women are not influenced by binge frequency. However, high binge frequency may be associated with a less cautious approach to post‐binge driving.