Binge drinking and health behavior in medical students

Gender-Specific Clustering of Lifestyle Behaviors and Its Impacts on Cardiovascular Health

BACKGROUND

Unhealthy lifestyle behaviors associated with cardiovascular risk manifest a clustering pattern.

OBJECTIVE

Our aim was to identify behavioral clusters by using 5 unhealthy lifestyle behaviors among the Korean population and examine the impacts of identified behavioral clusters on cardiovascular health (CVH).

METHODS

A cross-sectional study was conducted using data from the sixth Korea National Health and Nutrition Examination Survey. The participants were 7898, aged 19 to 64 years. The cluster analysis was performed using the behaviors of current smoking, binge drinking, physical inactivity, insufficient fruit intake, and sugar-sweetened beverage drinking. Cardiovascular health was defined as a composite modified z score calculated using biophysical factors.

RESULTS

Men manifested 4 clusters (ie, risky binge drinkers, dominant smokers, dominant sugar-sweetened beverage drinkers, and nonsubstance/low-fruit eaters) characterized predominantly by substance use; women had 4 clusters (ie, substance users, physically inactive/low-fruit eaters, physically inactive/fruit eaters, and active adherers) characterized predominantly by physical inactivity. Among men, the clusters of dominant smokers and risky binge drinkers had significantly lower CVH scores than those with poor eating behaviors. Among women, the clusters of substance users and physically inactive/low-fruit eaters had significantly lower CVH scores than the active adherers. All the clusters in men had lower CVH scores than the worst cluster in women.

CONCLUSIONS

There was a gender difference in the clustering pattern. The clusters with smoking and binge drinking in men and women were associated with negative impacts on CVH. Healthcare professionals should pay attention to the clustering pattern to design an efficient lifestyle intervention for cardiovascular disease prevention.

Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption

(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.

Association between autistic traits and binge drinking: Findings from Japan

PURPOSE

Substance misuse may be elevated in some individuals with autism spectrum disorder (ASD). As yet, however, little is known about the association between autistic traits (AT) and substance use/misuse in adults. This study examined the association between AT and binge drinking (BD) among individuals in Japan.

METHODS

Data were analyzed from 1452 individuals aged 18 and above collected during an online survey in February 2021. Self-reported information was obtained on BD assessed as consuming 5 or more (males) or 4 or more (females) drinks containing any kind of alcohol within a 2-h period. AT were assessed with the Japanese version of the Autism Spectrum Quotient - the AQ-J-10. Logistic regression analysis was used to examine associations.

RESULTS

The prevalence of past-month BD was significantly higher in individuals with AT compared to those without AT (42.7% > 27.6%). In a fully adjusted analysis that controlled for mental health (anxiety, depression) and attention-deficit/hyperactivity disorder symptoms, individuals with AT had significantly higher odds for BD once a week or more often (OR: 1.54, 95%CI: 1.04-2.29). AT were also associated with significantly higher odds for BD among women (OR: 2.27, 95%CI: 1.08-4.76), and those aged 18-34 (OR: 2.37, 95%CI: 1.09-5.18) and aged 60 and above (OR: 2.15, 95%CI: 1.02-4.53).

CONCLUSION

Individuals with AT have higher odds for BD. Increased efforts to detect alcohol use/misuse in adults with AT and AT in adults misusing alcohol may be efficacious in efforts to manage symptoms and eliminate harmful alcohol misuse.

Life in a New Normal with a Self-Care Routine: A Cross-Sectional Study of Older Adults' Daily Health Behaviors (DHB) Performance during the Initial Outbreak of COVID-19 in China

For older adults, self-care begins with daily health behaviors (DHB), which refers to a series of basic behaviors beneficial to health in daily life; it is the foundation for promoting health, preventing disease, and maintaining health with or without the support of a healthcare provider. Thus, this study aimed to observe the changes in DHB among older adults when the COVID-19 pan-demic first erupted in China (at the beginning of 2020) and explore the impact factors on self-care routines in daily life. We applied a cross-sectional study among 1256 (83.7%) valid older Chinese from 19 February 2020 to 19 March 2020, the score of DHB changes (mean ± SD, 14.70 ± 2.140; range, 8−18) presented a significant growth (t1256 = 44.636, p < 0.001) during COVID-19. From 3 hierarchical linear regression models, the older Chinese who received a higher education include high school (β = 0.403, 95% CI [0.009, 0.797], p = 0.045) and college degree and above (β = 0.488, 95% CI [0.034, 0.943], p = 0.035), and lived in the eastern China (β = 0.771, 95% CI [0.392, 1.151], p < 0.001) took DHB more frequently. However, the high-risk infection (β = −0.740, 95% CI [−1.248, −0.231], p = 0.004), overweight/obese character (β = −0.265, 95% CI [−0.526, −0.004], p = 0.047), and alcohol consumption (β = −0.350, 95% CI [−0.634, −0.065], p = 0.016) are significant factors in decreasing a senior’s DHB performance. For China, self-care offers a straightforward strategy among the range of measures required to combat COVID-19 and future health threats. In summary, findings in this study can build a foundation for developing healthcare policy and services for the relevant government and departments on prompting DHB and the importance of self-care among the older population.

What We Talk About When We Talk About Binge Drinking: Towards an Integrated Conceptualization and Evaluation

RATIONALE

Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function.

AIMS

Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach.

METHODS AND CONCLUSIONS

First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.

Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time

BACKGROUND

Health risk behaviors (HRBs) are common, yet not well understood in young adult smokers.

PURPOSE

We examined HRB profiles over 12 months in young adult smokers participating in a Facebook smoking cessation intervention clinical trial.

METHODS

Participants (N = 500; age M = 20.9 years; 54.6% women) were recruited online and randomized to receive either a 3-month Facebook smoking cessation intervention or referral to Smokefree.gov (control). A Health Risk Assessment determined risk for 10 behaviors at baseline and 3, 6, and 12 months. Latent class analysis (LCA) and latent transition analysis (LTA) were used to identify patterns of HRBs and changes over time.

RESULTS

At baseline, participants reported an average of 5.4 (standard deviation [SD] = 1.7) risk behaviors, including smoking (100%), high-fat diet (84.8%), poor sleep hygiene (71.6%), and low fruit and vegetable intake (69.4%). A 3-class model fit the data best at baseline and all follow-up time points: low risk (28.8% at baseline) with low likelihood of risk on all behaviors except smoking, substance use risk (14.0% at baseline) characterized by heavy episodic drinking, cannabis use, and other illicit drug use, and metabolic risk (57.2% at baseline), with a high percentage of members at risk for a low fruit and vegetable intake, high-fat diet, inactivity, stress, and poor sleep hygiene. Classes were very stable at 3, 6, and 12 months, with few participants transitioning between classes.

CONCLUSIONS

Most young adult smokers engaged in multiple risk behaviors, with meaningful clustering of behaviors, and demonstrated stability over a year's time. In addition to smoking, targets for intervention are co-occurring substance use and metabolic risk behaviors.

CLINICAL TRIALS REGISTRATION

NCT02207036.

A systematic review of physical activity, sedentary behavior, and substance use in adolescents and emerging adults

The transition from adolescence into emerging adulthood is marked by changes in both physical activity and substance use. This systematic review characterized associations between movement behaviors (physical activity, sedentary behavior) and frequently used substances (alcohol, cannabis) among adolescents and emerging adults to inform lifestyle interventions that target multiple behavior change outcomes. This systematic review was guided by PRISMA. Electronic databases of PubMed, PsycINFO, and Web of Science were searched from inception through June 25, 2019. The search was designed to identify empirical studies reporting an association between physical activity or sedentary behavior and alcohol or cannabis, with search criteria determining eligibility based on several sampling characteristics (e.g., participants under 25 years of age). After identifying and screening 5,610 studies, data were extracted from 97 studies. Physical activity was positively associated with alcohol use among emerging adults, but the literature was mixed among adolescents. Sedentary behavior was positively associated with alcohol and cannabis use among adolescents, but evidence was limited among emerging adults. Self-report measures were used in all but one study to assess these behaviors. Physical activity is linked to greater alcohol use among emerging adults. Whereas existing studies demonstrate that sedentary behavior might serve as a risk marker for alcohol and cannabis use among adolescents, additional primary research is needed to explore these associations in emerging adults. Future work should also use device-based measures to account for timing of and contextual features surrounding activity and substance use in these populations.

How to Cope with the Challenges of Medical Education? Stress, Depression, and Coping in Undergraduate Medical Students

OBJECTIVES

Up to 90% of medical students experience stress. Studies have observed a relationship between stress and depression. Coping strategies to deal with stress and depression are of great interest. This study aimed to evaluate the prevalence of stress and depression and the efficacy of coping strategies in undergraduate medical students.

METHODS

This survey was conducted with 589 second-year and sixth-year students in 2017 at the Medical University of Vienna. The questionnaire included a stress and coping questionnaire, depression screening, substance use questionnaire, and questionnaire concerning leisure time activities.

RESULTS

The coping strategies were included in a regression model to assess their predictive value for stress and depression screening scores. The most common stressor was performance pressure overload (92.1%). Overall, 52.4% of the participating students reached critical scores in the depression screening. Positive thinking and active coping were associated with lower stress scores. Positive thinking also was a protective factor against depressive symptoms. Less than 2% of all students reached high-risk values for substance use.

CONCLUSION

Accessible counseling for students in need of psychological care should be provided. Different interventions of positive psychology showed a positive impact on depression screening scores.

Patterns of Alcohol Consumption and Drinking Motives Among Korean Medical Students

Background

Physicians who have healthy lifestyles can provide quality healthcare to their patients and keep themselves healthy. There is little data on the prevalence of drinking behaviors and problems among East Asian medical students. Here, we explored alcohol use and drinking motives among medical students in Korea.

Material/Methods

A questionnaire-based, multicenter, cross-sectional study was carried out in 323 students from 5 medical colleges in Korea between July and October 2016. We used the Korean version of the Alcohol Use Disorders Identification Test (AUDIT) and an anonymous, self-administered questionnaire that included demographic characteristics, smoking status, consumption of alcohol, and drinking motives.

Results

The mean AUDIT score was 9.8±7.5 for males and 6.3±5.4 for females. Heavy drinking (75.9%) and binge drinking (56.0%) were very high among Korean medical students. Female medical students drank as much as male students, and much more than other women. The probability that a student would be a binge drinker was 2.72 times higher for a smoker than a non-smoker. The scores for drinking frequency, alcohol intake at one time, heavy drinking, binge drinking, and alcohol dependence symptoms were highest in the group who had “enhancement drinking motives”.

Conclusions

Heavy drinking and binge drinking are common among both male and female medical students in Korea and this behavior is associated with smoking and enhancement drinking motives. Medical schools should consider implementing effective interventions to prevent and reduce problem drinking among medical students.

Type 2 Diabetes Risk Among University Students in Malaysia

BACKGROUND

Type 2 diabetes (T2D) is a preventable condition. Targeting those who are at risk of getting this disease is essential.

OBJECTIVE

To examine T2D risk among university students in Malaysia and determine its relationship with socio-demographic characteristics and physical activity.

METHODS

The study was conducted cross-sectionally on 390 students selected using quota sampling method from 13 faculties in Universiti Kebangsaan Malaysia. A short form of the International Physical Activity Questionnaire and Finnish Diabetes Risk Score were used to measure the physical activity and T2D risk.

RESULTS

The T2D risk was found to be low (M = 5.23, SD = 3.32) with more than two-third of the student population at the low risk level while a significant proportion of 23.8%, 5.6% and 0.3% having slightly elevated, moderate and high risk respectively. The T2D risk was significantly related to their age (rho = 0.197, p < 0.000), gender (U = 12641, p = 0.011), ethnic group (Χ2 = 18.86, p < 0.000), marital status (Χ2 = 6.597, p = 0.037), residence (U = 10345, p = 0.008), academic year (Χ2 = 14.24, p = 0.007) and physical activity (rho = -0.205, p < 0.000 and Χ2 = 13.515, p = 0.001). Of these, only age (β=0.130) and physical activity (β=-0.159) remained significant in the regression analysis.

CONCLUSION

The findings call for a radical change in the nursing practice to target the amendable factors that are significant in order to prevent the progression of the risk towards type 2 diabetes.

A comparison of implicit and explicit reward learning in low risk alcohol users versus people who binge drink and people with alcohol dependence

Chronic alcohol use leads to specific neurobiological alterations in the dopaminergic brain reward system, which probably are leading to a reward deficiency syndrome in alcohol dependence. The purpose of our study was to examine the effects of such hypothesized neurobiological alterations on the behavioral level, and more precisely on the implicit and explicit reward learning. Alcohol users were classified as dependent drinkers (using the DSM-IV criteria), binge drinkers (using criteria of the USA National Institute on Alcohol Abuse and Alcoholism) or low-risk drinkers (following recommendations of the Scientific board of trustees of the German Health Ministry). The final sample (n = 94) consisted of 36 low-risk alcohol users, 37 binge drinkers and 21 abstinent alcohol dependent patients. Participants were administered a probabilistic implicit reward learning task and an explicit reward- and punishment-based trial-and-error-learning task. Alcohol dependent patients showed a lower performance in implicit and explicit reward learning than low risk drinkers. Binge drinkers learned less than low-risk drinkers in the implicit learning task. The results support the assumption that binge drinking and alcohol dependence are related to a chronic reward deficit. Binge drinking accompanied by implicit reward learning deficits could increase the risk for the development of an alcohol dependence.

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Alcohol dependent patients were impaired in implicit and explicit reward learning.

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Alcohol dependence may lead to implicit and explicit reward learning deficits.

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Binge drinkers learned less than low-risk drinkers in the implicit learning task.

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Binge drinking is related to implicit reward learning deficits.

Types of Polydrug Use Among Spanish Students in Health Sciences

Polydrug use among university students may be a predictor for established patterns of multiple substance use and potentially entail long-term health problems. This study examined the types of polydrug use among Spanish students in health sciences. Undergraduate students (n = 968), aged 18-38 years (M = 21.09 years, SD = 4.10), completed the survey. A percentage of 44.3% of the participants were classified as polydrug users. Type A users (alcohol and cigarettes) made up 17.8% of the participants surveyed, whereas 20.1% were Type B (cannabis with cigarettes and/or alcohol), and a further 5.7% were Type C (cannabis with cigarettes and/or alcohol, plus at least another kind of illegal drug). Type A was the most common type among women, whereas Type C was the most common among men. Type B use was higher among women 18-19 years old than among women 25-29 years old, whereas there were no female Type C users younger than 20 years old. Weekend consumption was higher, than weekday consumption, across all polydrug user types and substances. These results suggest that the prevalence of polydrug use among Spanish students in health sciences was similar to students in other disciplines, with Type B as the most prevalent among healthcare and nonhealthcare students. Taking into account the differences based on gender, age, and time of consumption, a specific approach to the different typologies of polydrug users might be a vital step in the successful development of preventive interventions tailored to the changing reality of psychoactive substance use.

Changes and specificities in health behaviors among healthcare students over an 8-year period

BACKGROUND

Healthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors.

OBJECTIVES

To assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students.

METHODS

Two cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs.

RESULTS

2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20-1.83) and AOR = 1.33 CI95% (1.11-1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19-0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students.

CONCLUSION

Our findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare curricula and nursing students demonstrated higher risks. As health behaviors are positively related to favorable attitudes towards preventive counseling, therefore healthcare students should receive training in preventive counseling and develop healthy lifestyles targeted according to the health curriculum.

Licit and illicit substance use patterns among university students in Germany using cluster analysis

BACKGROUND

The use of multiple licit and illicit substances plays an important role in many university students' lives. Previous research on multiple substance use patterns of university students, however, often fails to examine use of different illicit substances and/or hookah. Our objective was to complement and advance the current knowledge about common consumption patterns regarding illicit substances and hookah use in this group.

METHODS

Students from eight German universities completed an online survey as part of the INSIST study ('INternet-based Social norms Intervention for the prevention of substance use among STudents') regarding their consumption of alcohol, tobacco, hookah, cannabis and other illicit substances. Cluster analysis identified distinct consumption patterns of concurrent and non-concurrent substance use and multinomial logistic regressions described key sociodemographic factors associated with these clusters.

RESULTS

Six homogeneous groups were identified: 'Alcohol Abstainers' (10.8%), 'Drinkers Only' (48.2%), 'Drinkers and Cigarette Smokers' (14.6%), 'Cannabis and Licit Substance Users' (11.2%), 'Hookah Users with Co-Use' (9.8%) and 'Illicit Substance Users with Co-Use' (5.4%). Illicit substance use clustered with the consumption of alcohol, tobacco and cannabis. Hookah use was regularly associated with alcohol consumption, less commonly associated with tobacco or cannabis use and very rarely associated with use of other illicit substances. Individuals consuming licit and illicit substances or hookah were mostly male and lived together with other students. Characteristics such as the number of years an individual had spent studying at a university, subject of study, immigrant background and religious affiliation were less commonly associated with cluster membership.

CONCLUSIONS

Although we found substance use patterns in our sample largely similar to previous reports, we identified an important subgroup of individuals using both illicit and licit substances. These individuals may benefit especially from targeted interventions that focus on modifying addictive behavior patterns.

TRIAL REGISTRATION

DRKS00007635 . Registered 17 December 2014 (retrospectively registered).

Distress Response to the Failure to an Insoluble Anagrams Task: Maladaptive Emotion Regulation Strategies in Binge Drinking Students

Background: Emotion regulation refers to the attempt to influence the latency, magnitude, and duration of an emotion, and to modify the experiential, behavioral, or physiological components of the emotional response. In situations of personal failure, individuals, and in particular those who present a tendency to self-focus, may experience intense emotional distress. Individuals who lack proper adaptive emotion regulation strategies may engage in activities leading to immediate pleasure, such as alcohol drinking, in order to escape the self-relevance of emotional experiences. This self-awareness theory of drinking has been shown explain relapses in self-focused alcohol-dependent individuals in situations of personal failure, after detoxification. Such relapses support the existence of maladaptive emotion regulation strategies in alcohol dependence. As binge drinking may be considered as an early stage of alcohol-use-disorder, the aim of this study was to explore the relationship between emotional distress, self-regulation and self-consciousness in binge drinkers (BD). Methods: Fifty-five students (32 BD and 23 controls) completed different questionnaires related to the self (self-consciousness and self-regulation questionnaires) and were exposed to a situation of self-failure (insoluble anagrams). Results: The distress induced by the anagrams task was more related to self-blame, ruminations and maladaptive emotion regulation strategies in BD than in controls. Emotional distress was related to less positive refocusing, refocusing on planning, and adaptive emotion regulation strategies among the control group with less public self-consciousness. Emotional distress was related to more positive refocusing, positive reappraisal, refocusing on planning, and adaptive emotion regulation strategies among control participants with higher public self-consciousness. Low self-conscious BD who experienced anagram distress used less acceptance and less refocusing on planning strategies. Conversely, high self-conscious BD used more refocusing on planning strategies when experiencing anagram distress. Conclusion: This study suggests a relationship between emotional distress and self-regulation, in BD only. Moreover, public self-consciousness appears to be a disposition that motivates non-BD to improve actions and attitudes to meet self-standards. Finally, this study suggests a minor role of self-consciousness in the relationship between self-regulation and emotional distress in BD. Finally, low private/public self-consciousness in the binge drinking group may also be related to more maladaptive emotion regulation strategies.

Does college alcohol consumption impact employment upon graduation? Findings from a prospective study

[Correction Notice: An Erratum for this article was reported in Vol 103(1) of Journal of Applied Psychology (see record 2017-44578-001). In the article, the authors incorrectly used the term "probability" instead of the term "odds" when relating to the impact of drinking in college on post-graduation employment. The abstract should note "a roughly 10% reduction in the odds...", and in the 2nd paragraph of the Discussion section, (a) "a roughly 10% lower probability" should be "a roughly 10% lower odds", and (b) "their probability of full-time employment upon graduation is roughly 6% lower than..." should be "their odds of full-time employment upon graduation is roughly 6% lower than..." All versions of this article have been corrected.] Although scholars have extensively studied the impact of academic and vocational factors on college students' employment upon graduation, we still know little as to how students' health-related behaviors influence such outcomes. Focusing on student alcohol use as a widely prevalent, health-related behavior, in the current study, we examined the employment implications of student drinking behavior. Drawing from literature examining the productivity effects of drinking and research on job search, we posited that modal quantity and frequency of alcohol consumption, as well as the frequency of heavy episodic drinking (HED) adversely impact the probability of employment upon graduation. Using data from 827 graduating seniors from 4 geographically diverse universities in the United States collected in the context of a prospective study design, we found modal alcohol consumption to have no adverse effect on the likelihood of employment upon graduation. However, we did find a significant adverse effect for the frequency of heavy drinking, with the data suggesting a roughly 10% reduction in the odds of employment upon graduation among college seniors who reported engaging in the average level of HED. The theoretical and practical implications of these findings are discussed. (PsycINFO Database Record

Preserved Crossmodal Integration of Emotional Signals in Binge Drinking

Binge drinking is an alcohol consumption pattern with various psychological and cognitive consequences. As binge drinking showed qualitatively comparable cognitive impairments to those reported in alcohol-dependence, a continuum hypothesis suggests that this habit would be a first step toward alcohol-related disorders. Besides these cognitive impairments, alcohol-dependence is also characterized by large-scale deficits in emotional processing, particularly in crossmodal contexts, and these abilities have scarcely been explored in binge drinking. Emotional decoding, most often based on multiple modalities (e.g., facial expression, prosody or gesture), yet represents a crucial ability for efficient interpersonal communication and social integration. The present study is the first exploration of crossmodal emotional processing in binge drinking, in order to test whether binge drinkers already present the emotional impairments described among alcohol-dependent patients, in line with the continuum hypothesis. Twenty binge drinkers and 20 matched controls performed an experimental task requiring the identification of two emotions (happiness or anger) presented in two modalities (visual or auditory) within three conditions (unimodal, crossmodal congruent or crossmodal incongruent). In accordance with previous research in binge drinking and alcohol-dependence, this study was based on two main hypotheses. First, binge drinkers would present a reduced facilitation effect (i.e., classically indexed in healthy populations by faster reaction times when two congruent modalities are presented simultaneously). Second, binge drinkers would have higher difficulties to inhibit interference in incongruent modalities. Results showed no significant difference between groups in emotional decoding ability, whatever the modality or condition. Control participants, however, appeared slower than binge drinkers in recognizing facial expressions, also leading to a stronger facilitation effect when the two modalities were presented simultaneously. However, findings did not show a disrupted facilitation effect in binge drinkers, whom also presented preserved performance to inhibit incongruence during emotional decoding. The current results thus suggest that binge drinkers do not demonstrate a deficit for emotional processing, both in unimodal and crossmodal contexts. These results imply that binge drinking might not be characterized by impairments for the identification of primary emotions, which could also indicate that these emotional processing abilities are well-preserved at early stages of excessive alcohol consumption.

The Role of Friendship Reciprocity in University Freshmen's Alcohol Consumption

BACKGROUND

The similarity of friends in the frequency and quantity of alcohol consumption is explored.

METHOD

During their first semester, 57 psychology freshmen indicated weekly drinking frequency and quantity and nominated the three peers of this group they liked most. These nominations were then used to derive the weekly alcohol consumption of friends that either did or did not reciprocate a nomination.

RESULTS

Multilevel modeling of weekly variations showed that individuals' drinking frequency was similar to peers who reciprocated a friendship (b = 0.15, p = .001), but not to non-reciprocating peers (b = -0.01, p = .720). In contrast, weekly variation in quantity of individual students' drinking was similar to both reciprocating (b = 0.11, p = .018) and non-reciprocating peers' drinking (b = 0.10, p = .014). Yet across all weeks, quantity tended only to be similar to non-reciprocating peers (b = 0.49, p = .020).

CONCLUSIONS

Freshmen might spend drinking time with peers who reciprocate a friendship, but are similar regarding the quantity of drinks consumed to all people they find interesting. Thus, alcohol consumption is used strategically for social purposes. This social purpose should also be acknowledged in alcohol-reduction interventions.

Binging at the campus: Motivations and impulsivity influence binge drinking profiles in university students

This study explored the involvement of two key psychological factors, drinking motives and impulsivity traits, in binge drinking. On the basis of a large screening phase (N=4424), 867 binge drinkers were selected and were first compared with 924 non-binge drinkers. Then, a cluster analysis was performed, focusing on the binge drinker sample, to explore the respective involvement of four drinking motives (DMQ-R model) and four impulsivity facets (UPPS model) in this habit. Centrally, the cluster analysis identified three clusters of binge drinkers presenting distinct psychological characteristics and alcohol consumption patterns: emotional, recreational, and hazardous binge drinkers. Hazardous binge drinkers were characterized by strong drinking motives but moderate impulsivity. Binge drinking should thus no more be considered as a unitary drinking pattern but rather as a habit encompassing a variety of psychological profiles. Moreover, risky drinking habits in young people might be mainly related to disproportionate drinking motives. Future studies should thus consider binge drinking heterogeneity, and prevention programs focusing on drinking motivations should be developed.

Problematic Drinking Among Postgraduate Students: Binge Drinking, Prepartying, and Mixing Alcohol With Energy Drinks

BACKGROUND

Although problematic alcohol use has been studied extensively in undergraduate students, little is known about problematic drinking among postgraduate students.

OBJECTIVES

This study examined binge drinking, prepartying, and mixing alcohol with energy drinks to determine: (1) the extent to which postgraduate students engage in these drinking behaviors, (2) how postgraduate students differ from undergraduate students in these behaviors, and (3) the demographic risk factors for these behaviors in postgraduate (and undergraduate) students.

METHODS

This study utilized data from n = 695 students (n = 298 postgraduate; n = 397 undergraduate) who participated in the Healthy Minds Study at a large, public university in the Midwestern US.

RESULTS

Past-two-week binge drinking, past-year and past-30-day prepartying, and past-30-day mixing alcohol with energy drinks were reported by 26.2%, 28.6%, 14.9%, and 8.1% of postgraduate students, respectively. Multivariate analyses indicated that postgraduate status was a significant negative predictor of binge drinking and prepartying, and that status interacted with age in predicting prepartying such that the effect of age on prepartying was negative for postgraduate students and nonsignificant for undergraduates. Age was a significant negative predictor of mixing alcohol with energy drinks for all students.

CONCLUSIONS/IMPORTANCE

This study makes a unique contribution to the literature by providing information on problematic drinking in postgraduate students. Although there was evidence of "maturing out," a substantial number of postgraduate students were found to engage in binge drinking and prepartying, and a not insubstantial number of them were found to mix alcohol with energy drinks.

[Hazardous drinking in Parisian medical students]

OBJECTIVES

Binge drinking is widespread in medical students but is poorly studied in France. The aim was to evaluate the number of binge drinking episodes and to better characterize them among a sample of French medical students.

METHODS

We carried out a cross-sectional study at Paris VII's Faculty of Medicine. Through a brief self-questionnaire we focused on the prevalence rate of binge drinking in the past two weeks and examined the associations between hazardous drinking and the number of drinks consumed, demographic data (gender, age, familial status and student fraternity membership), clinical aspects (context, intended effects and adverse consequences), tobacco or illegal substances use, and eventual relationship with alcohol or tobacco use disorders.

RESULTS

Among 302 medical students, 74.8% of them experienced at least one binge-drinking episode in the last two weeks. There was no significant difference in demographic data. However, the association between binge drinking and to living alone was borderline significant (P=0.051). Students experienced on mean 2.4 (SD, 1.6) episodes in the last two weeks and their mean maximum number of drinks was equal to 10.3 (SD, 4.6). We observed a significant association between the number binge drinking episodes and the mean maximum consumption of alcohol drinks (P=0.004). The maximum quantity of alcohol drinks was significantly higher (P<0.001) in students who experienced two binge-drinking episodes (mean=11.23, SD=4.56), compared to those who experienced only one episode (mean=9.04, SD=3.96). Binge drinkers were more likely to consume alcohol at a party than at a friendly drink (P=0.029) and more frequently sought drunkenness (P<0.001) and to escape from daily concerns (P=0.004). They experienced more negative events like black-outs (P<0.001), aggressive behaviors (P=0.002), drunk driving (P=0.025), unsafe sexual relationships (P=0.010) and need of emergency responders (P=0.047). Binge drinkers were more likely to simultaneously consume tobacco (P<0.001) or illegal substances (P<0.001), and presented more alcohol use disorder (P<0.001) and tobacco-dependence (P=0.007).

CONCLUSIONS

This first French study in 302 medical students has highlighted the extent of binge drinking in this specific population. The threshold of two binge-drinking episodes in two weeks may be useful to identify a distinctive pattern of consumption and set up adequate prevention actions. Finally binge drinking seemed to be close to an addictive process. Our findings support the need to develop targeted prevention programs in French medical students, which could be designed around several interventions in campuses and student parties. Cohort studies could be necessary to provide an epidemiological follow-up of the French medical student population, particularly about the risk of alcohol use disorder.

The association between medical students' lifestyles and their attitudes towards preventive counseling in different countries

BACKGROUND

Preventive counselling is an effective approach to reducing the prevalence of non-communicable diseases. Studies have shown that there is a positive association between healthy behaviors of Colombian medical students and favorable attitudes towards preventive counselling. However, there is limited research that explores this relationship in different countries. The current study aimed to determine how the health behaviors of medical students from China, U.S., and Australia, are associated with attitudes towards preventive counseling.

METHODS

Students from five Chinese medical schools, Duke University in the U.S., and the University of Queensland in Australia, completed a 32-item, self-reported online survey. The survey was used to examine the prevalence of healthy behaviors and their association with attitudes towards preventive counseling. The target sample size was 150 students from each grade, or 450 students in total from different medical universities. Logistic regression analyses were used to assess the association between health behaviors and attitudes towards preventive counseling, stratified by grade and adjusted by gender.

RESULTS

A positive association was found between healthy behaviors and attitudes towards preventive counseling for all medical students. There are significant differences among medical students' self-reported health behaviors and their attitudes towards preventive counselling from three different countries (P < 0.05). Chinese medical students were more positive in stress control (OR > 1) and more passive in limiting their smoking and alcohol behaviors compared to medical students in Duke University. However, compared to medical students in University of Queensland, five Chinese medical students were more passive in stress control (OR < 1).

CONCLUSION

Based on the finding that healthy behaviors are positively related to favorable attitudes towards preventative counselling, medical students should adopt targeted courses and training in preventive counseling and develop healthy lifestyles.

Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey

This study investigated addictive substance use by French medical students. A cross-sectional survey was distributed to 255 participants randomly selected from 1,021 second- to sixth-year medical students. Questionnaires were self-administered and included questions on sociodemographic characteristics, mental health, and alcohol (The Alcohol Use Disorders Identification Test [AUDIT test]), tobacco (Fagerstrom test), and illegal substance consumption (Cannabis Abuse Screening Test [CAST test]). The AUDIT scores indicated that 11% of the study participants were at risk for addiction and 21% were high-risk users. Tobacco dependence was strong or very strong for 12% of the participants. The CAST score showed that 5% of cannabis users needed health care services. Cannabis users were also more likely than non-users to fail their medical school examinations (89% vs. 39%, p<.01). One quarter of medical student participants (n=41) had used other illegal drugs, and 10% of study participants had considered committing suicide during the previous 12 months. Psychoactive substance consumption by French medical students requires preventive measures, screening, and health care services.

The prevalence of binge drinking and receipt of provider drinking advice among US veterans with military service in Iraq or Afghanistan

BACKGROUND

Binge drinking is a significant public health concern linked to a number of health and psychosocial problems. Military service in Afghanistan (OEF) and Iraq (OIF) has been associated with posttraumatic stress disorder (PTSD) and increased hazardous drinking. Brief alcohol interventions may reduce hazardous drinking but are infrequently provided to at-risk drinkers.

OBJECTIVES

This study examined the association of combat exposure, PTSD symptoms, binge drinking, use of VA and non-VA healthcare services, and the incidence of provider drinking advice.

METHODS

OEF/OIF veterans (n = 1087) completed measures of demographics, military history, combat exposure, PTSD symptoms, and binge drinking as part of a confidential mail survey study conducted in 2009 and 2010 (response rate = 29%). Patient report of receiving advice in the past year from a provider about their drinking was queried for frequent binge drinkers. The association of demographic variables, combat exposure, PTSD, and use of healthcare services with binge drinking and receipt of provider drinking advice was estimated using logistic regression.

RESULTS

Overall, 51% of the sample reported at least one episode of binge drinking in the past year and 19% were identified as frequent binge drinkers. PTSD was related to frequent binge drinking. At-risk veterans using VA healthcare services were significantly more likely to receive provider drinking advice (50%) than veterans not using VA (13.4%).

CONCLUSIONS

There is a need for increased vigilance and action to identify and counsel at-risk veterans about alcohol misuse in this population.

“Social Stuff” and Institutional Micro-Processes

The literature on alcohol consumption among university and residential college students in Australia and comparable countries shows a high incidence of heavy and/or frequent drinking. In this article, we report the findings from a study on alcohol consumption among undergraduate university students living in residential colleges in Australia. The aim of the study was to examine residents’ alcohol use as part of a broader set of institutional practices in higher education that are constructed as central to the student experience. The data were collected through in-depth semistructured interviews with 29 students from seven residential colleges. We found that inclusion of alcohol in many students’ social and extracurricular activities while residing in college is associated with heavy and/or frequent drinking. We suggest that the use of alcohol among students is shaped by the colleges’ institutional micro-processes, leading to a tension between college managements’ aim to foster alcohol citizenship and students’ liberty to engage in frequent and/or heavy drinking.

Trading between healthy food, alcohol and physical activity behaviours

BACKGROUND

While recent lifestyle studies have explored the role that food, alcohol or physical activity have on health and wellbeing, few have explored the interplay between these behaviours and the impact this has on a healthy lifestyle. Given the long term health advantages associated with leading healthier lifestyles, this study seeks to: 1) explore the interplay between the food, alcohol and physical activity behaviours of young adults (aged 19-26 years) in the North East of England; 2) explore the trade-offs young adults make between their food, alcohol and physical activity behaviours; and 3) recognise the positive and negative associations between the three behaviours.

METHODS

Qualitative self-reported lifestyle diaries and in-depth interviews were conducted with 50 young adults from the North East of England between February and June 2008. Qualitative thematic analysis was undertaken using Nvivo QSR software, and diary coding using Windiets software.

RESULTS

Young adults who attempt to achieve a 'healthy lifestyle' make trade-offs between the food and alcohol they consume, and the amounts of physical activity they undertake. There are negative reasons and positive consequences associated with these trade-offs. Young adults recognise the consequences of their behaviours and as a result are prepared to undertake healthy behaviours to compensate for unhealthy behaviours. They prefer certain strategies to promote healthier behaviours over others, in particular those that relate to personalised advice and support, more affordable ways to be healthier and easily-accessed advice from a range of media sources.

CONCLUSIONS

Young adults seek to compensate unhealthy behaviours (e.g. binge drinking) with healthy behaviours (e.g. physical activity). Creative solutions may be required to tackle these trade-offs and promote a balance across the food, alcohol and physical activity behaviours of this age group. Solutions that may be effective with this age group include environmental changes (e.g. green spaces and increasing the price of alcohol) designed to encourage and facilitate young people making healthier choices and improving their access to, and lowering the price of, healthy food products. Solutions must recognise these trade-offs and in particular, the strong reluctance of young adults to alter their higher-than-recommended levels of alcohol consumption.

Prevalence of binge drinking and associated co-factors among medical students in a U.S. Jesuit University

BACKGROUND

Alcohol consumption is the third leading cause of preventable death in the U.S. Limited research has been conducted examining drinking habits of medical students.

OBJECTIVE

This study was designed to measure the prevalence and associated risk factors of binge drinking among a sample of medical students.

METHODS

A total of 485 medical students at a private, Jesuit medical school in the US participated in a confidential web-based survey in April 2011. Univariate and multivariate generalized linear regressions with robust error variance were performed for estimated prevalence ratio (PR) of binge drinking.

RESULTS

The prevalence of binge drinking was 58.1% among the sampled medical students with the majority being white (67.0%) and between 18 and 25 years old (60.0%). After adjusting for age, gender, race/ethnicity, and year in medical school, there were statistically significant (p < 0.05) associations of drinking during an after-exam party (PR = 2.82), protective behavioral strategy (PR = 0.97 per 1-score increase), self-reported diagnosis of depression (PR = 1.19), tobacco use (PR = 1.21 for previous use, 1.39 for current use), and previous illicit drug use (PR = 1.24) with binge drinking. In addition, the prevalence of binge drinking decreased among this sample of the medical students with older age (PR = 0.80 for 26-28, 0.60 for >28, p < 0.01) compared to those of 18-25 years old.

CONCLUSION

Binge drinking was highly prevalent among the sampled medical students, especially during an after-exam party. Identifying healthy coping strategies among medical students is warranted to reduce binge drinking.

Identity and norms: the role of group membership in medical student wellbeing

Medical students experience high levels of mental health problems, which can lead to poor academic performance, substance abuse and burnout. The current paper draws on social psychology to explore the factors underpinning wellbeing in medical students. From the literature it is evident that there is a strong association between group membership and wellbeing. There is also evidence, however, that when the norms of a group prescribe unhealthy behaviours, group members who identify strongly with the group are likely to engage in those behaviours. It was hypothesized that (a) there would be a positive relationship between identification and wellbeing in medical students, (b) perceptions of norms would be positively related to unhealthy behaviour which would be negatively related to wellbeing and (c) identification would be positively related to levels of norm-related unhealthy behaviour. Ninety-two Australian medical students completed measures of identification, endorsement of norms, own behaviour in relation to norms and three indicators of wellbeing. The results supported the first hypothesis and showed only partial support for the second, suggesting a primarily positive role of group processes in medical student wellbeing. The implications for interventions to improve wellbeing in medical schools and directions for future research are discussed.

Beyond prevalence to process: the role of self and identity in medical student well-being

CONTEXT

Problematic stress levels among medical students have been well established. This stress can lead to depression, suicidal ideation, substance abuse, burnout and cynicism, having a negative effect on students and their patients.

METHODS

We propose to move towards examining the processes underlying well-being in some medical students and vulnerability in others. We draw upon social psychological literature to propose that self-complexity, medical student identity and associated norms all have the capacity to influence medical students' well-being in both positive and negative ways.

RESULTS

We identify two key dilemmas facing medical students with regard to the social psychological factors investigated. First, a diverse set of interests and a high level of self-complexity is thought to buffer against the effects of stress and might also be beneficial for medical practitioners, but the intensive nature of medical education makes it difficult for students to pursue outside interests, leading to a strongly focused identity. Second, a strong group identity is associated with high levels of social support and improved well-being, but unhealthy group norms may have a greater influence on individuals who have a strong group identity, encouraging them to engage in behaviours that place their well-being at risk. A model is proposed outlining how these potentially contradictory social psychological processes may combine to impact upon medical students' well-being.

CONCLUSIONS

There is great scope for investigating the role of self-complexity, identity and norms in the medical education context, with room to investigate each of these factors alone and in combination. We highlight how our proposed model can inform medical educators as to the students who may be most vulnerable to the effects of stress and the potential interventions from which they may benefit. We conclude that social psychological factors make a valuable contribution to understanding the complex issue of well-being in medical education.

'Being sick a lot, often on each other': students' alcohol-related provocation

CONTEXT

Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent (n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK.

METHODS

A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation.

RESULTS

Seventy-five per cent (n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% (n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred.

CONCLUSIONS

Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption.

Risky drinking and its detection among medical students

The drinking patterns of physicians may affect their own health and how they treat patients with substance use disorders. This is why we wanted to find out risky drinking among medical students. A questionnaire was delivered to all medical students at the University of Tampere and risky alcohol drinking was defined as a minimum score of five for women and six for men in the AUDIT-C alcohol screen (rating 0 to 12). The respondent rate was 94% (n=465). Of the whole sample 33% were risky drinkers, 24% of women and 49% of men. After the first study year the female risky drinkers significantly decreased and men increased their drinking. Significantly more men but not women with moderate alcohol use reduced drinking during the first year of studies compared with risky drinkers of the same gender. The AUDIT-C scored higher in the subgroups of risky drinkers willing to reduce drinking compared with those who did not want to cut down drinking (7.3. and 6.5., p<0.001). In the male sample the third AUDIT-C sub-question on binge drinking (=AUDIT-3, rating 0 to 4) at a cut-off point of ≥2 was nearly as effective as the whole AUDIT-C at a cut-off point of ≥6. This was not the case in the female sub-sample. Risky drinking is common among medical students and continues throughout the studies especially among men. AUDIT-3 is a short and reliable screening tool for male but not for female students.

Increased cortical activity in binge drinkers during working memory task: a preliminary assessment through a functional magnetic resonance imaging study

BACKGROUND

Cerebral dysfunction is a common feature of both chronic alcohol abusers and binge drinkers. Here, we aimed to study whether, at equated behavioral performance levels, binge drinkers exhibited increased neural activity while performing simple cognitive tasks.

METHODS

Thirty-two participants (16 binge drinkers and 16 matched controls) were scanned using functional magnetic resonance imaging (fMRI) while performing an n-back working memory task. In the control zero-back (N0) condition, subjects were required to press a button with the right hand when the number "2" was displayed. In the two-back (N2) condition, subjects had to press a button when the displayed number was identical to the number shown two trials before.

RESULTS

fMRI analyses revealed higher bilateral activity in the pre-supplementary motor area in binge drinkers than matched controls, even though behavioral performances were similar. Moreover, binge drinkers showed specific positive correlations between the number of alcohol doses consumed per occasion and higher activity in the dorsomedial prefrontal cortex, as well as between the number of drinking occasions per week and higher activity in cerebellum, thalamus and insula while performing the N2 memory task.

CONCLUSIONS

Binge alcohol consumption leads to possible compensatory cerebral changes in binge drinkers that facilitate normal behavioral performance. These changes in cerebral responses may be considered as vulnerability factors for developing adult substance use disorders.

Alcohol-related harm among university students in Hanoi, Vietnam

Introduction and Aim

This study examines the prevalence of and risk factors for alcohol-related harm and types of harm among medical students from Hanoi Medical University (Vietnam). Risk factors include aspects of drinking patterns and relevant socio-demographic variables.

Study Design and Methods

A cross-sectional study involving 1st to 6th year students (N=1216; response rate 96.5%). Of these, 210 students from each academic year were randomly selected from a sampling frame covering all students from each academic year. Data were collected using a questionnaire distributed in class by researchers. Drinkers completed 23 questions on alcohol-related harm categorized into: 1) ‘negative influence on daily activities’; 2) ‘social conflict’; 3) ‘loss of control, acute consequences, and withdrawal’; 4) ‘mental health conditions’; and 5) ‘physical and medical health problems’. Logistic and Poisson regression models were used to identify the predictors of alcohol-related harm and the amount of harm, respectively.

Results

The prevalence of alcohol use associated with at least one or more of the five types of harm was higher in men (81.8%) than in women (60.4%). In female and male students, the most common harm category was ‘loss of control, acute consequences, and withdrawal’ (51.8 and 75.6%, respectively), followed by ‘negative influence on daily activities’ (29.4 and 55.8%, respectively). Age, living away from home, and average number of standard drinks per occasion among male drinkers, and age and frequency of drinking per week among female drinkers were associated with alcohol-related harm.

Conclusions

These data suggest that alcohol-related harm represents a serious public health problem among young educated individuals in Vietnam. The risk factors indicate that prevention should be aimed at aspects of drinking patterns and specific subpopulations defined by gender, age, and (for men only) type of living situation.

The simultaneous presence of health risk behaviors in freshman college students in Brazil

The objective of this study was to assess the prevalence and factors associated with simultaneous health risk behaviors in freshmen college students enrolled in a Brazilian university. We interviewed 738 students (59.2% men) with average age of 20.1 years (CI 95%: 19.8-20.5). The risk behaviors assessed were smoking habit, alcohol use, unhealthy diet and physical inactivity. Independent variables were sex, age, employment, marital status, maternal education, study shift and socioeconomic level. It was found that 8.7% were smokers, 45.9% showed alcohol abuse, 59.4% had inadequate diet and 18.5% were physically inactive. Of the students, 20.2% showed no risk behavior, 39.1% one behavior, 29.0% two risk behaviors and 11.7% three and/or four risk behaviors. Males (OR: 2.04, CI 95%: 1.13-3.67) and night shift students (OR: 1.83, CI 95%: 1.01-3.33) were more likely to have three and/or four risk behaviors. Health promotion interventions focusing simultaneous behavior changes should be employed at the university.

Early attentional modulation by alcohol-related cues in young binge drinkers: an event-related potentials study

OBJECTIVE

Episodic excessive alcohol consumption (i.e., binge drinking) is now considered to be a major concern in our society. Previous studies have shown that alcohol cues can capture attentional resources in chronic alcoholic populations and that the phenomenon is associated with the development and maintenance of alcoholism. Using event-related potentials (ERPs), we investigated the responses of binge drinkers to alcohol-related pictures.

METHODS

Two groups of college students (n=18 in each group) were recruited for the study. One group was composed of binge drinkers and the other of controls. Each student completed a simple visual oddball paradigm in which alcohol-related and non-alcohol-related pictures (positive, neutral or negative) were presented. ERPs were recorded to explore the electrophysiological activity associated with the processing of each cue during the different cognitive steps.

RESULTS

Although there were no behavioural differences between the two groups after detection of alcohol- and non-alcohol-related cues, the ERP data indicated that processing of alcohol-related stimuli was modulated by binge drinking: in the binge drinkers, the P100 amplitudes elicited by the alcohol-related pictures were significantly larger than those elicited by the non-alcohol pictures.

CONCLUSIONS

The present study provides evidence for an early processing enhancement, indexed by increased P100 amplitude, in binge drinkers when confronted with alcohol cues.

SIGNIFICANCE

These findings suggest that higher reactivity to alcohol cues is not a phenomenon limited to adult alcoholics, but that young binge drinkers exhibit signs of prioritizing processing related to alcohol. Prevention intervention for alcohol misuse in young people should consider approaches that address this automatic cue reactivity.

Health behaviors, care needs and attitudes towards self-prescription: a cross-sectional survey among Dutch medical students

Purpose

There is a growing awareness of the potent ways in which the wellbeing of physicians impacts the health of their patients. The purpose of this study was to investigate the health behaviors, care needs and attitudes towards self-prescription of Dutch medical students, and any differences between junior preclinical and senior clinically active students.

Methods

All students (n = 2695) of a major Dutch medical school were invited for an online survey. Physical activity, eating habits, alcohol consumption, smoking, Body Mass Index, substance use and amount of sleep per night were inquired, as well as their need for different forms of care and their attitude towards self-prescription.

Results

Data of 902 students were used. Physical activity levels (90% sufficient) and smoking prevalence (94% non-smokers) were satisfying. Healthy eating habits (51% insufficient) and alcohol consumption (46% excessive) were worrying. Body Mass Indexes were acceptable (20% unhealthy). We found no significant differences in health behaviors between preclinical and clinically active students. Care needs were significantly lower among clinically active students. (p<0.05) Student acceptance of self-prescription was significantly higher among clinically active students. (p<0.001)

Conclusions

Unhealthy behaviors are prevalent among medical students, but are no more prevalent during the clinical study phase. The need for specific forms of care appears lower with study progression. This could be worrying as the acceptance of self-care and self-prescription is higher among senior clinical students. Medical faculties need to address students' unhealthy behaviors and meet their care needs for the benefit of both the future physicians as well as their patients.

Faculty perceptions of appropriate faculty behaviors in social interactions with student pharmacists

OBJECTIVE

To determine faculty and administrator perceptions about appropriate behavior in social interactions between pharmacy students and faculty members.

METHODS

Four private and 2 public colleges and schools of pharmacy conducted focus groups of faculty members and interviews with administrators. Three scenarios describing social interactions between faculty members and students were used. For each scenario, participants reported whether the faculty member's behavior was appropriate and provided reasons for their opinions.

RESULTS

Forty-four percent of those surveyed or interviewed considered interactions between faculty members and pharmacy students at a bar to be a boundary violation. Administrators were more likely than faculty members to consider discussing other faculty members with a student to be a boundary violation (82% vs. 46%, respectively, P <0.009). A majority (87%) of faculty members and administrators considered "friending" students on Facebook a boundary violation.

CONCLUSIONS

There was no clear consensus about whether socializing with students at a bar was a boundary violation. In general, study participants agreed that faculty members should not initiate friendships with current students on social networks but that taking a student employee to lunch was acceptable.

Alcohol consumption among university students in North Rhine-Westphalia, Germany--results from a multicenter cross-sectional study

OBJECTIVE

To assess alcohol use and problem drinking among university students in the German Federal State of North Rhine-Westphalia (NRW) and to examine the associated factors.

METHOD

A multicenter cross-sectional study was conducted in 16 universities in 2006-2007 in NRW by a standardized questionnaire and 3,306 students provided information (response rate of 88%). Problem drinking was measured by the CAGE questionnaire.

RESULTS

Alcohol consumption in the last 3 months was reported by >90 % of students. About 80% reported heavy drinking, and 20% displayed problem drinking. Male students, students living in residence halls, and students from sport faculties had a higher risk of heavy drinking and problem drinking. When students were compared across study years, frequency of heavy drinking decreased with higher semesters.

CONCLUSIONS

Overall, heavy drinking and problem drinking are common among university students in this sample. Intervention programs should be designed for students at a particularly high risk.

Experiences of alcohol-related harassment among medical students

OBJECTIVES

Although fatal accidents caused by alcohol-related harassment occur frequently among college students, this issue has not been adequately examined. This study set out to investigate the prevalence of alcohol-related harassment among medical students in Japan.

METHODS

A multi-institutional, cross-sectional survey was carried out across seven medical schools in Japan. A self-report anonymous questionnaire was distributed to 1152 medical students; 951 respondents (82.6%) satisfactorily completed it. From the responses, we determined the reported prevalences of the following types of alcohol-related harassment among medical students by senior medical students or doctors: (i) being coerced into drinking alcohol; (ii) being compelled to drink an alcoholic beverage all at once (the ikki drinking game); (iii) being deliberately forced to drink until unconscious, and (iv) being subjected to verbal abuse, physical abuse or sexual harassment in relation to alcohol. The prevalence of becoming a harasser among medical students was also measured. Multivariate regressions were used to assess the associations between experiences of alcohol-related harassment and student characteristics.

RESULTS

A total of 821 respondents (86.3%) had experienced alcohol-related harassment and 686 (72.1%) had harassed others. Experiences of the ikki drinking game were frequently reported by both victims (n=686, 72.1% of all respondents) and harassers (n=595, 62.6% of all respondents). In multivariate regression, having an experience of alcohol-related harassment correlated with both being harassed (odds ratio [OR] 14.22, 95% confidence interval [CI] 8.73-23.98) and being a harasser (OR 13.19, 95% CI 8.05-22.34). The presence of senior members of medical college clubs who were regular drinkers also correlated with both being harassed (OR 2.96, 95% CI 1.88-4.67) and being a harasser (OR 2.97, 95% CI 2.06-4.27).

CONCLUSIONS

Alcohol-related harassment among medical students is common and tends to occur at drinking parties with senior college club members. Hence, one of the most important strategies for preventing alcohol-related harassment may be to disrupt this vicious cycle.

Drinking at European universities? A review of students' alcohol use

BACKGROUND

High volumes of alcohol consumption and risky single occasion drinking (RSOD) among university students have been shown to be associated with considerable harm to both those who consume alcohol and their fellow students. The vast majority of these studies are based on US and Canadian samples.

AIM

The present article provides an overview of the characteristics of alcohol-consuming university students in Europe.

METHOD

65 relevant articles published within the last 20years using European student populations could be identified.

RESULTS

Sociodemographic, individual, social, and university-related characteristics associated with alcohol consumption patterns could be identified. Male students, in particular, tended to consume alcohol more often and in higher quantities, including RSOD. Students consumed alcohol chiefly during social gatherings and for social and enhancement motives. Those without family obligations and those living alone, with roommates or in areas with a high density of students were more likely to consume alcohol in higher quantities, and to engage in RSOD. Students tend to overestimate the extent of their fellow students' alcohol consumption.

CONCLUSIONS

Health promotion and prevention efforts which focus on these characteristics (i.e., gender, drinking motives, living conditions and social norms), and which have been successful and evaluated among university students in the US and Canada, may also be very promising for their European counterparts.

Alcohol consumption and alcohol-related problems among Vietnamese medical students

INTRODUCTION AND AIMS

This study examined prevalence and predictors of alcohol consumption and alcohol problems in a sample of medical students in Vietnam.

DESIGN AND METHODS

A cross-sectional survey using a multi-stage cluster sampling approach was conducted in 2007 in two universities in Vietnam. The students (n = 619, 100% response rate) completed questionnaires based on the Alcohol Use Disorder Identification Test. A score of >or=8 defined presence of alcohol problems. Data analyses adjusted for the cluster sampling approach.

RESULTS

Overall 65.5% of students had drunk alcohol during the previous year while alcohol problems were detected in 12.5%. Male students, students who reported that their family members drank and students who reported that their flat mates were drinking were more likely to be current drinkers. Male students were 14.3 times more likely to have an Alcohol Use Disorder Identification Test score of >or=8 compared with female students (P = 0.005).

DISCUSSION AND CONCLUSIONS

Intervention programs focusing on male students and their social environment are warranted. As Vietnamese society rapidly modernises prevention programs for female students may also be needed.