A systematic review of college student-athlete drinking: Prevalence rates, sport-related factors, and interventions

Drinking among college student athletes during the COVID-19 pandemic

Objective: To investigate demographics, sport type, athletic identity, and COVID-19 sport season cancelation in relation to alcohol consumption among college student athletes shortly after the pandemic emerged. Participants: College student athletes recruited from U.S. athletic departments. Methods: Survey data were collected from 5,915 college student athletes in April/May 2020. Results: Being female, Latinx, and in a relationship were associated with lower alcohol consumption. Among males, team sport participation was related to greater alcohol consumption. Among females, athletic identity was inversely related to drinking, which was moderated by sport type, such that alcohol consumption was lower as athletic identity strengthened in individual (vs. team) sport athletes. However, we did not find a relationship of COVID-19 sport season cancelation with drinking. Conclusions: Our gender-specific findings are novel and generalizable based on a large, national sample of college student athletes, and may inform strategies for alcohol consumption education among college team sport athletes.

Racial, ethnic, and sex differences in heavy drinking and negative alcohol-related consequences in a national sample of NCAA student-athlete drinkers

Objective: Athletic involvement is linked to increased risk for heavy alcohol use among college students. We examined whether student-athletes from diverse racial/ethnic backgrounds differ with respect to heavy drinking and related consequences. Method: Participants were 15,135 student-athlete drinkers (50.7% female) from 170 NCAA member institutions who participated in an online study. Results: Findings from our hierarchical linear models indicated that being a male student-athlete was associated with an increased likelihood of high intensity drinking (10/8 + drinks/per sitting for males/females) for White, Asian American/Pacific Islander, and Black student-athletes, but not for Hispanic student-athletes. Additionally, being a female student-athlete was associated with higher levels of negative alcohol-related consequences across all racial/ethnic groups. Finally, at similar drink quantities, compared to being a White student-athlete, being an Asian American/Pacific Islander student-athlete was associated with higher levels of alcohol-related consequences. Conclusions: Student-athlete drinkers are not homogeneous with respect to heavy drinking and related consequences.

Substance Use and Addiction in Athletes: The Case for Neuromodulation and Beyond

Substance use, misuse and use disorders continue to be major problems in society as a whole and athletes are certainly not exempt. Substance use has surrounded sports since ancient times and the pressures associated with competition sometimes can increase the likelihood of use and subsequent misuse. The addiction field as a whole has very few answers to how to prevent and secondarily treat substance use disorders and the treatments overall do not necessarily agree with the role of being an athlete. With concerns for side effects that may affect performance coupled with organizational rules and high rates of recidivism in the general population, newer treatments must be investigated. Prevention strategies must continue to be improved and more systems need to be in place to find and treat any underlying causes leading to these behaviors. This review attempts to highlight some of the data regarding the field of substance misuse and addiction in the athletic population as well as explore possible future directions for treatment including Neuromodulation methods and Ketamine. There is a need for more rigorous, high-quality studies to look at addiction as a whole and in particular how to approach this vulnerable subset of the population.

Athletes' use of analgesics is related to doping attitudes, competitive anxiety, and situational opportunity

This study aimed to investigate athletes' hypothetical use of non-steroidal anti-inflammatory drugs (NSAIDs), a behavior similar to doping, and its association with doping attitudes, competitive anxiety and situational opportunity. One hundred twenty-two sport science students completed an online survey assessing biographical information, doping attitudes, and competitive anxiety. Students' intention to use analgesics was measured via two different hypothetical situations using the vignette technique. The favorable situation included an absence of potential witnesses and presence of an attractive good whereas witnesses were present in the unfavorable situation and an attractive goal was absent. The results of two hierarchical multiple regression models showed that doping attitudes and competitive anxiety, especially worry, predicted the use of analgesics. In the situation featuring a favorable opportunity, worry was the strongest predictor, whereas in the situation of an unfavorable opportunity, doping attitudes was the strongest predictor for using NSAIDs. Results indicate that NSAID use is associated with positive attitudes toward doping and competitive anxiety, and that it is situationally dependent. Future research perspectives and practical implications are discussed.

A Single Dose of Beer after Moderate Aerobic Exercise Did Not Affect the Cardiorespiratory and Autonomic Recovery in Young Men and Women: A Crossover, Randomized and Controlled Trial

Background: Beer is a choice beverage worldwide and is often consumed after sports for social interaction. Beer has been suggested for hydration after exercise, but the effects on cardiovascular and autonomic systems in men and women after effort are unknown. Objectives: We assessed the effect of beer absorption immediately after moderate exercise on heart rate (HR) variability (HRV) and cardiovascular recovery after effort in women and men separately. Methods: This is a crossover, randomized and controlled trial performed on 15 healthy female and 17 male adults submitted to two protocols on two randomized days: (1) Water (350 mL) and (2) Beer (350 mL). The subjects underwent 15 minutes seated at rest, followed by aerobic exercise on a treadmill (five minutes at 50-55% of maximum HR and 25 min 60-65% of maximum HR) and then remained 3 min stood on treadmill and 57 min seated for recovery from the exercise. Water or beer was consumed between four and ten minutes after exercise cessation. Blood pressure, HR and HRV were evaluated before exercise, during exercise and during recovery from exercise. Results: Systolic and diastolic blood pressure, HRV and HR changes during and following recovery from exercise were similar when women consumed beer or water. HR, systolic and diastolic blood pressures also returned to baseline levels in the beer and water protocols in males. Yet, parasympathetic indices of HRV recovery from exercise were comparable between protocols in males. Conclusions: Ingestion of 300 mL of beer did not significantly affect HRV and cardiovascular parameters following effort. Our data indicate that beer was safe for this population.

Acute effect of physical exercise on negative affect in borderline personality disorder: A pilot study

Background

Physical exercise is an evidence-based treatment to reduce symptoms and negative affect in several psychiatric disorders, including depressive, anxiety, and psychotic disorders. However, the effect of physical exercise on negative affect in patients with borderline personality disorder (BPD) has not yet been investigated. In this pilot study, we tested the safety, acceptability, and potential acute effects on negative affect of a single session of aerobic physical exercise in adults with BPD.

Method

After completing a negative mood induction procedure, 28 adults with BPD were randomly assigned to a 20-minute single session of stationary bicycle or a control condition (emotionally neutral video).

Results

No adverse effects attributed to the physical exercise were reported and it was considered acceptable to patients. Following the negative mood induction, both conditions decreased the level of negative affect with a medium effect size but there was no significant difference between them.

Conclusion

The results suggest that a single 20-minute session of physical exercise does not produce a reduction of negative affect in BPD. Future research should consider the duration and intensities of physical exercise with the greatest potential to reduce negative affect both acutely and in a more prolonged manner in this patient group.

Student awareness of campus medical amnesty policies

ObjectiveExamine students' awareness of medical amnesty policies and the influence of policy awareness on the expected consequences of bystander help seeking in alcohol-related emergencies among student-athletes and non-athletes. Participants: 1,012 college students. Methods: Spearman's correlation and chi-square tests were used to examine accuracy in awareness of amnesty policies. Nominal logistic regression was used to test the relationship between amnesty policy awareness and expected consequences of bystander help seeking. Results: About 25% of students were unsure if their school had an amnesty policy; of these students, 67% attended schools with such a policy. Students who were unsure about the presence of amnesty policies were more likely to expect serious negative consequences of calling for help for both non-athlete peers (B = 1.152 p < 0.001) and student-athlete peers (B = 0.887 p = 0.001). Conclusions: Greater attention is needed to how amnesty policies are implemented on college campuses, including how they are communicated to and interpreted by student-athletes.

Dietary Intakes, Knowledge, and Perceptions of Semi-professional Rugby Athletes in Scotland

Background

Adequate nutritional intake plays a pivotal role in optimizing performance, recovery, and body composition goals. This study aimed to investigate the dietary intakes (DIs); nutritional knowledge (NK); and attitudes, perceptions, and challenges (APC) of semiprofessional rugby players in Scotland.

Methods

Dietary intakes and NK of 24 male semiprofessional rugby players of a Super6 club were evaluated using validated questionnaires. Players were categorized as having good or poor NK according to NK scores. Diet-related APCs were assessed using researcher-developed questionnaires and 1-1 semi-structured interviews.

Results

Mean ± SD total NK% was poor, 53.7 ± 11.9%. The ‘Good’ NK group scored significantly higher in the Weight Management (p = 0.014), Macronutrients (p < 0.001), Micronutrients (p = 0.001), and Sports Nutrition (p < 0.001) sections. Mean DIs from food sources were 26.3 ± 9.2 kcal/kg/day energy, 1.4 ± 0.4 g/kg/day protein, and 21.7 ± 10.1 g/day fibre. Median (25th,75th) carbohydrate intake was 3.0 (2.0, 3.0) g/kg/day, and 6.3 (2.3, 10.6) units/week alcohol. Mean ± SD fat and saturated fat (SFA) % total energy intake (EI) were 36.2 ± 3.7% and 12.8 ± 1.9%, respectively, and SFA %EI exceeded recommendations (p < 0.001). The ‘Good’ NK group had significantly higher intakes of all macronutrients (p < 0.05). Total NK% positively correlated with intakes of meat (r = 0.556, p = 0.011), cereals (r = 0.458, p = 0.042), dietary fat (r = 0.477, p = 0.034), vegetables (r = 0.487, p = 0.030), and alcoholic beverages (r = 0.541, p = 0.014). Supplement use was 68%. Players felt diet affected performance (94%) but 31% of them were unaware of any specific nutritional strategies. A healthy diet was perceived to be ‘balanced’ with ‘variety from all food groups. Lack of time for preparation was described as the main barrier to healthy eating.

Conclusions

Overall, players had poor NK, their fibre and carbohydrate intake was suboptimal, whereas saturated fat intake exceeded recommendations. Many lacked awareness of current sports nutrition guidelines. Further nutrition education may be needed to improve diet quality and aid performance goals.

Do varsity college athletes have a greater likelihood of risky alcohol and cannabis use than non-athletes? Results from a National Survey in Brazil

OBJECTIVE

We examined the prevalence of risky alcohol and cannabis use among Brazilian varsity college athletes and whether this group had a greater likelihood of risky use than non-athletes.

METHODS

In 2009, Brazilian college students (n=12,711) were recruited for a national stratified random survey. Their sociodemographic characteristics, mental health, substance use, and participation in varsity sports were assessed. Binary logistic regression models were used to examine the association between varsity athlete status and moderate to high-risk alcohol and cannabis use.

RESULTS

Among varsity athletes, 67.6 and 10.7% reported risky alcohol and cannabis use, respectively. Varsity athletes had greater odds of risky alcohol consumption than non-athletes (aOR = 2.02, 95%CI 1.08-3.78). Varsity athletes also had greater odds of risky cannabis use than non-athletes in unadjusted analyses (OR = 2.57, 95%CI 1.05-6.28), although this relationship was attenuated after covariate adjustment.

CONCLUSIONS

Among college students in Brazil, varsity athletes had a higher prevalence of risky alcohol and cannabis use than non-athletes. The rates were considerably higher than those observed among samples of U.S. college athletes. Future research should examine the use of these substances among varsity college athletes in other middle-income countries since these findings will likely guide prevention and treatment efforts.

Heavy Drinking among High School Student Athletes and Non-Athletes: Do Differences Emerge as Early as the Ninth Grade?

High school athletes have been identified as a high-risk group for heavy drinking. Little is known, however, about the timing of when student athlete heavy drinking begins to diverge from that of non-athletes. Objectives: The aim of the current study is to examine differences in changes in heavy drinking among ninth grade student athletes and non-athletes across the academic year. We hypothesized that student athletes would report greater increases in heavy drinking compared to non-athletes from fall to spring semester. Ninth grade students (N = 217) aged 13 to 15 completed questionnaires on heavy drinking indices, quantity of peak drinking, frequency of binge drinking, and estimated blood alcohol concentration (eBAC) during the fall and spring semesters. Consistent with our hypothesis, student athletes reported significantly greater increases in heavy drinking compared to non-athletes from fall to spring semester. Additionally, there was a significant increase in all three indices of heavy drinking for student athletes, whereas there were no significant changes for non-athletes. Results demonstrate divergence in the quantity and frequency of heavy drinking between student athletes and non-athletes during the ninth grade. These findings indicate the optimal timing of preventive intervention programs may be different for student athletes and non-athletes. Results also suggest that preventive intervention program targeting heavy drinking should be implemented for high school student athletes as early as the fall semester of the ninth grade when students are transitioning to high school.

Examining Sex Differences in Associations between Pain and Alcohol Use among College Student-Athletes

Background: College student-athletes are a high-risk population for both pain and alcohol use. Although a growing literature indicates that pain motivates alcohol consumption, no studies have tested associations between pain and alcohol in college student-athletes. Methods and Results: Among National Collegiate Athletic Association Division I student-athletes at a large public university (N = 65; 48% Female), nearly all student-athletes (97%) reported alcohol use and 65% reported pain due to an athletic injury. Pain intensity was positively associated with greater motivation to reduce drinking prior to receiving a brief alcohol intervention. Among females, pain intensity was associated with lower self-reported alcohol consumption. Among male athletes, pain-related interference was associated with greater alcohol-related problems and lower perceived ability to deal with alcohol-related situations. Conclusion: Results provide initial evidence that pain may be important to consider when addressing alcohol use among student-athletes.

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Adolescents' beliefs, attitudes and social norms with regard to smoking and sports: a qualitative study

OBJECTIVES

The aim of this study is to explore the beliefs, attitudes and social norms of Dutch adolescents with regard to smoking and sports. In addition, we examine whether there are differences between adolescents at sports clubs with versus without an outdoor smoke-free policy (SFP).

DESIGN

Qualitative design in the form of focus group interviews.

SETTING

Focus group interviews (n=27) were conducted at 16 sports clubs in the Netherlands. Soccer, tennis, field hockey and korfball clubs were included. Focus group discussions were transcribed verbatim and analysed thematically using MAXQDA.

PARTICIPANTS

180 adolescents aged 13-18 years old were included in the study. All participants signed an informed consent form. For participants younger than 16 years, parental consent was required.

RESULTS

With respect to smoking in relation to sports, participants had mostly negative beliefs (ie, smoking has a negative effect on health and sports performance), attitudes (ie, sports and smoking are activities that do not fit together; at sports clubs smoking is not appropriate), and social norms (ie, it is not normal to smoke at sports clubs). The same beliefs, attitudes and social norms were expressed by participants at both sports clubs with and without an outdoor SFP. However, argumentation against smoking was more detailed and more consistent among participants at sports clubs with an outdoor SFP.

CONCLUSION

Adolescents have negative beliefs, attitudes and social norms with regard to smoking in relationship to sports. Outdoor SFP at sports clubs might reinforce these negative associations. These findings point to the potential importance of sports in the prevention of adolescent smoking.

Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage

The rise in energy drink (ED) intake in the general population and athletes has been achieved with smart and effective marketing strategies. There is a robust base of evidence showing that adolescents are the main consumers of EDs. The prevalence of ED usage in this group ranges from 52% to 68%, whilst in adults is estimated at 32%. The compositions of EDs vary widely. Caffeine content can range from 75 to 240 mg, whereas the average taurine quantity is 342.28 mg/100 mL. Unfortunately, exact amounts of the other ED elements are often not disclosed by manufacturers. Caffeine and taurine in doses 3–6 mg/kg and 1–6 g, respectively, appear to be the main ergogenic elements. However, additive or synergic properties between them seem to be implausible. Because of non-unified protocol design, presented studies show inconsistency between ED ingestion and improved physical performance. Potential side effects caused by abusive consumption or missed contraindications are the aspects that are the most often overlooked by consumers and not fully elucidated by ED producers. In this review, the authors aimed to present the latest scientific information on ED components and their possible impact on improving physical performance as well as to bring emphasis to the danger of inordinate consumption.

Overuse Injury, Substance Use, and Resilience in Collegiate Female Athlete

BACKGROUND

Overuse injury is a common stressor experienced by female collegiate athletes and is often underreported. In response, athletes may develop negative coping skills such as substance use. Alternatively, resilience is a modifiable trait that may positively influence response to musculoskeletal injuries and substance use.

PURPOSE

To provide an updated epidemiological profile of overuse injury and substance use and examine the relationship between resilience, overuse injury, and substance use among collegiate female athletes.

DESIGN

Cross-sectional study.

METHODS

Two-hundred and thirty female collegiate athletes were classified into overuse injury and resilience groups. Overuse injury, pain, and substance use incidence proportions (IP) were calculated. Kruskal-Wallis analyses were performed to investigate differences in substance use among resilience groups. Analyses of covariance were performed to evaluate differences in overuse injuries, substantial overuse injuries, and time loss injuries, among resilience groups.

RESULTS

IP for pain was 45.0% (95% CI: 38.2-51.9); Overuse injury 52.0% (45.1-58.9); Alcohol use 35.1% (28.6-41.6); Electronic cigarette use 19.5% (14.6-24.9); Cigarette use 2.8% (6-5.1); and Drug use 3.3% (0.9-5.8). No significant differences were found between resilience groups for the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC) variables (Pain: p=0.102; Overuse injury: p=0.331; Substantial overuse injury: p=0.084; Not playing: p=0.058), alcohol (p=0.723), or combined substance use (p=0.069).

CONCLUSIONS

Pain and overuse injury prevalence is high among female collegiate athletes. Alcohol followed by electronic cigarette use were the most commonly utilized substances. No significant differences were identified in substance use or overuse injury presentation between resilience groups, though further investigation is warranted.

LEVEL OF EVIDENCE

3.

Patterns of health behaviors affecting mental health in collegiate athletes

OBJECTIVE

To examine the association of multiple health behaviors to mental health functioning in male and female collegiate athletes. Participants: Prospective National Collegiate Athletic Association (NCAA) Division I athletes (n = 183) completed a health and wellness survey in the summer prior to joining the athletic program. Methods: Health behaviors (eating, sleeping, substance use, sexual, and aggressive behaviors) and mental health functioning (psychological distress and perceived stress) were assessed. Partial least squares (PLS) modeling was used as a multivariate approach to simultaneously examine the association of health behaviors to mental health functioning. Results: Aggressive behaviors, alcohol use, and fatigue were significantly associated with symptoms of psychological distress and stress in both males and females. Attention to nutrition, unhealthy dietary habits, and lower alcohol use was further related to psychological distress in female athletes only. Conclusions: Athletes' eating, sleeping, substance use, and aggressive behaviors may provide insight into their mental health functioning.

The prevalence of common mental disorders and its relationship with mental toughness in professional South African rugby players

This study explores the relationship between common mental disorders and mental toughness in professional South African rugby players. A cross-sectional survey design was used by administering a questionnaire and preliminary and bivariate analyses were conducted. The inclusion criteria were professional rugby players who are able to communicate in English. The results indicated that, in general, these players (N = 215) portray significant mental toughness ( M = 5.69) on a 7-point scale. Anxiety/depression and distress measured the lowest ( M = 1.65) of all the common mental disorders measured in this study. Furthermore, the results indicated a positive relationship between mental toughness and sound sleep ( r = .262). Negative relationships were found between mental toughness and all other common mental disorders with the highest relationship being with anxiety/depression positive2 ( r = –.423). Other significant relationships were found with anxiety/depression ( r = –.401), distress ( r = –.259), and common mental disorders problems in general ( r = –.220). The results indicated that the management of teams and clinicians need to look at specific aspects, such as alcohol consumption among players, the implications of alcohol use on performance, but also mental wellbeing in general.

Sport-Related and Psychosocial Factors Associated With Motives and Consequences Of Alcohol and Cannabis Use Among NCAA Athletes: A Systematic Review

AIMS

To review differences in alcohol- and cannabis-related motives and consequences among National Collegiate Athletic Association (NCAA) athletes as a function of athlete characteristics (e.g. gender and competition season status).

METHODS

Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, PsycINFO and manual reference list review were used to identify studies that reported alcohol- or cannabis-related motives and consequences among NCAA athletes as a function of gender, race, season status, division level or sport-type through December 2019. Relevant findings and any reported psychosocial correlates were extracted by two independent reviewers.

RESULTS

The majority of studies (K = 15) focused on alcohol-related motives or consequences, with one examining cannabis-related motives, and no studies examined cannabis-related consequences. Social drinking motives were strongest among men and White NCAA athletes, and athlete-specific motives were most salient for men and in-season athletes. Cannabis use motives for positive reinforcement (e.g. enhancement) and coping were also strongest during the in-season. Negative alcohol-related consequences were greatest among men, athletes of color and out-of-season athletes, although women and in-season athletes experienced more consequences in athletic performance. Our exploratory aim revealed two studies that examined psychosocial correlates, and the results indicate that sensation-seeking, stress and negative affect were associated with more alcohol-related consequences.

CONCLUSION

NCAA athletes are a heterogenous population, and their motives and consequences of use appear to vary across multiple athlete factors (e.g., gender). This review highlights the gaps in the literature and suggests future research directions to identify the risk and protective factors for substance use among NCAA athletes.

The Impact of Perceived Sleep, Mood and Alcohol Use on Verbal, Physical and Sexual Assault Experiences among Student Athletes and Student Non-Athletes

Previous research has shown that student athletes are more likely to be involved in a physical altercation or be a victim of verbal, physical and/or sexual abuse than student non-athletes, which can have long-lasting negative effects on mood, behavior and quality of life. In addition, among college students, sleep difficulties are ubiquitous and may deteriorate the unique life experience that university represents. The influences of poor sleep quality, mood and alcohol consumption related to these events are examined here between student athletes and student non-athletes. A series of hierarchical logistic regressions explored the relationship between verbal, physical and sexual assault risk factors. Results suggest that poor sleep, alcohol consumption and mood are all associated with exposure to a physical altercation or episode of abuse, irrespective of athlete status. Results also show that variables targeting self-reported difficulty sleeping and experiences of verbal, physical and sexual assault were positively associated. However, given the cross-sectional nature of the study, it is impossible to establish the direction of these relationships.

A Comprehensive Examination of Factors Impacting Collegiate Athletes' Utilization of Psychological Assessment and Intervention Services

Although collegiate athletes underutilize mental health programming, investigators have rarely examined factors that may influence their participation in such programs. The current study examined how structured interviews and demographic factors influence collegiate athletes to use psychological programming. Two-hundred and eighty-nine collegiate athletes were referred to the study. They were screened for mental health and randomly assigned to one of two semi-structured interviews based on experimental phase. Participants in Phase I received standard engagement (SE; N = 35) or SE+discussion of mental health (DMH; N = 44). Phase II participants received SE+DMH (N = 82) or SE+DMH + discussion of personal ambitions (DPA; N = 66). Phase III participants received SE+DMH+discussion about their culture of choice (DCC) (N = 25) or SE+DMH+discussion of sport culture (DSC) (N = 37). After receiving the respective interview participants were offered psychological assessment and intervention. Chi squared analyses revealed class standing, mental health symptom severity, referral type, and type of engagement interview influenced program commitment/utilization. Logistic regression analyses indicated SE+DMH+DPA and SE+DMH+DSC uniquely improved assessment attendance whereas referrals from the athletic department and coaches/teammates, participation in sport performance workshops, and senior status uniquely improved assessment and intervention attendance.

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusion

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

Reducing Alcohol Use among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback (PNF) intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and a 6-week follow-up. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared to those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings provide support the efficacy of web-based PNF intervention for reducing alcohol use among high school senior athletes.

Alcohol and Athletics: A Study of Canadian Student-Athlete Risk

American student-athletes (SAs) are at heightened risk for hazardous alcohol consumption compared with their nonathlete peers. However, little is known about this risk or the influence of psychosocial predictors on drinking behavior among Canadian SAs. This study compared rates of alcohol use across Canadian SAs and nonathletes and investigated whether the use of athlete-specific psychosocial predictors can improve the prediction of alcohol use outcomes in SAs. Participants (179 varsity athletes and 366 nonathletes) completed anonymous self-report questionnaires. Results suggest that Canadian athletes are at a heightened risk for experiencing alcohol-related problems compared with nonathletes, with general psychosocial predictors explaining the majority of variance in SA alcohol use. However, and quite notably, athlete-specific positive reinforcement motives predicted SA binge drinking. This research provides some of the first evidence of drinking-related problems among Canadian SAs and supports the potential use of preventative efforts to help SAs develop safe strategies for alcohol use.

Relevance of Athlete-Specific Psychosocial Factors in High School Student-Athlete Alcohol Consumption

Background: Research suggests that adolescent student-athletes are at heightened risk for alcohol consumption. The identification of unique, modifiable risk factors for alcohol use in this population is needed. Purpose/Objectives: Building on previous work highlighting the importance of each of athlete-specific drinking motives and alcohol expectancies, this study investigated whether athlete-specific psychosocial predictors optimize our ability to predict adolescent athlete alcohol consumption after accounting for general psychosocial predictors. Methods: Participants were 352 current high school student-athletes who completed a self-report questionnaire about their alcohol use attitudes, behaviors, and cognitions. Results: Hierarchical regression revealed that among the total sample, gender, class year, liquid courage/sociability, sexuality, and negative alcohol expectancies, and negative athletic-functioning alcohol expectancies predicted alcohol consumption. Among lifetime drinkers, gender, class year, enhancement motives, conformity motives (negative), negative athlete-functioning alcohol expectancies, and sport-related coping motives predicted alcohol consumption. Conclusions/Importance: Negative athletic-functioning alcohol expectancies and sport-related coping motives emerged as important, athlete-specific predictors of adolescent athlete alcohol use. These factors provide important opportunities for targeted prevention efforts.

The health-related determinants of eating pattern of high school athletes in Goiás, Brazil

Background

Athletes put their health at short- and long-term risk and a detailed investigation of health outcomes is important because it should allow the development of more specific interventions. This study aimed to evaluate the health-related determinants of eating pattern of high school athletes.

Methods

The study enrolled 248 Brazilian athletes aged 14–20 years. Eating pattern outcomes included skipping breakfast, vegetable and fruit consumption, and sweets consumption. The following factors were considered as independent variables: sociodemographic, economic, anthropometry, body weight control, psychosocial, sedentary behavior, sleeping time, meals, alcohol and smoking, and strength variables. Data were analyzed using Poisson regression model and the effect measure was the prevalence ratio (PR).

Results

The results showed that 45.6% of the athletes skipped breakfast, 29.8% ate sweets regularly, and only 8.9% consumed vegetables and fruit regularly. Multiple analysis revealed the following positive associations: breakfast skipping and vomiting or using laxatives to lose weight (PR, 1.12; 95% CI, 1.01–1.26); low fruit and vegetable consumption and using pills to lose weight (PR, 1.05; 95% CI, 1.02–1.07); high sweets consumption and female athletes (PR, 1.32; 95% CI, 1.12–1.55); high sweets consumption and more than 2 h spent watching TV (PR, 1.19; 95% CI, 1.02–1.39).

Conclusions

Our findings indicated that sociodemographic, body weight control and sedentary factors are determinants on eating patterns of high school athletes.

Physical activity, use of alcohol and smoking in middle-aged and aging men. A longitudinal study among Finnish male former athletes and controls

It is not known whether decrease in physical activity (PA) is associated with binge drinking among former athletes. The purpose of this study was to investigate the reciprocal associations between PA and use of alcohol among former athletes and controls at four time points. Furthermore, we examined whether there were longitudinal latent profiles related to use of alcohol, smoking and PA during the follow-up. Finnish male former elite athletes (n = 1633) and matched controls (n = 1099) questionnaire-reported their PA, alcohol consumption and smoking at four time points in 1985, 1995, 2001 and 2008. Former athletes were more physically active and smoked less than controls, but in all profiles smoking decreased during the follow-up. Former athletes consumed alcohol significantly more compared to controls in 1985, especially if their athletic career had ended suddenly by sports injury. At other time points, no differences were seen. Five latent profiles were found, and there were significant differences between former athletes and controls in the probabilities to belong to four of them. PA decreased in four of five profiles, while alcohol consumption decreased or increased in some profiles. But PA did not predict later alcohol consumption at any time point. Cross-lagged path model indicated that the mutual associations of alcohol use and PA were weak at most. Although risk of excessive alcohol consumption may increase in individuals, whose athletic career has ended suddenly by sports injury, overall PA and alcohol affected each other's development only modestly among former athletes and controls during the 23-year follow-up.

American Medical Society for Sports Medicine Position Statement: Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention-Executive Summary

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practice document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health (MH) issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and MH providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact MH, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific MH disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.

Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention: American Medical Society for Sports Medicine Position Statement

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders, and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy (SORT) to grade level of evidence.

Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.

How Coaches Can Prevent and Address Alcohol Consumption Among Student-Athletes

This manuscript seeks to offer insight about how coaches can better address drinking among collegiate student-athletes. Using a mixed-methods design, 519 NCAA coaches reported their attitudes and behaviors toward student-athlete drinking, and responded to open-ended questions about their perceived role, strategies, and challenges to addressing problems in this population. Three dimensions of coaches’ attitudes and behaviors toward student-athlete drinking emerged that were consistent regardless of the players’ or coach’s gender or division: Concerned Communication, Conditional Leniency, and Enforcement. Effective strategies identified by coaches included enforcement of policy, education about consequences of drinking, establishment of quality coach-athlete relationships, and management of athletes’ schedules. Coaches indicated the need to play a role in managing, educating, influencing, and supporting the student-athletes to prevent alcohol misuse. Coaches reported challenges regarding the culture of drinking on college campuses, individual differences (e.g., age) among student-athletes, acceptance and enforcement of the alcohol policy, lack of awareness about student-athletes’ activities, and identification of alcohol misuse.

Test-Retest Reliability of the 7-Factor Motives for Playing Drinking Games Scale and its Associations With Drinking Game Behaviors Among Female College Athletes

Drinking games (DGs) participation is prevalent among college-attending emerging adults. Research also suggests that student-athletes play DGs more frequently than non student-athletes, but what motivates student-athletes to participate in DGs is not well understood. Using data from a larger longitudinal study with Division III female athletes, we examined the test-retest reliability and minimal detectable change of the revised 7-factor Motives for Playing Drinking Games (MPDG) measure, and explored how its subscales were related to DGs behavior across two annual timepoints (n = 49). Results indicated that the MPDG shows adequate test-retest reliability over a one year period among student-athletes. Controlling for age and general alcohol consumption, conformity motives were positively associated with DG consumption at timepoint 1, whereas the DG motives of enhancement/thrills and boredom were positively related to DG consumption at timepoint 2. Implications for future research directions on motives for playing DGs and DGs behavior among student-athletes are discussed.

Association between sex, race/ethnicity, season, day of week, and alcohol use and related risks in college student athletes and nonathletes

Objective: To examine personal and social constructs (eg, sex, race) and external influences (ie, competition schedules) that are associated with the pattern and amount of alcohol consumption by student athletes compared to nonathletes. Participants: Students (n = 2,984; 57% female, 61% white, 16% athlete) on a single campus were surveyed in Fall 2011 and Spring 2012. Methods: Anonymous surveys included demographics, alcohol use, and related problems. Results: Student athletes consumed more alcohol than nonathletes, with male and white athletes posing the highest levels of risk for heavy consumption. Expanded examination of in- and out-of-season athletes found out-of-season athletes drink more frequently and more per occasion than their in-season peers. Athletes were more likely than nonathletes to drink on specific days of the week and daily patterns differed between in- and out-of-season athletes. Conclusions: The risk of athlete status is moderated by sex, race, season, and day of the week.

Secondary effects of myPlaybook on college athletes' avoidance of drinking games or pregaming as a protective behavior strategy: A multisite randomized controlled study

RATIONALE

Student-athletes are at risk for engaging in drinking games and pregaming. Research suggests that brief motivational and alcohol education intervention approaches designed to reduce harmful drinking behaviors may not be effective in lowering students' participation in drinking games or pregaming.

METHOD

We evaluated the effects of myPlaybook (a student-athlete-specific web-based alcohol intervention) on student-athletes' avoidance of drinking games and pregaming over a 4-month period. Seventy-three NCAA member institutions were randomly assigned to the treatment condition or a no-intervention control. Student-athletes at these schools (N = 2449) completed assessments at baseline, 1-, and 4-months post-intervention. At each assessment, participants indicated how often they used each of several harm prevention strategies when they drank in the past month including "avoided drinking games" and "avoided drinking before going out (i.e., pregaming or pre-drinking)."

RESULTS

Controlling for gender and race/ethnicity, treatment condition was not associated with change in avoidance of drinking games and pregaming between baseline and either follow-up. Athletic season did not moderate treatment effects on avoidance of either behavior. We found no evidence that myPlaybook, a general alcohol-reduction intervention, is efficacious in influencing student-athletes' avoidance of drinking games or pregaming as a protective strategy.

CONCLUSIONS

Findings from the present study as well as other research suggest that general alcohol-focused interventions may not have secondary effects on reducing students' participation in drinking games and pregaming and as such, more specific targeted interventions should be investigated.

Beer or Ethanol Effects on the Body Composition Response to High-Intensity Interval Training. The BEER-HIIT Study

High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition but concomitant beer intake, which is common among physically active individuals, may interfere with these effects. The primary aim of this study is to determine the effects of a 10-week (2 days/week) HIIT program on anthropometric and body composition measurements, and to assess whether those effects are influenced by the moderate consumption of beer (at least 5 days/week), or its alcohol equivalent. Young (24 ± 6 years old) healthy adults (n = 72, 35 females) volunteered for a non-training group (Non-Training group) or for HIIT training. Those going for training choose whether they preferred to receive alcohol or not. Those choosing alcohol were randomly allocated for receiving beer (5.4%; T-Beer group) or the equivalent amount of alcohol (vodka; T-Ethanol group) in sparkling water. Those choosing no-alcohol were randomly allocated for receiving alcohol-free beer (0.0%; T-0.0Beer group) or sparkling water (T-Water group). From Monday through Friday, men ingested 330 mL of the beverage with lunch and 330 mL with dinner; women ingested 330 mL with dinner. Before and after the intervention, anthropometry and body composition, through dual-emission X-ray absorptiometry, were measured. No changes in body mass, waist circumference, waist/hip ratio, visceral adipose tissue or bone mineral density occurred in any of the groups. By contrast, in all the training groups, significant decreases in fat mass together with increases in lean mass (all p < 0.05) occurred. These positive effects were not influenced by the regular intake of beer or alcohol. In conclusion, a moderate beer intake does not blunt the positive effect of 10-week HIIT on body composition in young healthy adults.

Humble Coaches and Their Influence on Players and Teams: The Mediating Role of Affect-Based (but Not Cognition-Based) Trust

Humility is a desirable quality for leaders across different domains, but not much is known about humility in sports coaches. This study integrated positive and organizational psychology to define humility as it pertains to sports coaches and examined humble coaches' influence on player development and team climate. Additionally, trust was examined as a mediator between coaches' humility and the two outcomes. Participants (N = 184; M_age = 23.44, SD_age = 8.69; 73.4% women) rated their coaches' humility and reflected on the coaches' influence and their team climate. Results indicated that affect-based, but not cognition-based, trust mediated the relationship between humility and coaches' influence on players and team climate. Theoretical and practical implications for sports coaches are discussed.

Family contributions to sport performance and their utility in predicting appropriate referrals to mental health optimization programmes

Limited research has examined the contributions of sport-specific family relationship problems to athlete mental health. In the current study we examined the extent to which collegiate athletes' family problems (as measured by the Student Athlete Relationship Instrument factors, SARI) predict athletes' general mental health distress and specific mental health symptoms that are relatively common in athletes (i.e. depression, anxiety, and drug and alcohol use). The study included 85 collegiate athletes (intramural, n = 26; club sport, n = 12; NCAA Division I, n = 47). We hypothesized that both general mental health distress and commonly evidenced mental health symptoms would be predicted by athletes' responses to the SARI factors (Poor Relationship and Lack of Support, General Pressure, Pressure to Quit or Continue Unsafely, Embarrassing Comments, and Negative Attitude). Results indicated that all of the aforementioned SARI factors predicted athletes' ratings of depression and general mental health distress levels. Only the General Pressure SARI factor predicted athletes' anxiety and drug use. Alcohol use was not predicted by any of the SARI factors. Receiver operating characteristic (ROC) analyses indicated that sport-specific problems in family relationships provided a good classification of athletes at risk for general mental health distress, depression, and anxiety. Practice implications are discussed in light of the results.

Relationship between General and Sport-Related Drinking Motives and Athlete Alcohol Use and Problems

OBJECTIVE

Alcohol use (and adverse consequences due to alcohol use) among college student-athletes is a common occurrence and consequently garners attention as a health concern within athletic departments and the NCAA. One of the strongest predictors of alcohol use in athletes is motivation to drink. However, not much is known about the influence of alcohol use motivations on drinking in collegiate athletes. Therefore, this study examined the influence of sport-related and general drinking motives on alcohol use and alcohol-related problems.

METHOD

Participants were female collegiate softball players (N = 721) from 62 NCAA teams. Athletes completed the Athlete Drinking Scale (Martens et al., 2005), the Drinking Motives Questionnaire, revised (Cooper, 1994; Cooper et al., 1992), alcohol consumption measures, and the Rutgers Alcohol Problems Index (White & Labouvie, 1989). Multilevel modeling was used to analyze the data.

RESULTS

Higher scores on Positive Reinforcement motives were associated with greater alcohol consumption, heavy episodic drinking, and alcohol-related problems. Enhancement motives were positively associated with heavy episodic drinking and alcohol-related problems, while Coping motives were positively associated with alcohol-related problems. Lower scores on Conformity motives were related to higher alcohol consumption, whereas higher scores were related to more alcohol-related problems.

CONCLUSIONS

These results assist in understanding salient drinking motives among athletes while accounting for nesting effects of athletes within teams. Results demonstrate alcohol use as a perceived means of reward for hard work or good athletic performance, thus attempts to control alcohol use in college athletics should emphasize alternative methods to positively reinforce efforts or celebrate victories.

Efficacy of interventions targeting alcohol, drug and smoking behaviors in university and college students: A review of randomized controlled trials

OBJECTIVE

To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.

PARTICIPANTS

College/University students.

METHODS

Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.

RESULTS

88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.

CONCLUSIONS

University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.

Examination of Risk for Sleep-Disordered Breathing Among College Football Players

CONTEXT

Professional football linemen are at risk for sleep-disordered breathing (SDB) compared with other types of athletes. It is currently unknown whether college football linemen display a similar risk profile.

OBJECTIVE

(1) To determine for the first time whether college football linemen show risk for SDB and (2) test the hypothesis that SDB risk is higher in college football linemen compared with an athletic comparison group.

DESIGN

Descriptive laboratory study.

SETTING

The Health Risk Assessment Laboratory.

PARTICIPANTS

Male football linemen (n = 21) and track (n = 19) Division I athletes between the ages of 18 and 22 years.

INTERVENTIONS

Participants completed the Multivariable Apnea Prediction Index and Epworth Sleepiness Scale surveys, validated measures of symptoms of sleep apnea and daytime sleepiness, respectively. Neck and waist circumferences, blood pressure, Modified Mallampati Index (MMPI), and tonsil size were determined, followed by body composition assessment using dual-energy X-ray absorptiometry.

MAIN OUTCOME MEASURES

Scores from surveys, anthropometric data, MMPI, and body composition.

RESULTS

Survey data demonstrated a deficiency in sleep quality and efficiency, coinciding with increased self-reported symptoms of apnea (Multivariable Apnea Prediction Index = 0.78) in college linemen relative to track athletes. Neck circumference (44.36 cm), waist circumference (107.07 cm), body mass index (35.87 kg/m²), and percent body fat (29.20%), all of which exceeded the clinical predictors of risk for obstructive sleep apnea, were significantly greater in linemen compared with track athletes. Multivariable Apnea Prediction variables were significantly correlated with MMPI, neck circumference, percent body fat, body mass index, and systolic blood pressure (r ≥ .31, P < .05), indicating that college football linemen are at increased risk for SDB.

CONCLUSIONS

Risk factors for SDB recognized in professional football linemen are also present at the college level. Screening may minimize present or future risk for SDB, as well as the downstream risk of SDB-associated metabolic and cardiovascular disease.

The psychological effects of physical exercise: A controlled study of the placebo effect

The research on well-being and physical exercise point to the possibility of a placebo effect. This study analyzes the effect of expectancy manipulation on psychological (well-being and self-esteem) and physical (agility and cardiorespiratory fitness) outcomes after a seven-week program of aerobic training. 114 undergraduate students (age M = 19.81, SD = 1.75; 86.1% women) were randomized into G1 - No Exercise (n = 13), G2 - Exercise only (n = 15), G3 - Exercise + Manipulation of expectations: No psychological effect (n = 17) and G4 - Exercise + Manipulation of expectations: Psychological effect (n = 21). Outcome measures were the Rosenberg Self-Esteem Scale, the Well-Being subscale of the Subjective Exercise Experiences Scale, the Agility T-test and the 20-meter Shuttle Run Test. Paired t-tests showed significant improvements from baseline in self-esteem, agility, and cardiovascular fitness for the exercise groups. G4 also showed a significant improvement in well-being. ANCOVA with adjustments for the baseline measures was used to test between-group differences at the end of the program. The only significant differences at posttest were between G1 and the exercise groups. The data do not support a differential effect of elevated expectations of psychological benefits on the participants' self-esteem or psychological well-being after an aerobic training program. Future research should analyze whether reinforcing expectations more frequently throughout the program might show a more robust influence.

Student-Athlete and Student Non-Athletes’ Stigma and Attitudes Toward Seeking Online and Face-to-Face Counseling

This study investigated differences in stigmatization by others, self-stigma, and attitudes (value and discomfort) toward online counseling (OC) and face-to-face counseling (F2F), and the relationships between these variables, in college student-athletes (n = 101) and non-athletes (n = 101). Results revealed no differences in levels of stigmatization by others and self-stigma between student-athletes and non-athletes. Furthermore, both groups reported higher value, and less discomfort, in F2F compared to OC, while non-athletes reported higher levels of value in F2F compared to student-athletes. A multiple group path analysis revealed no difference in the relationship of the stigma and attitudes variables between the two groups. Stigmatization by others was a significant positive predictor of self-stigma and value in OC. In addition, self-stigma was a significant negative predictor of value in F2F, and a significant positive predictor of discomfort in F2F. The current findings have implications for university counseling centers and athletic departments.

The Relationship Between Handball Players and Alcohol and Smoking Habits

Recent studies have revealed that sport activity is a protective factor regarding smoking, but a risk factor for alcohol abuse. Considering these findings, it is necessary to investigate the occurrence of substance misuse. Sports that are associated with a substantial amount of physical/mental stress are very interesting from the perspective of substance misuse (e.g., handball). This research was performed to more closely study the population engaged in handball regarding the risk for alcohol and/or tobacco consumption. The sample of respondents consisted of 150 senior handball players who were members of 9 first-league handball clubs from Croatia and abroad. The respondents were grouped into sub-samples according to sex, age, experience, the number of weekly training sessions and their social environment (clubs). Alcohol consumption data were obtained using the AUDIT questionnaire. The differences between groups were tested using the Kruskal-Wallis and Mann-Whitney U tests. The study revealed that handball players engaged in alcohol misuse, and they were grouped in the harmful drinking category (AUDIT score, 16-19 for all groups). Regarding tobacco product consumption, the risk groups were women (who smoked significantly more than men, MWU test: Z = 3.30. p < 0.001), handball players with less experience (who smoked significantly more than experienced players, MWU test: Z = 3.68, p < 0.001). Borderline significance was observed for the impact made by social environments, and age was not a significant predictor of tobacco consumption. Regarding alcohol consumption, the highest hazard group were national handball players, who drank much more than foreign players did (MWU test: Z = 2.04, p = 0.04); however, sex, age, experience and training habits were not alcohol consumption predictors in handball. This study reveal that the typical behaviors regarding alcohol and tobacco consumption followed by the general population do not apply to handball players. Targeted prevention can be much more precisely established considering this research.

Trends in incidence and risk markers of student emergency department visits with alcohol intoxication in a U.S. public university-A longitudinal data linkage study

BACKGROUND

To examine the trends in incidence and socio-demographic, organizational, academic, and clinical risk markers of student alcohol intoxication associated with emergency department (ED) visits.

METHODS

Student admission data from 2009 to 2015 were linked to primary healthcare data and subsequent ED visits with alcohol intoxication identified using ICD-9 codes within one year following the first (index) enrollment each year. Incidence rate per 10,000 person-years was calculated. Cox proportional hazard regression provided adjusted hazard ratios (HR) (95 % CIs) for the association between student characteristics and subsequent ED visits with alcohol intoxication.

RESULTS

Of 177,128 students aged 16-49 enrolled, 889 had at least one ED visit with alcohol intoxication, resulting in an incidence rate of 59/10,000 person-years. Incidence increased linearly from 45/10,000 person-years in 2009-10 to 71/10,000 person-years in the 2014-15 academic year (p < 0.001). HRs (95%CIs) of student characteristics associated with this outcome were: males (versus females): 1.38 (1.21-1.58); below 20 years of age (versus 25-30 years): 3.36 (1.99-5.65); Hispanic (versus Asian) students: 1.61 (1.16-2.25); parental tax dependency: 1.49 (1.16-1.91); Greek life member: 1.96 (1.69-2.26); member of an athletic team: 0.51 (0.36-0.72); undergraduate (versus graduate) students: 2.65 (1.88-3.74). Past year alcohol use or having been diagnosed with depression or anxiety were also significant predictors. Adjustments for campus-related factors strongly attenuated the associations between student socio-demographic characteristics with this outcome.

CONCLUSIONS

Linking student admission data with ED clinical data can help monitor student alcohol intoxication associated with ED visits and identify student groups at higher risk who subsequently can be targeted for intervention efforts.

Controlled Evaluation of an Optimization Approach to Mental Health and Sport Performance

Athletes experience unique stressors that have been indicated to compromise their mental wellness and sport performance, yet they underutilize mental health services. Indeed, very few mental health interventions for athletes have been developed to fit sport culture, and well-controlled mental health outcome research in athlete populations is warranted. In this randomized controlled trial, a sport specific optimization approach to concurrent mental health and sport performance (The Optimum Performance Program in Sports; TOPPS) was examined. Seventy-four collegiate athletes (NCAA = 42; club = 11; intramural = 21) formally assessed for mental health diagnostic severity were randomly assigned to TOPPS or campus counseling/psychological services as usual (SAU) after baseline. Dependent measures assessed general mental health, mood, mental health factors affecting sport performance in training, competition and life outside of sports, days using substances, sexual risk behaviors, happiness in relationships, relationships affecting sport performance, and contributions of relationship to sport performance. Intent to treat repeated measures analyses indicated that participants in TOPPS consistently demonstrated better outcomes than SAU up to 8-months post-randomization and for mental health/substance use measures, particularly when diagnostic criteria were most severe. Recommendations are provided in light of the results to assist sport-specific mental health intervention development and implementation within athlete populations.

The relationship between concussion and alcohol consumption among university athletes

INTRODUCTION

This study investigated concussion as a potential risk factor for increased alcohol consumption in university athletes.

METHODS

Using a cross-sectional design, 41 university students (37% with a history of concussion) completed self-report measures, while electrodermal activation (EDA) was recorded for each participant to capture baseline physiological arousal.

RESULTS

As expected, concussion status significantly predicted alcohol consumption over and above athletic status, b = 0.34, p = 0.034, 95% CI [0.195, 4.832], such that those with a prior concussion history engaged in greater alcohol consumption. Importantly, concussion status also significantly predicted baseline physiological arousal, b = -0.39, p = 0.014, 95% CI [-0.979, -0.120], such that those with a history of concussion exhibited lower EDA.

CONCLUSIONS

Elevated alcohol consumption among athletes is a pronounced associate of concussion in sports and may be a behavioral reflection of disruption to the orbitofrontal cortex - an area implicated in inhibition.