Measuring problem drinking in first time offenders. Development and validation of the College Alcohol Problem Scale (CAPS)

A systematic review of event-level measures of risk-taking behaviors and harms during alcohol intoxication

Alcohol intoxication is associated with transient increases in risk-taking behaviors which can lead to harm. Certain assessment and intervention evaluation approaches require measurement of risk behaviors and associated harms at the event-level (i.e., within a single drinking session). This systematic review aimed to identify measures solely assessing risk-taking behaviors and harms while intoxicated and identify evidence of their reliability and validity. EMBASE, Medline, PsycINFO, and PsycTESTs were searched for articles published between 1997 and 2019. Articles were selected based on use of a scale with one or more items measuring risk-taking behaviors and harms (to the individual or others around them) occurring while intoxicated. Additional searches were run to identify studies reporting estimates of reliability and validity for identified measures. Nineteen measures were identified containing at least one relevant item. Most measures indexed both acute and chronic risk behaviors and consequences, mainly with the intent of screening for established patterns of problematic use. No individual measure was identified exclusively quantifying risk-taking behavior and harms which had occurred within a drinking session (with the exception of one scale measuring tendency to engage in risk behaviors), yet three measures had a subscale meeting this criterion. These measures demonstrated good validity and reliability. This gap represents an opportunity for scale development, designed for use in ecological momentary assessment and evaluation of structural interventions targeting risk behaviors and harms whilst intoxicated.

Genes, Roommates, and Residence Halls: A Multidimensional Study of the Role of Peer Drinking on College Students' Alcohol Use

BACKGROUND

Peer drinking is one of the most robust predictors of college students' alcohol use and can moderate students' genetic risk for alcohol use. Peer effect research generally suffers from 2 problems: selection into peer groups and relying more on perceptions of peer alcohol use than peers' self-report. The goal of the present study was to overcome those limitations by capitalizing on a genetically informed sample of randomly assigned college roommates to examine multiple dimensions of peer influence and the interplay between peer effects and genetic predisposition on alcohol use, in the form of polygenic scores.

METHODS

We used a subsample (n = 755) of participants from a university-wide, longitudinal study at a large, diverse, urban university. Participants reported their own alcohol use during fall and spring and their perceptions of college peers' alcohol use in spring. We matched individuals into their rooms and residence halls to create a composite score of peer-reported alcohol use for each of those levels. We examined multiple dimensions of peer influence and whether peer influence moderated genetic predisposition to predict college students' alcohol use using multilevel models to account for clustering at the room and residence hall level.

RESULTS

We found that polygenic scores (β = 0.12), perceptions of peer drinking (β = 0.37), and roommates' self-reported drinking (β = 0.10) predicted alcohol use (all ps < 0.001), while average alcohol use across residence hall did not (β = -0.01, p = 0.86). We found no evidence for interactions between peer influence and genome-wide polygenic scores for alcohol use.

CONCLUSIONS

Our findings underscore the importance of genetic predisposition on individual alcohol use and support the potentially causal nature of the association between peer influence and alcohol use.

Validity of the AUDIT-C screen for at-risk drinking among students utilizing university primary care

OBJECTIVE

Research is needed to establish the psychometric properties of brief screens in university primary care settings. This study aimed to assess the construct validity of one such screen, the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), for detecting at-risk drinking among students who have utilized on-campus primary care.

PARTICIPANTS

389 students recently seen in university primary care completed a confidential online survey in December 2014.

METHODS

Bivariate correlations between the AUDIT-C and measures of alcohol consumption and negative drinking consequences provided concurrent evidence for construct validity. Receiver Operating Characteristic curve analyses determined optimal cut-off scores for at-risk drinking.

RESULTS

The AUDIT-C significantly correlated with measures of alcohol consumption and negative drinking consequences (p < .001). Analyses support optimal AUDIT-C cut-off scores of 5 for females and 7 for males.

CONCLUSIONS

The AUDIT-C is a valid screen for at-risk drinking among students who utilize university primary care.

Problem drinking among Flemish students: beverage type, early drinking onset and negative personal & social consequences

Background

Although alcohol is socially accepted in most Western societies, studies are clear about its associated negative consequences, especially among university and college students. Studies on the relationship between alcohol-related consequences and both beverage type and drinking onset, however, are scarce, especially in a European context. The aim of this research was, therefore, twofold: (1) What is the relationship between beverage type and the negative consequences experienced by students? and (2) Are these consequences determined by early drinking onset? We will examine these questions within the context of a wide range of alcohol-related consequences.

Methods

The analyses are based on data collected by the inter-university project ‘Head in the clouds?’, measuring alcohol use among students in Flanders (Belgium). In total, a large dataset consisting of information from 19,253 anonymously participating students was available. Negative consequences were measured using a shortened version of the Core Alcohol and Drug Survey (CADS_D). Data were analysed using negative binomial regression.

Results

Results vary depending on the type of alcohol-related consequences: Personal negative consequences occur frequently among daily beer drinkers. However, a high rate of social negative consequences was recorded for both daily beer drinkers and daily spirits drinkers. Finally, early drinking onset was significantly associated with both personal and social negative consequences, and this association was especially strong between beer and spirits drinking onset and social negative consequences.

Conclusions

Numerous negative consequences, both personal and social, are related to frequent beer and spirits drinking. Our findings indicate a close association between drinking beer and personal negative consequences as well as between drinking beer and/or spirits and social negative consequences. Similarly, early drinking onset has a major influence on the rates of both personal and social negative consequences. The earlier students started drinking, the more negative consequences they experienced during college or university. Several (policy) interventions are discussed. This study is the first to incorporate detailed information on both beverage type and drinking onset, and its associated negative consequences, as measured by the CADS_D, in a large student population.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5120-7) contains supplementary material, which is available to authorized users.

The psychometric properties of a shortened Dutch version of the consequences scale used in the Core Alcohol and Drug Survey

BACKGROUND

Alcohol and drug misuse among college students has been studied extensively and has been clearly identified as a public health problem. Within more general populations alcohol misuse remains one of the leading causes of disease, disability and death worldwide. Conducting research on alcohol misuse requires valid and reliable instruments to measure its consequences. One scale that is often used is the consequences scale in the Core Alcohol and Drug Survey (CADS). However, psychometric studies on the CADS are rare and the ones that do exist report varying results. This article aims to address this imbalance by examining the psychometric properties of a Dutch version of the CADS in a large sample of Flemish university and college students.

METHODS

The analyses are based on data collected by the inter-university project 'Head in the clouds', measuring alcohol use among students. In total, 19,253 students participated (22.1% response rate). The CADS scale was measured using 19 consequences, and participants were asked how often they had experienced these on a 6-point scale. Firstly, the factor structure of the CADS was examined. Two models from literature were compared by performing confirmatory factor analyses (CFA) and were adapted if necessary. Secondly, we assessed the composite reliability as well as the convergent, discriminant and concurrent validity.

RESULTS

The two-factor model, identifying personal consequences (had a hangover; got nauseated or vomited; missed a class) and social consequences (got into an argument or fight; been criticized by someone I know; done something I later regretted; been hurt or injured) was indicated to be the best model, having both a good model fit and an acceptable composite reliability. In addition, construct validity was evaluated to be acceptable, with good discriminant validity, although the convergent validity of the factor measuring 'social consequences' could be improved. Concurrent validity was evaluated as good.

CONCLUSIONS

In deciding which model best represents the data, it is crucial that not only the model fit is evaluated, but the importance of factor reliability and validity issues is also taken into account. The two-factor model, identifying personal consequences and social consequences, was concluded to be the best model. This shortened Dutch version of the CADS (CADS_D) is a useful tool to screen alcohol-related consequences among college students.

Rates and Correlates of Binge Drinking Among College Students With Disabilities, United States, 2013

OBJECTIVE

Our objective was to provide the first comprehensive picture of alcohol use and binge drinking by US college students with disabilities (SWDs), who represent at least 11% (1.6 million) of the US college student population.

METHODS

In fall 2013, we used a stratified random sampling technique to identify and recruit 2440 SWDs from 122 US colleges and universities. A total of 1285 (53%) SWDs from 61 (50%) colleges and universities completed a survey of alcohol and other drug use and the use of substances by student peers. We conducted 4 multiple logistic regression analyses to compare binge-drinking and non-binge-drinking SWDs by potential correlates of such use and a final model that included only significant variables.

RESULTS

SWDs aged <21 vs ≥21 (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.82-0.99) who spent more time vs less time socializing (OR = 1.24; 95% CI, 1.11-1.38), who spent less time vs more time studying (OR = -0.89; 95% CI, -0.80 to -0.99), and who used vs did not use marijuana (OR = 1.44; 95% CI, 1.18-1.75) or amphetamines (OR = 1.82; 95% CI, 1.15-2.89) were significantly more likely to binge drink. SWDs who reported using barbiturates were less likely to binge drink than were those who did not use barbiturates (OR = -0.36; 95% CI, -0.21 to -0.61). In the final model, use of amphetamines (OR = 1.74; 95% CI, 1.15-2.65) or marijuana (OR = 1.60; 95% CI, 1.32-1.94) was the highest predictor of binge drinking.

CONCLUSION

SWDs' reported rates of binge drinking, although high, were not as high as those of nondisabled college students. Nevertheless, prevention efforts should be targeted toward college SWDs.

Measuring alcohol-related consequences and motives among students attending Historically Black Colleges and Universities

INTRODUCTION

College student drinkers have the propensity to engage in heavy alcohol consumption. These consumption patterns can be problematic given the well-established relationship between heavy drinking and negative consequences of alcohol consumption. Though the research on college student drinking is abundant, much of the work conducted has been with Caucasian samples and less so with African American samples or at Historically Black Colleges and Universities (HBCUs).

METHODS

The current paper assessed the internal reliability and concurrent validity of two popular measures of alcohol related negative consequences (CAPS-r and YAACQ) and a measure of drinking motives (DMQ-R) within a HBCU sample.

RESULTS

Total scores for the CAPS-r and YAACQ and all five subscales of the DMQ-R were internally reliable as determined by Cronbach's alpha. Correlations and regressions established concurrent validity for both measures of negative consequences as well as the subscales for the DMQ-R.

CONCLUSIONS

Findings support the use of these measures in the assessment of negative consequences and motivations for alcohol consumption within a HBCU population.

A pilot study of two supervision approaches for peer-led alcohol interventions with mandated college students

OBJECTIVE

Despite the increasing need to identify and implement effective interventions to reduce drinking with mandated college students, peer-led brief alcohol interventions have received minimal research attention. The current pilot study tested whether enhanced supervision (evidence-based application approach [EAA; group plus individual]) would improve peer counseling skills beyond those acquired by a common practice approach (CPA; group only).

METHOD

Following initial peer counselor skill evaluation, drinking outcomes after intervention were compared between supervision groups with a mandated college student sample (N = 82; 65 men). The relationship between acquired motivational interviewing skills and subsequent drinking behaviors was also assessed.

RESULTS

EAA peer counselors showed higher motivational interviewing skill acquisition than CPA peer counselors. Despite differences in counselor skill demonstration, mandated clients in both intervention groups significantly reduced drinking behaviors. Further, higher reflection-to-question ratio and motivational interviewing spirit demonstrated by peer counselors were significantly related to poorer follow-up drinking outcomes.

CONCLUSIONS

Findings identify supervision practices that may result in optimal peer counselor learning and brief intervention implementation while also offering initial data about the way in which peer counseling session implementation may relate to drinking outcomes. Future research is needed to identify the within-session processes of peer-led interventions that predict drinking outcomes, which may offer additional direction for training approaches.

Validation of Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ): Portuguese Version

Extant literature suggests that Portuguese college students frequently drinking alcohol and experience a variety of alcohol-related negative consequences. However, to our knowledge, there is no validated measure to assess negative consequences of drinking alcohol for college students in Portugal. This article describes a validation of the Portuguese version of the Brief Young Adult Alcohol Consequences Questionnaire. Originally developed by Kahler, Strong, and Read (2005), this 24-item questionnaire is a widely used self-report measure with strong psychometric properties and validity for the evaluation of the negative consequences of drinking in college students. We collected data from 620 students at the University of Coimbra (Portugal). Participants completed (a) a background questionnaire, (b) the Alcohol Use Disorders Identification Test (AUDIT), (c) the Daily Drinking Questionnaire - Revised (DDQ-R), and (d) the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) translated into Portuguese as part of this study. Analyses showed that items fit a unidimensional Rasch model well with items infit statistics raging from .82 to 1.27, supporting using all items to create a total sum score of the Portuguese version of the B-YAACQ. The Portuguese version of the B-YAACQ showed adequate internal reliability (α = .87) and concurrent validity. Results support its use and integration in research on interventions targeted to reduce adverse effects associated with excessive drinking among Portuguese college students.

Compensatory and non-compensatory multidimensional randomized item response models

Randomized response (RR) models are often used for analysing univariate randomized response data and measuring population prevalence of sensitive behaviours. There is much empirical support for the belief that RR methods improve the cooperation of the respondents. Recently, RR models have been extended to measure individual unidimensional behaviour. An extension of this modelling framework is proposed to measure compensatory or non-compensatory multiple sensitive factors underlying the randomized item response process. A confirmatory multidimensional randomized item response theory model (MRIRT) is proposed for the analysis of multivariate RR data by modelling the response process and specifying structural relationships between sensitive behaviours and background information. A Markov chain Monte Carlo algorithm is developed to estimate simultaneously the parameters of the MRIRT model. The model extension enables the computation of individual true item response probabilities, estimates of individuals' sensitive behaviour on different domains, and their relationships with background variables. An MRIRT analysis is presented of data from a college alcohol problem scale, measuring alcohol-related socio-emotional and community problems, and alcohol expectancy questionnaire, measuring alcohol-related sexual enhancement expectancies. Students were interviewed via direct or RR questioning. Scores of alcohol-related problems and expectancies are significantly higher for the group of students questioned using the RR technique. Alcohol-related problems and sexual enhancement expectancies are positively moderately correlated and vary differently across gender and universities.

Do ADHD symptoms moderate the relation between positive alcohol expectancies and alcohol-related outcomes?

Research indicates that attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for heavy alcohol use and related problems. Research also suggests that positive alcohol expectancies (i.e., positive beliefs about the effects of alcohol) are predictive of risky alcohol use and related problems (e.g., driving while intoxicated). However, no research has examined the association between ADHD symptoms and positive expectancies or the role of ADHD symptoms in the relation between positive expectancies and alcohol use and related problems, an unexplored area addressed by the current study. Participants were 889 undergraduates (76% female, 82.3% Caucasian) at a Southeastern University who completed self-report measures. Parent report (59%) of current and childhood ADHD symptoms was also collected. Findings indicated that ADHD symptoms moderated the relation between positive alcohol expectancies and alcohol-related problems, but not the relation between expectancies and alcohol use. Additional analyses revealed that ADHD symptoms moderated the specific relation between positive expectancies and social alcohol problems (e.g., engaging in unplanned sexual behavior), but not between expectancies and internal alcohol problems (e.g., feeling sad). Moderating effects were significant even after controlling for conduct disorder symptoms and stimulant medication use. Findings have implications for the identification of college students who are at particularly high risk for heavy drinking and alcohol-related problems. Results may also aid in the development of interventions aimed at reducing risky drinking among students.

Feedback-based alcohol interventions for mandated students: an effectiveness study of three modalities

The present study used a randomized clinical trial design to examine the effectiveness of personalized alcohol feedback delivered individually, in a group and via computer on alcohol use and related negative consequences in a sample of 173 college students referred for alcohol-related violations. Findings revealed statistically significant reductions in alcohol use and related harms for the individually delivered intervention, with significant reductions in alcohol-related harms for the electronically delivered intervention. No statistically significant results were found for the group-delivered intervention or between groups, and a main effect of time was noted for all outcome variables. This study adds to the literature by being the first randomized clinical trial to include analyses of an empirically supported individually delivered personalized alcohol feedback intervention with more cost-effective group-delivered and electronically delivered feedback formats within a single research design, by expanding the range of participant drinking habits reported at baseline to include all drinking levels and not solely those classified as 'heavy drinking' and by providing anonymity pre-intervention and post-intervention given the potential demand characteristics to underreport illegal and/or illicit behaviours in this vulnerable population.

KEY PRACTITIONER MESSAGE

Personalized alcohol feedback delivered in a one-on-one, face-to-face format serves to decrease both alcohol use and harms in mandated college students. The use of web-delivered personalized alcohol feedback may be clinically useful when working with a mandated student population to reduce alcohol-related harms. Personalized alcohol feedback delivered in a group setting may not be indicated for use with a mandated student population as it does not demonstrate decreases in either alcohol use or harms, possibly because of the normalization of deviant behaviour.

Incident-specific and individual-level moderators of brief intervention effects with mandated college students

Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been successful in reducing drinking behaviors with mandated college students. However, research examining moderators of intervention effects have found mixed results. The current study sought to replicate and extend the research on moderators of intervention efficacy with mandated students. Baseline alcohol-related problems, readiness to change, gender, incident consequences, and participant responses to the event (personal attributions about the incident, aversiveness of the incident) were examined as moderators of intervention and booster condition efficacy on alcohol use and problems. Mandated students (N = 225) were randomized to complete either a BMI or CDI (Alcohol 101; Century Council, 1998), with or without a 1-month booster session, following a campus alcohol sanction. Outcomes were measured three months after baseline. Attributions moderated intervention condition such that participants low in personal attributions for their incident showed significantly less drinking following a CDI than a BMI. Men and individuals who reported low incident aversiveness showed higher drinks per occasion after receiving a booster, while individuals high in alcohol-related problems reported fewer heavy drinking days after completing a booster session. Findings suggest that identifying specific characteristics related to the precipitating event may inform intervention approaches in this high-risk population; however, additional research is needed to offer concrete guidance to practitioners in the field.

Screening for alcohol problems among 4-year colleges and universities

OBJECTIVE

To assess the use of alcohol screening tools across US colleges.

PARTICIPANTS

Directors of health services at 333 four-year colleges.

METHODS

An online survey was conducted regarding the use of alcohol screening tools. Schools reporting use of formal tools were further described in terms of 4 tools (AUDIT, CUGE, CAPS, and RAPS) that the authors judged to be the most favorable based on prior empirical comparative studies.

RESULTS

Forty-four percent of colleges reported use of at least 1 formal alcohol screening tool and nearly all of these used a tool appropriate for college students. However, less than half of the 44% of colleges that used a screening tool used 1 of the 4 most favorable tools.

CONCLUSIONS

Continued efforts are needed to encourage colleges to use the most effective available screening tools to identify alcohol-related problems that require intervention among students.

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

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

Correlates of AUDIT risk status for male and female college students

OBJECTIVE

The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT.

PARTICIPANTS

A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%).

METHODS

Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women.

RESULTS

The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females.

CONCLUSIONS

Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.

Assessing the effectiveness of peer-facilitated interventions addressing high-risk drinking among judicially mandated college students

OBJECTIVE

This study examined the effectiveness of three peer-facilitated brief alcohol interventions-small group motivational interviewing, motivationally enhanced peer theater, and an interactive alcohol-education program-with students engaging in high-risk drinking who were referred for alcohol policy violations.

METHOD

Undergraduate students referred for alcohol policy violations (N = 695) at a large northeastern public university were randomized to one of the three conditions. Six-month follow-up data were collected on drinking frequency and quantity, negative consequences, use of protective behaviors, and perceptions of peers' drinking norms.

RESULTS

There were no statistically significant overall pre-post effects or treatment effects. However, exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up (p < .01).

CONCLUSIONS

The presence of nonsignificant pre-post or main effects is, in part, consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change. The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice. The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocols delivered by trained peer facilitators warrants further study using randomized clinical trials.

Validation of the College Alcohol Problem Scale-revised (CAPS-r) for use with non-adjudicated first-year students

First-year students in transition to college are at increased risk for consuming greater amounts of alcohol and are subject to subsequent alcohol-related problems. The 8-item College Alcohol Problem Scale-revised (CAPS-r) has been used to measure alcohol-related problems in adjudicated undergraduates and psychology majors. However, structural validity of the CAPS-r has not been examined in a general first-year student population. Confirmatory factor analysis (CFA) was used to test the structural validity of this two-factor model using LISREL 8.5. The original two-factor measurement model for the 8-item CAPS-r represented acceptable fit to the data (chi(2)=37.52, df=19, p=.007, CFI=.968, SRMR=.0449), supporting its use with first-year college students. Future studies need to examine invariance across ethnic, gender, and geographical groups.

Validation of the Dutch version of the brief young adult alcohol consequences questionnaire (B-YAACQ)

PURPOSE

The purpose of this study was to validate the Dutch version of the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ).

METHOD

The B-YAACQ was translated into the Dutch language and 800 students were invited to complete the questionnaire. A number of drinking behaviors were also assessed; including weekly drinking, age of drinking onset, and blood alcohol concentration on a typical night out. Students also completed a short version of the Alcohol Use Disorders Identification Test (AUDIT-PC).

RESULTS

Data from 667 undergraduate and graduate students (184 men and 483 women) who reported alcohol use during the past year was used in the analysis. On average, students in this study report 4.7 alcohol-related consequences. The Dutch B-YAACQ was shown to have a high reliability and validity: Cronbach's Alpha was 0.816, and B-YAACQ scores correlated significantly with AUDIT-PC scores (r=0.747). B-YAACQ scores correlated significantly (p<0.01) with various drinking variables, including drinking onset age, drinking days per week, alcoholic drinks per week, number of drinks on a night out and blood alcohol concentration when returning home.

CONCLUSION

The Dutch B-YAACQ is a useful new tool for screening of alcohol-related consequences.

Development and validation of the Retrospective Alcohol Context Scale

BACKGROUND

Few validated measures exist to capture the context and consequences of specific drinking events among college students.

OBJECTIVES

This study sought to describe the development and validation of the Retrospective Alcohol Context Scale (RACS), a 30-day measure of drinking context among college students.

METHODS

A sample of 169 college students completed daily alcohol assessments for 30 days and completed the RACS at follow-up.

RESULTS

The RACS captured fewer negative consequences than daily assessments; however, high agreement was observed on context variables.

CONCLUSION

Results support the validity of the RACS as a measure of drinking context among college students. The RACS may be most useful when information about drinking needs to be collected under limited time and resources.

SCIENTIFIC SIGNIFICANCE

Further research is needed to examine the RACS among more diverse, probability samples and over longer time periods.

Association between alcohol intoxication and alcohol-related problems: an event-level analysis

Heavy-drinking students experience a myriad of alcohol-related negative consequences. Use of event-level data permits predictions to be made regarding (a) the likelihood of alcohol-related consequences occurring after specific drinking events, and (b) moderators of the association between intoxication and consequences. College students (N = 183, 64% female) completed 4 consecutive 7-day drinking diaries and turned them in weekly. The diaries yielded prospective event-level data on daily drinks, time spent drinking, and negative consequences related to each drinking event. Alcohol intoxication on a given day was significantly associated with increased levels of risk, although this association was moderated by average level of intoxication. Furthermore, self-control was associated with increased likelihood of negative consequences at all levels of intoxication, and self-regulation and impulsivity moderated the event-level association between daily intoxication and likelihood of negative consequences. Results suggest that self-regulation subsumes impulsivity and self-control.

Social anxiety, alcohol expectancies, and self-efficacy as predictors of heavy drinking in college students

Burke and Stephens (1999) [Burke, R.S., Stephens, R.S. Social anxiety and drinking in college students: A social cognitive theory analysis. Clinical Psychology Review, 19, (1999) 513-530.] proposed a social cognitive theory of heavy drinking in college students. According to this theory, alcohol expectancies for social facilitation and self-efficacy for refusing heavy drinking in anxiety-producing social situations moderate the relationship between social anxiety and drinking. In the current study, a significant three-way interaction was observed among social anxiety, expectancies, and self-efficacy when amount and frequency of drinking was the dependent variable. As predicted by the model, socially anxious college students with low self-efficacy for avoiding heavy drinking in social situations and high positive expectancies for social facilitation reported more alcohol consumption than other socially anxious individuals.

Toward Efficient and Comprehensive Measurement of the Alcohol Problems Continuum in College Students: The Brief Young Adult Alcohol Consequences Questionnaire

BACKGROUND

Although a number of measures of alcohol problems in college students have been studied, the psychometric development and validation of these scales have been limited, for the most part, to methods based on classical test theory. In this study, we conducted analyses based on item response theory to select a set of items for measuring the alcohol problem severity continuum in college students that balances comprehensiveness and efficiency and is free from significant gender bias.

METHOD

We conducted Rasch model analyses of responses to the 48-item Young Adult Alcohol Consequences Questionnaire by 164 male and 176 female college students who drank on at least a weekly basis. An iterative process using item fit statistics, item severities, item discrimination parameters, model residuals, and analysis of differential item functioning by gender was used to pare the items down to those that best fit a Rasch model and that were most efficient in discriminating among levels of alcohol problems in the sample.

RESULTS

The process of iterative Rasch model analyses resulted in a final 24-item scale with the data fitting the unidimensional Rasch model very well. The scale showed excellent distributional properties, had items adequately matched to the severity of alcohol problems in the sample, covered a full range of problem severity, and appeared highly efficient in retaining all of the meaningful variance captured by the original set of 48 items.

CONCLUSIONS

The use of Rasch model analyses to inform item selection produced a final scale that, in both its comprehensiveness and its efficiency, should be a useful tool for researchers studying alcohol problems in college students. To aid interpretation of raw scores, examples of the types of alcohol problems that are likely to be experienced across a range of selected scores are provided.

College students and problematic drinking: a review of the literature

Problem drinking during the college years is a significant public health concern. The goal of the current review was to examine the primary psychosocial factors that predict problem drinking in college students. Variables examined included demographic variables, personality, drinking history, alcohol expectancies, drinking motives, stress and coping, activity involvement, and peer and family influence. Evidence from studies of college drinking indicated that the variables associated with college drinking seem to vary at levels dealing with one's personality and coping mechanisms, one's thought processes about drinking, and the environment. It seems that expectancies and drinking motives may serve as explanations for the pathways from certain personality types (i.e., sensation seeking and neurotic) to problem drinking in the college setting. Factors that predicted future drinking problems after college were also examined. Overall, it seems that interventions and prevention programs would need to reach college students at all three levels--the environment, individual personality traits, and cognitive processes. Future research should address the limitations in the previous research as well as test comprehensive models of college drinking.

The College Alcohol Problems Scale

A short, reliable two-factor instrument measuring drinking-related negative consequences was developed from a previous measure using two samples of college students. In Study I, data on alcohol use and problems associated with alcohol use were collected on 382 introductory psychology students. The original College Alcohol Problems Scale (CAPS) was tested and found to fit the data poorly. Sequential methods were used to develop a revised instrument. Principal components analyses (PCA) on half of the sample were conducted on 20 items written to measure negative consequences related to college student drinking. Results indicated a two-factor solution measuring social and emotional problems. Confirmatory factor analyses (CFA) on the other half of the sample confirmed the two-factor structure. Further refinement of the instrument resulted in the revised CAPS (CAPS-r), an eight-item two-factor scale. In Study II, the response format was altered to coincide with the Young Adult Problem Screening Test. A total of 726 students completed the instrument as part of a university-wide random sample. CFA showed that the hypothesized model fit well across all measures of model fit and the factor structure was invariant across gender. Additional analyses revealed that the scale was internally consistent and externally valid. A short reliable and valid measure of alcohol-related problems is needed to enable low-cost data collection on college campuses across the nation, as well as to facilitate program evaluation and routine epidemiological surveillance and monitoring.

The Drinking Context Scale. A confirmatory factor analysis

The current article examines the development and validation of the Drinking Context Scale through the use of confirmatory factor analysis. The scale measures the self-reported likelihood of excessive drinking across a number of specific social-cognitive drinking contexts. Five-hundred-and-five college students adjudicated for breaking university drinking rules filled out the anonymous questionnaire. Three factors including convivial, intimate, and negative coping contexts were confirmed, and these factors demonstrated good reliability and evidence of concurrent validity with other substance abuse indices, including the Alcohol Use Disorders Identification Test and the College Alcohol Problem Scale. Implications for the DCS as an assessment tool for prevention and early intervention with young people are discussed.

Short form of a situational temptation scale for heavy, episodic drinking

PURPOSE

A short form for situational temptations to drink scale was developed from an original 21-item inventory by Migneault.

METHODS

The form measured four hypothesized subscales of temptations on a sample of 348 college drinkers (66% female). Peer pressure, social anxiety, negative affect, and positive/social situations subscales were replicated and reduced.

RESULTS

Strong empirical support was found for a hierarchical model, indicating that the four subscales can be summed to provide a global measure of situational temptations. Confirmatory factor results, internal and external validity, and high correlations with the original measures indicate that the short form was as psychometrically valid as the original measure.

IMPLICATIONS

Measures of external validity demonstrated the applicability of this measure to heavy drinking prevention programs.

Validating the Alcohol Use Disorder Identification Test with college first-offenders

Although the Alcohol Use Disorders Identification Test (AUDIT) has been shown to have good validity and reliability with clinical samples, little data has been examined with respect to youthful problem drinkers, particularly college students. Data collected with 312 students cited their first time for breaking university drinking rules was examined to evaluate the factorial validity and internal consistency of the 10-item scale, and also to test the validity of the AUDIT against two scales designed with a previous cohort specifically to measure hazardous (The Drinking Context Scale) and harmful drinking (the College Alcohol Problem Scale) in college students. Overall, results suggest that the AUDIT is a valid and reliable screening device for college students, and could play an important role in assessing youthful problem drinkers for early intervention programming.